AngioDG: Interpretable Channel-informed Feature-modulated Single-source Domain Generalization for Coronary Vessel Segmentation in X-ray Angiography

Cardiovascular diseases are the leading cause of death globally, with X-ray Coronary Angiography (XCA) as the gold standard during real-time cardiac interventions. Segmentation of coronary vessels from XCA can facilitate downstream quantitative assessments, such as measurement of the stenosis severity and enhancing clinical decision-making. However, developing generalizable vessel segmentation models for XCA is challenging due to variations in imaging protocols and patient demographics that cause domain shifts. These limitations are exacerbated by the lack of annotated datasets, making Single-source Domain Generalization (SDG) a necessary solution for achieving generalization. Existing SDG methods are largely augmentation-based, which may not guarantee the mitigation of overfitting to augmented or synthetic domains. We propose a novel approach, ``AngioDG", to bridge this gap by channel regularization strategy to promote generalization. Our method identifies the contributions of early feature channels to task-specific metrics for DG, facilitating interpretability, and then reweights channels to calibrate and amplify domain-invariant features while attenuating domain-specific ones. We evaluate AngioDG on 6 x-ray angiography datasets for coronary vessels segmentation, achieving the best out-of-distribution performance among the compared methods, while maintaining consistent in-domain test performance.