Abstract:Scribble annotations significantly reduce the cost and labor required for dense labeling in large medical datasets with complex anatomical structures. However, current scribble-supervised learning methods are limited in their ability to effectively propagate sparse annotation labels to dense segmentation masks and accurately segment object boundaries. To address these issues, we propose a Progressive Collaborative Learning framework that leverages novel algorithms and the Med-SAM foundation model to enhance information quality during training. (1) We enrich ground truth scribble segmentation labels through a new algorithm, propagating scribbles to estimate object boundaries. (2) We enhance feature representation by optimizing Med-SAM-guided training through the fusion of feature embeddings from Med-SAM and our proposed Sparse Mamba network. This enriched representation also facilitates the fine-tuning of the Med-SAM decoder with enriched scribbles. (3) For inference, we introduce a Sparse Mamba network, which is highly capable of capturing local and global dependencies by replacing the traditional sequential patch processing method with a skip-sampling procedure. Experiments on the ACDC, CHAOS, and MSCMRSeg datasets validate the effectiveness of our framework, outperforming nine state-of-the-art methods. Our code is available at \href{https://github.com/QLYCode/SparseMamba-PCL}{SparseMamba-PCL.git}.