# Evaluating self-supervised echocardiographic representations across downstream extraction strategies for left-ventricular segmentation and ejection fraction estimation

arXiv: https://arxiv.org/abs/2606.22943 · HTML: https://mlsanity.com/paper/2606.22943/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 10 of its 14 references that are in the map.
- First posted on arXiv 22 Jun 2026.

## Builds on (most cited first, 10 of 10)

- [U-Net: Convolutional Networks for Biomedical Image Segmentation](https://mlsanity.com/paper/1505.04597/) (2015)
- [A Simple Framework for Contrastive Learning of Visual Representations](https://mlsanity.com/paper/2002.05709/) (2020)
- [Emerging Properties in Self-Supervised Vision Transformers](https://mlsanity.com/paper/2104.14294/) (2021)
- [Bootstrap your own latent: A new approach to self-supervised Learning](https://mlsanity.com/paper/2006.07733/) (2020)
- [Big Self-Supervised Models Advance Medical Image Classification](https://mlsanity.com/paper/2101.05224/) (2021)
- [What Do Self-Supervised Vision Transformers Learn?](https://mlsanity.com/paper/2305.00729/) (2023)
- [From Entropy to Epiplexity: Rethinking Information for Computationally Bounded Intelligence](https://mlsanity.com/paper/2601.03220/) (2026)
- [Models Genesis](https://mlsanity.com/paper/2004.07882/) (2020)
- [Label-free segmentation from cardiac ultrasound using self-supervised learning](https://mlsanity.com/paper/2210.04979/) (2022)
- [Dense Self-Supervised Learning for Medical Image Segmentation](https://mlsanity.com/paper/2407.20395/) (2024)

## Abstract (arXiv)

Self-supervised learning (SSL) is increasingly used in medical imaging to reduce annotation requirements, but representation quality is often judged using a single downstream evaluation setting. For dense clinical tasks, this can confound representation quality with the capacity of the downstream model used to recover task-relevant information. We present a systematic evaluation of self-supervised representations for left-ventricular segmentation and ejection fraction (EF) estimation from apical four-chamber echocardiography on EchoNet-Dynamic. Rather than relying on a single downstream probe, we compare a hierarchy of extraction strategies with increasing expressivity: heuristic extraction without mask-supervised training, frozen linear probes, frozen lightweight decoder probes, and partial fine-tuning. We apply this framework to two complementary representation families: generic frozen self-DIstillation with NO labels (DINOv3) features and a task-adapted dense self-supervised representation, Bootstrap Your Own Segmentation (BYOS). In both families, heuristic extraction substantially understated what was recoverable from the frozen representation. For DINOv3, performance improved from Dice 0.684 and EF mean absolute error (MAE) 13.01 under heuristic extraction to Dice 0.906 and EF MAE 9.65 with a frozen lightweight decoder, approaching a supervised U-Net baseline (Dice 0.915, EF MAE 9.72). For BYOS, performance improved from Dice 0.687 and EF MAE 17.83 under heuristic extraction to Dice 0.902 and EF MAE 8.74 with a frozen lightweight decoder. These results show that conclusions about self-supervised representation quality in dense echocardiographic analysis depend strongly on the downstream extraction strategy used for evaluation. We therefore argue that multi-strategy evaluation is an important methodological consideration for SSL in dense medical image analysis.