The Devil is in the Statistics: Mitigating and Exploiting Statistics Difference for Generalizable Semi-supervised Medical Image Segmentation

Despite the recent success of domain generalization in medical image segmentation, voxel-wise annotation for all source domains remains a huge burden. Semi-supervised domain generalization has been proposed very recently to combat this challenge by leveraging limited labeled data along with abundant unlabeled data collected from multiple medical institutions, depending on precisely harnessing unlabeled data while improving generalization simultaneously. In this work, we observe that domain shifts between medical institutions cause disparate feature statistics, which significantly deteriorates pseudo-label quality due to an unexpected normalization process. Nevertheless, this phenomenon could be exploited to facilitate unseen domain generalization. Therefore, we propose 1) multiple statistics-individual branches to mitigate the impact of domain shifts for reliable pseudo-labels and 2) one statistics-aggregated branch for domain-invariant feature learning. Furthermore, to simulate unseen domains with statistics difference, we approach this from two aspects, i.e., a perturbation with histogram matching at image level and a random batch normalization selection strategy at feature level, producing diverse statistics to expand the training distribution. Evaluation results on three medical image datasets demonstrate the effectiveness of our method compared with recent SOTA methods. The code is available at https://github.com/qiumuyang/SIAB.