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Semi-supervised TEE Segmentation via Interacting with SAM Equipped with Noise-Resilient Prompting
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Proposes a semi-supervised LAA segmentation method for TEE images that uses SAM, prompted with noise-resilient points from a self-reconstruction teacher-student network, to refine pseudo labels, plus feature-level self-perturbation.
Problem
Semi-supervised left atrial appendage segmentation in transesophageal echocardiography (TEE) suffers from pseudo-label bias due to distribution mismatch between highly imbalanced labeled and unlabeled data, and from scarce annotations and noisy TEE images.
Approach
Incorporates the foundation model SAM into a teacher-student SSL framework: a self-reconstruction (denoising) module produces reconstructed images and candidate masks from which consensus high-confidence points serve as noise-resilient SAM prompts, and SAM outputs are adaptively fused with the teacher's predictions into pseudo labels; a self-perturbation module (SPFA) swaps encoder features betwee
Key results
- With 20% labeled data, the method reaches Dice 0.8604 and ASD 1.65, versus 0.8405 for the best baseline BCP and 0.8290 for fully supervised Unet.
- With 50% labeled data, Dice 0.8830 and ASD 1.28, outperforming UniMatch (0.8764) and ST++ (0.8694).
- Removing SAM-powered pseudo label generation drops 20%-label Dice from 0.8604 to 0.8366.
Measured effects reported in the paper
| What was changed | Where | Measured | Effect |
|---|---|---|---|
| add the SAM-powered pseudo label generator (GPL) (ablation) | semi-supervised Unet · TEE dataset, 20% labeled | Dice: 0.8293 -> 0.8469 | Helped |
| add the SAM-powered pseudo label generator (GPL) (ablation) | semi-supervised Unet · TEE dataset, 20% labeled | ASD: 2.08 -> 1.92 | Helped |
| add SPFA (ablation) | semi-supervised Unet · TEE dataset, 20% labeled | Dice: 0.8293 -> 0.8366 | Helped |
| add SPFA (ablation) | semi-supervised Unet · TEE dataset, 20% labeled | ASD: 2.08 -> 1.94 | Helped |
| add the self-reconstruction mechanism (SRM) for prompts and reconstructed inputs (ablation) | SAM-powered semi-supervised Unet · TEE dataset, 20% labeled | Dice: 0.8249 -> 0.8604 | Helped |
| add the self-reconstruction mechanism (SRM) for prompts and reconstructed inputs (ablation) | SAM-powered semi-supervised Unet · TEE dataset, 20% labeled | ASD: 2.16 -> 1.65 | Helped |
| use SPFA instead of DA (ablation) | GPL-based semi-supervised Unet · TEE dataset, 20% labeled | Dice: 0.8385 -> 0.8604 | Helped |
| use SPFA instead of DA (ablation) | GPL-based semi-supervised Unet · TEE dataset, 20% labeled | ASD: 1.97 -> 1.65 | Helped |
| use SPFA instead of FA dropout (ablation) | GPL-based semi-supervised Unet · TEE dataset, 20% labeled | Dice: 0.8404 -> 0.8604 | Helped |
| use SPFA instead of FA dropout (ablation) | GPL-based semi-supervised Unet · TEE dataset, 20% labeled | ASD: 1.84 -> 1.65 | Helped |
Surprising findings
- Directly using SAM to generate pseudo labels without the self-reconstruction prompts yields Dice 0.8249, worse than the fully supervised Unet, indicating large domain gap for SAM on TEE.
Limitations
- Evaluated only on a single in-house TEE dataset of 100 patients.
- Relies on SAM's zero-shot quality on TEE, which the paper shows is weak without the proposed prompting.
Experimental setup
Datasets: in-house TEE dataset (100 patients)
Benchmarks: in-house TEE LAA dataset
Metrics: Dice ASD
Baselines: Unet ST++ UniMatch MCF BCP UCMT
Builds on: Mean Teacher Neighbor2Neighbor Segment Anything UniMatch ST++
Closest papers by meaning
- Enhancing SAM with Efficient Prompting and Preference Optimization for Semi-supervised Medical Image Segmentation (CVPR 2025 · similarity 0.88)
- SGTC: Semantic-Guided Triplet Co-training for Sparsely Annotated Semi-Supervised Medical Image Segmentation (AAAI 2025 · similarity 0.87)
- Constructing and Exploring Intermediate Domains in Mixed Domain Semi-supervised Medical Image Segmentation (CVPR 2024 · similarity 0.87)
- Annotation Ambiguity Aware Semi-Supervised Medical Image Segmentation (CVPR 2025 · similarity 0.86)
- beta-FFT: Nonlinear Interpolation and Differentiated Training Strategies for Semi-Supervised Medical Image Segmentation (CVPR 2025 · similarity 0.86)
- Combinatorial CNN-Transformer Learning with Manifold Constraints for Semi-supervised Medical Image Segmentation (AAAI 2024 · similarity 0.86)
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