# Class Incremental Medical Image Segmentation via Prototype-Guided Calibration and Dual-Aligned Distillation

arXiv: https://arxiv.org/abs/2511.07749 · HTML: https://mlsanity.com/paper/2511.07749/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 19 of its 39 references that are in the map.
- First posted on arXiv 11 Nov 2025.

## Builds on (most cited first, 19 of 19)

- [Overcoming catastrophic forgetting in neural networks](https://mlsanity.com/paper/1612.00796/) (2016)
- [Prototypical Networks for Few-shot Learning](https://mlsanity.com/paper/1703.05175/) (2017)
- [Learning without Forgetting](https://mlsanity.com/paper/1606.09282/) (2016)
- [Continual Learning with Deep Generative Replay](https://mlsanity.com/paper/1705.08690/) (2017)
- [Swin UNETR: Swin Transformers for Semantic Segmentation of Brain Tumors in MRI Images](https://mlsanity.com/paper/2201.01266/) (2022)
- [Class-incremental learning: survey and performance evaluation on image classification](https://mlsanity.com/paper/2010.15277/) (2020)
- [Rainbow Memory: Continual Learning with a Memory of Diverse Samples](https://mlsanity.com/paper/2103.17230/) (2021)
- [Modeling the Background for Incremental Learning in Semantic Segmentation](https://mlsanity.com/paper/2002.00718/) (2020)
- [PLOP: Learning without Forgetting for Continual Semantic Segmentation](https://mlsanity.com/paper/2011.11390/) (2020)
- [Incremental Learning Techniques for Semantic Segmentation](https://mlsanity.com/paper/1907.13372/) (2019)
- [Memory-Efficient Incremental Learning Through Feature Adaptation](https://mlsanity.com/paper/2004.00713/) (2020)
- [Continual Semantic Segmentation via Repulsion-Attraction of Sparse and Disentangled Latent Representations](https://mlsanity.com/paper/2103.06342/) (2021)
- [SSUL: Semantic Segmentation with Unknown Label for Exemplar-based Class-Incremental Learning](https://mlsanity.com/paper/2106.11562/) (2021)
- [MDNet: A Semantically and Visually Interpretable Medical Image Diagnosis Network](https://mlsanity.com/paper/1707.02485/) (2017)
- [Continual Learning for Abdominal Multi-Organ and Tumor Segmentation](https://mlsanity.com/paper/2306.00988/) (2023)
- [Dynamic Divide-and-Conquer Adversarial Training for Robust Semantic Segmentation](https://mlsanity.com/paper/2003.06555/) (2020)
- [An Incremental Unified Framework for Small Defect Inspection](https://mlsanity.com/paper/2312.08917/) (2023)
- [Cs2K: Class-specific and Class-shared Knowledge Guidance for Incremental Semantic Segmentation](https://mlsanity.com/paper/2407.09047/) (2024)
- [General Adversarial Defense Against Black-box Attacks via Pixel Level and Feature Level Distribution Alignments](https://mlsanity.com/paper/2212.05387/) (2022)

## Abstract (arXiv)

Class incremental medical image segmentation (CIMIS) aims to preserve knowledge of previously learned classes while learning new ones without relying on old-class labels. However, existing methods 1) either adopt one-size-fits-all strategies that treat all spatial regions and feature channels equally, which may hinder the preservation of accurate old knowledge, 2) or focus solely on aligning local prototypes with global ones for old classes while overlooking their local representations in new data, leading to knowledge degradation. To mitigate the above issues, we propose Prototype-Guided Calibration Distillation (PGCD) and Dual-Aligned Prototype Distillation (DAPD) for CIMIS in this paper. Specifically, PGCD exploits prototype-to-feature similarity to calibrate class-specific distillation intensity in different spatial regions, effectively reinforcing reliable old knowledge and suppressing misleading information from old classes. Complementarily, DAPD aligns the local prototypes of old classes extracted from the current model with both global prototypes and local prototypes, further enhancing segmentation performance on old categories. Comprehensive evaluations on two widely used multi-organ segmentation benchmarks demonstrate that our method outperforms state-of-the-art methods, highlighting its robustness and generalization capabilities.