# SHAPE: Structure-aware Hierarchical Unsupervised Domain Adaptation with Plausibility Evaluation for Medical Image Segmentation

arXiv: https://arxiv.org/abs/2603.21904 · HTML: https://mlsanity.com/paper/2603.21904/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 32 of its 50 references that are in the map.
- First posted on arXiv 23 Mar 2026.

## Builds on (most cited first, 30 of 32)

- [Learning Transferable Visual Models From Natural Language Supervision](https://mlsanity.com/paper/2103.00020/) (2021)
- [U-Net: Convolutional Networks for Biomedical Image Segmentation](https://mlsanity.com/paper/1505.04597/) (2015)
- [Segment Anything](https://mlsanity.com/paper/2304.02643/) (2023)
- [Momentum Contrast for Unsupervised Visual Representation Learning](https://mlsanity.com/paper/1911.05722/) (2019)
- [Masked Autoencoders Are Scalable Vision Learners](https://mlsanity.com/paper/2111.06377/) (2021)
- [V-Net: Fully Convolutional Neural Networks for Volumetric Medical Image Segmentation](https://mlsanity.com/paper/1606.04797/) (2016)
- [Arbitrary Style Transfer in Real-time with Adaptive Instance Normalization](https://mlsanity.com/paper/1703.06868/) (2017)
- [An Empirical Study of Training Self-Supervised Vision Transformers](https://mlsanity.com/paper/2104.02057/) (2021)
- [DINOv3](https://mlsanity.com/paper/2508.10104/) (2025)
- [Big Self-Supervised Models are Strong Semi-Supervised Learners](https://mlsanity.com/paper/2006.10029/) (2020)
- [ADVENT: Adversarial Entropy Minimization for Domain Adaptation in Semantic Segmentation](https://mlsanity.com/paper/1811.12833/) (2018)
- [Learning to Adapt Structured Output Space for Semantic Segmentation](https://mlsanity.com/paper/1802.10349/) (2018)
- [CHAOS Challenge -- Combined (CT-MR) Healthy Abdominal Organ Segmentation](https://mlsanity.com/paper/2001.06535/) (2020)
- [BEiT v2: Masked Image Modeling with Vector-Quantized Visual Tokenizers](https://mlsanity.com/paper/2208.06366/) (2022)
- [A Survey on Self-supervised Learning: Algorithms, Applications, and Future Trends](https://mlsanity.com/paper/2301.05712/) (2023)
- [Unsupervised Bidirectional Cross-Modality Adaptation via Deeply Synergistic Image and Feature Alignment for Medical Image Segmentation](https://mlsanity.com/paper/2002.02255/) (2020)
- [Dual Mixup Regularized Learning for Adversarial Domain Adaptation](https://mlsanity.com/paper/2007.03141/) (2020)
- [Deep Symmetric Adaptation Network for Cross-modality Medical Image Segmentation](https://mlsanity.com/paper/2101.06853/) (2021)
- [MedCLIP-SAM: Bridging Text and Image Towards Universal Medical Image Segmentation](https://mlsanity.com/paper/2403.20253/) (2024)
- [Towards Generic Semi-Supervised Framework for Volumetric Medical Image Segmentation](https://mlsanity.com/paper/2310.11320/) (2023)
- [Improving Robustness of Deep Learning Based Knee MRI Segmentation: Mixup and Adversarial Domain Adaptation](https://mlsanity.com/paper/1908.04126/) (2019)
- [LE-UDA: Label-efficient unsupervised domain adaptation for medical image segmentation](https://mlsanity.com/paper/2212.02078/) (2022)
- [MAPSeg: Unified Unsupervised Domain Adaptation for Heterogeneous Medical Image Segmentation Based on 3D Masked Autoencoding and Pseudo-Labeling](https://mlsanity.com/paper/2303.09373/) (2023)
- [Self-Attentive Spatial Adaptive Normalization for Cross-Modality Domain Adaptation](https://mlsanity.com/paper/2103.03781/) (2021)
- [UPL-SFDA: Uncertainty-aware Pseudo Label Guided Source-Free Domain Adaptation for Medical Image Segmentation](https://mlsanity.com/paper/2309.10244/) (2023)
- [Unsupervised domain adaptation for cross-modality liver segmentation via joint adversarial learning and self-learning](https://mlsanity.com/paper/2109.05664/) (2021)
- [Topology-Aware Focal Loss for 3D Image Segmentation](https://mlsanity.com/paper/2304.12223/) (2023)
- [ASC: Appearance and Structure Consistency for Unsupervised Domain Adaptation in Fetal Brain MRI Segmentation](https://mlsanity.com/paper/2310.14172/) (2023)
- [Hypergraph Tversky-Aware Domain Incremental Learning for Brain Tumor Segmentation with Missing Modalities](https://mlsanity.com/paper/2505.16809/) (2025)
- [Reliable Source Approximation: Source-Free Unsupervised Domain Adaptation for Vestibular Schwannoma MRI Segmentation](https://mlsanity.com/paper/2405.16102/) (2024)

## Abstract (arXiv)

Unsupervised Domain Adaptation (UDA) is essential for deploying medical segmentation models across diverse clinical environments. Existing methods are fundamentally limited, suffering from semantically unaware feature alignment that results in poor distributional fidelity and from pseudo-label validation that disregards global anatomical constraints, thus failing to prevent the formation of globally implausible structures. To address these issues, we propose SHAPE (Structure-aware Hierarchical Unsupervised Domain Adaptation with Plausibility Evaluation), a framework that reframes adaptation towards global anatomical plausibility. Built on a DINOv3 foundation, its Hierarchical Feature Modulation (HFM) module first generates features with both high fidelity and class-awareness. This shifts the core challenge to robustly validating pseudo-labels. To augment conventional pixel-level validation, we introduce Hypergraph Plausibility Estimation (HPE), which leverages hypergraphs to assess the global anatomical plausibility that standard graphs cannot capture. This is complemented by Structural Anomaly Pruning (SAP) to purge remaining artifacts via cross-view stability. SHAPE significantly outperforms prior methods on cardiac and abdominal cross-modality benchmarks, achieving state-of-the-art average Dice scores of 90.08% (MRI->CT) and 78.51% (CT->MRI) on cardiac data, and 87.48% (MRI->CT) and 86.89% (CT->MRI) on abdominal data. The code is available at https://github.com/BioMedIA-repo/SHAPE.