Attentional adversarial training for few-shot medical image segmentation without annotations

Medical image segmentation is a critical application that plays a significant role in clinical research. Despite the fact that many deep neural networks have achieved quite high accuracy in the field of medical image segmentation, there is still a scarcity of annotated labels, making it difficult to train a robust and generalized model. Few-shot learning has the potential to predict new classes that are unseen in training with a few annotations. In this study, a novel few-shot semantic segmentation framework named prototype-based generative adversarial network (PG-Net) is proposed for medical image segmentation without annotations. The proposed PG-Net consists of two subnetworks: the prototype-based segmentation network (P-Net) and the guided evaluation network (G-Net). On one hand, the P-Net as a generator focuses on extracting multi-scale features and local spatial information in order to produce refined predictions with discriminative context between foreground and background. On the other hand, the G-Net as a discriminator, which employs an attention mechanism, further distills the relation knowledge between support and query, and contributes to P-Net producing segmentation masks of query with more similar distributions as support. Hence, the PG-Net can enhance segmentation quality by an adversarial training strategy. Compared to the state-of-the-art (SOTA) few-shot segmentation methods, comparative experiments demonstrate that the proposed PG-Net provides noticeably more robust and prominent generalization ability on different medical image modality datasets, including an abdominal Computed Tomography (CT) dataset and an abdominal Magnetic Resonance Imaging (MRI) dataset.