PCA: Semi-supervised Segmentation with Patch Confidence Adversarial Training

Deep learning based semi-supervised learning (SSL) methods have achieved strong performance in medical image segmentation, which can alleviate doctors' expensive annotation by utilizing a large amount of unlabeled data. Unlike most existing semi-supervised learning methods, adversarial training based methods distinguish samples from different sources by learning the data distribution of the segmentation map, leading the segmenter to generate more accurate predictions. We argue that the current performance restrictions for such approaches are the problems of feature extraction and learning preference. In this paper, we propose a new semi-supervised adversarial method called Patch Confidence Adversarial Training (PCA) for medical image segmentation. Rather than single scalar classification results or pixel-level confidence maps, our proposed discriminator creates patch confidence maps and classifies them at the scale of the patches. The prediction of unlabeled data learns the pixel structure and context information in each patch to get enough gradient feedback, which aids the discriminator in convergent to an optimal state and improves semi-supervised segmentation performance. Furthermore, at the discriminator's input, we supplement semantic information constraints on images, making it simpler for unlabeled data to fit the expected data distribution. Extensive experiments on the Automated Cardiac Diagnosis Challenge (ACDC) 2017 dataset and the Brain Tumor Segmentation (BraTS) 2019 challenge dataset show that our method outperforms the state-of-the-art semi-supervised methods, which demonstrates its effectiveness for medical image segmentation.