Optic disc and cup segmentation play a crucial role in automating the screening and diagnosis of optic glaucoma. While data-driven convolutional neural networks (CNNs) show promise in this area, the inherent ambiguity of segmenting object and background boundaries in the task of optic disc and cup segmentation leads to noisy annotations that impact model performance. To address this, we propose an innovative label-denoising method of Multiple Pseudo-labels Noise-aware Network (MPNN) for accurate optic disc and cup segmentation. Specifically, the Multiple Pseudo-labels Generation and Guided Denoising (MPGGD) module generates pseudo-labels by multiple different initialization networks trained on true labels, and the pixel-level consensus information extracted from these pseudo-labels guides to differentiate clean pixels from noisy pixels. The training framework of the MPNN is constructed by a teacher-student architecture to learn segmentation from clean pixels and noisy pixels. Particularly, such a framework adeptly leverages (i) reliable and fundamental insights from clean pixels and (ii) the supplementary knowledge within noisy pixels via multiple perturbation-based unsupervised consistency. Compared to other label-denoising methods, comprehensive experimental results on the RIGA dataset demonstrate our method's excellent performance and significant denoising ability.
Medical image segmentation annotations exhibit variations among experts due to the ambiguous boundaries of segmented objects and backgrounds in medical images. Although using multiple annotations for each image in the fully-supervised has been extensively studied for training deep models, obtaining a large amount of multi-annotated data is challenging due to the substantial time and manpower costs required for segmentation annotations, resulting in most images lacking any annotations. To address this, we propose Multi-annotated Semi-supervised Ensemble Networks (MSE-Nets) for learning segmentation from limited multi-annotated and abundant unannotated data. Specifically, we introduce the Network Pairwise Consistency Enhancement (NPCE) module and Multi-Network Pseudo Supervised (MNPS) module to enhance MSE-Nets for the segmentation task by considering two major factors: (1) to optimize the utilization of all accessible multi-annotated data, the NPCE separates (dis)agreement annotations of multi-annotated data at the pixel level and handles agreement and disagreement annotations in different ways, (2) to mitigate the introduction of imprecise pseudo-labels, the MNPS extends the training data by leveraging consistent pseudo-labels from unannotated data. Finally, we improve confidence calibration by averaging the predictions of base networks. Experiments on the ISIC dataset show that we reduced the demand for multi-annotated data by 97.75\% and narrowed the gap with the best fully-supervised baseline to just a Jaccard index of 4\%. Furthermore, compared to other semi-supervised methods that rely only on a single annotation or a combined fusion approach, the comprehensive experimental results on ISIC and RIGA datasets demonstrate the superior performance of our proposed method in medical image segmentation with ambiguous boundaries.