# Weighted Knowledge Distillation for Semi-Supervised Segmentation of Maxillary Sinus in Panoramic X-ray Images

arXiv: https://arxiv.org/abs/2604.20213 · HTML: https://mlsanity.com/paper/2604.20213/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Placed in Distillation for medical imaging, one of 12 directions in Knowledge distillation.
- Builds on 13 of its 33 references that are in the map.
- First posted on arXiv 22 Apr 2026.

## Placed in

- Knowledge distillation / [Distillation for medical imaging](https://mlsanity.com/distill/distillation-for-medical-imaging/)

## Builds on (most cited first, 13 of 13)

- [U-Net: Convolutional Networks for Biomedical Image Segmentation](https://mlsanity.com/paper/1505.04597/) (2015)
- [Distilling the Knowledge in a Neural Network](https://mlsanity.com/paper/1503.02531/) (2015)
- [Encoder-Decoder with Atrous Separable Convolution for Semantic Image Segmentation](https://mlsanity.com/paper/1802.02611/) (2018)
- [CBAM: Convolutional Block Attention Module](https://mlsanity.com/paper/1807.06521/) (2018)
- [TransUNet: Transformers Make Strong Encoders for Medical Image Segmentation](https://mlsanity.com/paper/2102.04306/) (2021)
- [Least Squares Generative Adversarial Networks](https://mlsanity.com/paper/1611.04076/) (2016)
- [UNETR: Transformers for 3D Medical Image Segmentation](https://mlsanity.com/paper/2103.10504/) (2021)
- [Cross-Image Relational Knowledge Distillation for Semantic Segmentation](https://mlsanity.com/paper/2204.06986/) (2022)
- [Looking for the Devil in the Details: Learning Trilinear Attention Sampling Network for Fine-grained Image Recognition](https://mlsanity.com/paper/1903.06150/) (2019)
- [Knowledge distillation from multi-modal to mono-modal segmentation networks](https://mlsanity.com/paper/2106.09564/) (2021)
- [BPKD: Boundary Privileged Knowledge Distillation For Semantic Segmentation](https://mlsanity.com/paper/2306.08075/) (2023)
- [Shape-intensity knowledge distillation for robust medical image segmentation](https://mlsanity.com/paper/2409.17503/) (2024)
- [Relative Difficulty Distillation for Semantic Segmentation](https://mlsanity.com/paper/2407.03719/) (2024)

## Abstract (arXiv)

Accurate segmentation of maxillary sinus in panoramic X-ray images is essential for dental diagnosis and surgical planning; however, this task remains relatively underexplored in dental imaging research. Structural overlap, ambiguous anatomical boundaries inherent to two-dimensional panoramic projections, and the limited availability of large scale clinical datasets with reliable pixel-level annotations make the development and evaluation of segmentation models challenging. To address these challenges, we propose a semi-supervised segmentation framework that effectively leverages both labeled and unlabeled panoramic radiographs, where knowledge distillation is utilized to train a student model with reliable structural information distilled from a teacher model. Specifically, we introduce a weighted knowledge distillation loss to suppress unreliable distillation signals caused by structural discrepancies between teacher and student predictions. To further enhance the quality of pseudo labels generated by the teacher network, we introduce SinusCycle-GAN which is a refinement network based on unpaired image-to-image translation. This refinement process improves the precision of boundaries and reduces noise propagation when learning from unlabeled data during semi-supervised training. To evaluate the proposed method, we collected clinical panoramic X-ray images from 2,511 patients, and experimental results demonstrate that the proposed method outperforms state-of-the-art segmentation models, achieving the Dice score of 96.35% while reducing boundary error. The results indicate that the proposed semi-supervised framework provides robust and anatomically consistent segmentation performance under limited labeled data conditions, highlighting its potential for broader dental image analysis applications.