Annotation Ambiguity Aware Semi-Supervised Medical Image Segmentation

Suruchi Kumari, Pravendra Singh; Proceedings of the Computer Vision and Pattern Recognition Conference (CVPR), 2025, pp. 10404-10413

Despite the remarkable progress of deep learning-based methods in medical image segmentation, their use in clinical practice remains limited for two main reasons. First, obtaining a large medical dataset with precise annotations to train segmentation models is challenging. Secondly, most current segmentation techniques generate a single deterministic segmentation mask for each image. However, in real-world scenarios, there is often significant uncertainty regarding what defines the "correct" segmentation, and various expert annotators might provide different segmentations for the same image. To tackle both of these problems, we propose Annotation Ambiguity Aware Semi-Supervised Medical Image Segmentation (AmbiSSL). AmbiSSL combines a small amount of multi-annotator labeled data and a large set of unlabeled data to generate diverse and plausible segmentation maps. Our method consists of three key components: (1) The Diverse Pseudo-Label Generation (DPG) module utilizes multiple decoders, created by performing randomized pruning on the original backbone decoder. These pruned decoders enable the generation of a diverse pseudo-label set; (2) a Semi-Supervised Latent Distribution Learning (SSLDL) module constructs a common latent space by utilizing both ground truth annotations and pseudo-label set; and (3) a Cross-Decoder Supervision (CDS) module, which enables pruned decoders to guide each other's learning. We evaluated the proposed method on two publicly available datasets. Extensive experiments demonstrate that AmbiSSL can generate diverse segmentation maps using only a small amount of labeled data and abundant unlabeled data, offering a more practical solution for medical image segmentation by reducing reliance on large labeled datasets.