Striving for Simplicity: Simple Yet Effective Prior-Aware Pseudo-labeling for Semi-supervised Ultrasound Image Segmentation

Medical ultrasound imaging is ubiquitous, but manual analysis struggles to keep pace. Automated segmentation can help but requires large labeled datasets, which are scarce. Semi-supervised learning leveraging both unlabeled and limited labeled data is a promising approach. State-of-the-art methods use consistency regularization or pseudo-labeling but grow increasingly complex. Without sufficient labels, these models often latch onto artifacts or allow anatomically implausible segmentations. In this paper, we present a simple yet effective pseudo-labeling method with an adversarially learned shape prior to regularize segmentations. Specifically, we devise an encoder-twin-decoder network where the shape prior acts as an implicit shape model, penalizing anatomically implausible but not ground-truth-deviating predictions. Without bells and whistles, our simple approach achieves state-of-the-art performance on two benchmarks under different partition protocols. We provide a strong baseline for future semi-supervised medical image segmentation. Code is available at https://github.com/WUTCM-Lab/Shape-Prior-Semi-Seg .