Precise segmentation for skin cancer lesions at different stages is conducive to early detection and further treatment. Considering the huge cost of obtaining pixel-perfect annotations for this task, segmentation using less expensive image-level labels has become a research direction. Most image-level label weakly supervised segmentation uses class activation mapping (CAM) methods. A common consequence of this method is incomplete foreground segmentation, insufficient segmentation, or false negatives. At the same time, when performing weakly supervised segmentation of skin cancer lesions, ulcers, redness, and swelling may appear near the segmented areas of individual disease categories. This co-occurrence problem affects the model\'s accuracy in segmenting class-related tissue boundaries to a certain extent. The above two issues are determined by the loosely constrained nature of image-level labels that penalize the entire image space. Therefore, providing pixel-level constraints for weak supervision of image-level labels is the key to improving performance. To solve the above problems, this paper proposes a joint unsupervised constraint-assisted weakly supervised segmentation model (UCA-WSS). The weakly supervised part of the model adopts a dual-branch adversarial erasure mechanism to generate higher-quality CAM. The unsupervised part uses contrastive learning and clustering algorithms to generate foreground labels and fine boundary labels to assist segmentation and solve common co-occurrence problems in weakly supervised skin cancer lesion segmentation through unsupervised constraints. The model proposed in the article is evaluated comparatively with other related models on some public dermatology data sets. Experimental results show that our model performs better on the skin cancer segmentation task than other weakly supervised segmentation models, showing the potential of combining unsupervised constraint methods on weakly supervised segmentation.

Despite that deep learning has achieved state-of-the-art performance for automatic medical image segmentation, it often requires a large amount of pixel-level manual annotations for training. Obtaining these high-quality annotations is time-consuming and requires specialized knowledge, which hinders the widespread application that relies on such annotations to train a model with good segmentation performance. Using scribble annotations can substantially reduce the annotation cost, but often leads to poor segmentation performance due to insufficient supervision. In this work, we propose a novel framework named as ScribSD+ that is based on multi-scale knowledge distillation and class-wise contrastive regularization for learning from scribble annotations. For a student network supervised by scribbles and the teacher based on Exponential Moving Average (EMA), we first introduce multi-scale prediction-level Knowledge Distillation (KD) that leverages soft predictions of the teacher network to supervise the student at multiple scales, and then propose class-wise contrastive regularization which encourages feature similarity within the same class and dissimilarity across different classes, thereby effectively improving the segmentation performance of the student network. Experimental results on the ACDC dataset for heart structure segmentation and a fetal MRI dataset for placenta and fetal brain segmentation demonstrate that our method significantly improves the student\'s performance and outperforms five state-of-the-art scribble-supervised learning methods. Consequently, the method has a potential for reducing the annotation cost in developing deep learning models for clinical diagnosis.

UNASSIGNED: The molecular classification of breast cancer is crucial for effective treatment. The emergence of digital pathology has ushered in a new era in which weakly supervised learning leveraging whole-slide images has gained prominence in developing deep learning models because this approach alleviates the need for extensive manual annotation. Weakly supervised learning was employed to classify the molecular subtypes of breast cancer.
UNASSIGNED: Our approach capitalizes on two whole-slide image datasets: one consisting of breast cancer cases from the Korea University Guro Hospital (KG) and the other originating from The Cancer Genomic Atlas dataset (TCGA). Furthermore, we visualized the inferred results using an attention-based heat map and reviewed the histomorphological features of the most attentive patches.
UNASSIGNED: The KG+TCGA-trained model achieved an area under the receiver operating characteristics value of 0.749. An inherent challenge lies in the imbalance among subtypes. Additionally, discrepancies between the two datasets resulted in different molecular subtype proportions. To mitigate this imbalance, we merged the two datasets, and the resulting model exhibited improved performance. The attentive patches correlated well with widely recognized histomorphologic features. The triple-negative subtype has a high incidence of high-grade nuclei, tumor necrosis, and intratumoral tumor-infiltrating lymphocytes. The luminal A subtype showed a high incidence of collagen fibers.
UNASSIGNED: The artificial intelligence (AI) model based on weakly supervised learning showed promising performance. A review of the most attentive patches provided insights into the predictions of the AI model. AI models can become invaluable screening tools that reduce costs and workloads in practice.

The annotation of magnetic resonance imaging (MRI) images plays an important role in deep learning-based MRI segmentation tasks. Semi-automatic annotation algorithms are helpful for improving the efficiency and reducing the difficulty of MRI image annotation. However, the existing semi-automatic annotation algorithms based on deep learning have poor pre-annotation performance in the case of insufficient segmentation labels. In this paper, we propose a semi-automatic MRI annotation algorithm based on semi-weakly supervised learning. In order to achieve a better pre-annotation performance in the case of insufficient segmentation labels, semi-supervised and weakly supervised learning were introduced, and a semi-weakly supervised learning segmentation algorithm based on sparse labels was proposed. In addition, in order to improve the contribution rate of a single segmentation label to the performance of the pre-annotation model, an iterative annotation strategy based on active learning was designed. The experimental results on public MRI datasets show that the proposed algorithm achieved an equivalent pre-annotation performance when the number of segmentation labels was much less than that of the fully supervised learning algorithm, which proves the effectiveness of the proposed algorithm.

