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Unifying Active Learning and Semi-Supervised Learning for Medical Image Segmentation

The paper introduces RegAL, a unified active semi-supervised framework using topology-aware Pareto optimization to couple sample acquisition with unlabeled data utilization, outperforming baselines under extreme annotation scarcity.

SourcearXiv Computer VisionAuthor: Bahram Jafrasteh, Cheng Wan, Heejong Kim, Johannes C. Paetzold, Qingyu Zhao

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[Submitted on 27 Jul 2026]

Title:Unifying Active Learning and Semi-Supervised Learning for Medical Image Segmentation

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Abstract:In practical settings, medical image segmentation models are often developed with limited annotated data rather than fully labeled datasets. Training frequently begins in ultra-low labeled regimes where only a small number of volumes are annotated. In such scenarios, practitioners must simultaneously decide which cases to annotate and how to best use the remaining unlabeled data. Although active learning (AL) and semi-supervised learning (SSL) both target annotation scarcity, they are typically designed and optimized independently, resulting in objective mismatch and unstable training during early-stage "cold start" conditions. We propose RegAL, a unified active semi-supervised framework governed by a shared topology-aware Pareto optimization that couples sample acquisition with unlabeled data utilization. RegAL evaluates images along three complementary axes, voxel-wise uncertainty, feature diversity, and a novel topological consistency metric, to select anatomically informative edge cases for annotation. On the other hand, the same criteria are used to identify geometrically stable atlas candidates for diffeomorphic registration-guided augmentation to train a self-supervised Mean Teacher segmentation network. Across BraTS 2021, dHCP, and ProstateX, RegAL remains stable with few labeled volumes and consistently outperforms state-of-the-art AL, SSL, and active semi-supervised baselines across Dice and boundary-distance (ASD, HD95) metrics under extreme annotation scarcity.

Subjects:

Computer Vision and Pattern Recognition (cs.CV); Machine Learning (stat.ML)

Cite as: arXiv:2607.25014 [cs.CV]

(or arXiv:2607.25014v1 [cs.CV] for this version)

https://doi.org/10.48550/arXiv.2607.25014

arXiv-issued DOI via DataCite (pending registration)

Submission history

From: Bahram Jafrasteh [view email] [v1] Mon, 27 Jul 2026 19:10:12 UTC (10,705 KB)

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