Interstitial lung disease (ILD) is characterized by progressive pathological changes that require timely and accurate diagnosis. The early detection and progression assessment of ILD are important for effective management. This study introduces a novel quantitative evaluation method utilizing chest radiographs to analyze pixel-wise changes in ILD. Using a weakly supervised learning framework, the approach incorporates the contrastive unpaired translation model and a newly developed ILD extent scoring algorithm for more precise and objective quantification of disease changes than conventional visual assessments. The ILD extent score calculated through this method demonstrated a classification accuracy of 92.98% between ILD and normal classes. Additionally, using an ILD follow-up dataset for interval change analysis, this method assessed disease progression with an accuracy of 85.29%. These findings validate the reliability of the ILD extent score as a tool for ILD monitoring. The results of this study suggest that the proposed quantitative method may improve the monitoring and management of ILD.

Instrument pose estimation is a key demand in computer-aided surgery, and its main challenges lie in two aspects: Firstly, the difficulty of obtaining stable corresponding image feature points due to the instruments\' high refraction and complicated background, and secondly, the lack of labeled pose data. This study aims to tackle the pose estimation problem of surgical instruments in the current endoscope system using a single endoscopic image. More specifically, a weakly supervised method based on the instrument\'s image segmentation contour is proposed, with the effective assistance of synthesized endoscopic images. Our method consists of the following three modules: a segmentation module to automatically detect the instrument in the input image, followed by a point inference module to predict the image locations of the implicit feature points of the instrument, and a point back-propagatable Perspective-n-Point module to estimate the pose from the tentative 2D-3D corresponding points. To alleviate the over-reliance on point correspondence accuracy, the local errors of feature point matching and the global inconsistency of the corresponding contours are simultaneously minimized. Our proposed method is validated with both real and synthetic images in comparison with the current state-of-the-art methods.

Colorectal cancer (CRC) is the third most common cancer in the United States. Tumor Budding (TB) detection and quantification are crucial yet labor-intensive steps in determining the CRC stage through the analysis of histopathology images. To help with this process, we adapt the Segment Anything Model (SAM) on the CRC histopathology images to segment TBs using SAM-Adapter. In this approach, we automatically take task-specific prompts from CRC images and train the SAM model in a parameter-efficient way. We compare the predictions of our model with the predictions from a trained-from-scratch model using the annotations from a pathologist. As a result, our model achieves an intersection over union (IoU) of 0.65 and an instance-level Dice score of 0.75, which are promising in matching the pathologist\'s TB annotation. We believe our study offers a novel solution to identify TBs on H&E-stained histopathology images. Our study also demonstrates the value of adapting the foundation model for pathology image segmentation tasks.

OBJECTIVE: Current automatic electrocardiogram (ECG) diagnostic systems could provide classification outcomes but often lack explanations for these results. This limitation hampers their application in clinical diagnoses. Previous supervised learning could not highlight abnormal segmentation output accurately enough for clinical application without manual labeling of large ECG datasets.
METHODS: In this study, we present a multi-instance learning framework called MA-MIL, which has designed a multi-layer and multi-instance structure that is aggregated step by step at different scales. We evaluated our method using the public MIT-BIH dataset and our private dataset.
RESULTS: The results show that our model performed well in both ECG classification output and heartbeat level, sub-heartbeat level abnormal segment detection, with accuracy and F1 scores of 0.987 and 0.986 for ECG classification and 0.968 and 0.949 for heartbeat level abnormal detection, respectively. Compared to visualization methods, the IoU values of MA-MIL improved by at least 17 % and at most 31 % across all categories.
CONCLUSIONS: MA-MIL could accurately locate the abnormal ECG segment, offering more trustworthy results for clinical application.

Automatic crack segmentation plays an essential role in maintaining the structural health of buildings and infrastructure. Despite the success in fully supervised crack segmentation, the costly pixel-level annotation restricts its application, leading to increased exploration in weakly supervised crack segmentation (WSCS). However, WSCS methods inevitably bring in noisy pseudo-labels, which results in large fluctuations. To address this problem, we propose a novel confidence-aware co-training (CAC) framework for WSCS. This framework aims to iteratively refine pseudo-labels, facilitating the learning of a more robust segmentation model. Specifically, a co-training mechanism is designed and constructs two collaborative networks to learn uncertain crack pixels, from easy to hard. Moreover, the dynamic division strategy is designed to divide the pseudo-labels based on the crack confidence score. Among them, the high-confidence pseudo-labels are utilized to optimize the initialization parameters for the collaborative network, while low-confidence pseudo-labels enrich the diversity of crack samples. Extensive experiments conducted on the Crack500, DeepCrack, and CFD datasets demonstrate that the proposed CAC significantly outperforms other WSCS methods.

Weakly supervised temporal action localization aims to locate the temporal boundaries of action instances in untrimmed videos using video-level labels and assign them the corresponding action category. Generally, it is solved by a pipeline called \"localization-by-classification\", which finds the action instances by classifying video snippets. However, since this approach optimizes the video-level classification objective, the generated activation sequences often suffer interference from class-related scenes, resulting in a large number of false positives in the prediction results. Many existing works treat background as an independent category, forcing models to learn to distinguish background snippets. However, under weakly supervised conditions, the background information is fuzzy and uncertain, making this method extremely difficult. To alleviate the impact of false positives, we propose a new actionness-guided false positive suppression framework. Our method seeks to suppress false positive backgrounds without introducing the background category. Firstly, we propose a self-training actionness branch to learn class-agnostic actionness, which can minimize the interference of class-related scene information by ignoring the video labels. Secondly, we propose a false positive suppression module to mine false positive snippets and suppress them. Finally, we introduce the foreground enhancement module, which guides the model to learn the foreground with the help of the attention mechanism as well as class-agnostic actionness. We conduct extensive experiments on three benchmarks (THUMOS14, ActivityNet1.2, and ActivityNet1.3). The results demonstrate the effectiveness of our method in suppressing false positives and it achieves the state-of-the-art performance. Code: https://github.com/lizhilin-ustc/AFPS.