Self-supervised pre-training has become the priory choice to establish reliable models for automated recognition of massive medical images, which are routinely annotation-free, without semantics, and without guarantee of quality. Note that this paradigm is still at its infancy and limited by closely related open issues: 1) how to learn robust representations in an unsupervised manner from unlabelled medical images of low diversity in samples? and 2) how to obtain the most significant representations demanded by a high-quality segmentation? Aiming at these issues, this study proposes a knowledge-based learning framework towards enhanced recognition of medical images, which works in three phases by synergizing contrastive learning and generative learning models: 1) Sample Space Diversification: Reconstructive proxy tasks have been enabled to embed a priori knowledge with context highlighted to diversify the expanded sample space; 2) Enhanced Representation Learning: Informative noise-contrastive estimation loss regularizes the encoder to enhance representation learning of annotation-free images; 3) Correlated Optimization: Optimization operations in pre-training the encoder and the decoder have been correlated via image restoration from proxy tasks, targeting the need for semantic segmentation. Extensive experiments have been performed on various public medical image datasets (e.g., CheXpert and DRIVE) against the state-of-the-art counterparts (e.g., SimCLR and MoCo), and results demonstrate that: The proposed framework statistically excels in self-supervised benchmarks, achieving 2.08, 1.23, 1.12, 0.76 and 1.38 percentage points improvements over SimCLR in AUC/Dice. The proposed framework achieves label-efficient semi-supervised learning, e.g., reducing the annotation cost by up to 99% in pathological classification.

本研究提出了一个基于知识的学习框架 （TOWER），通过协同对比学习和生成学习方法的三个阶段，实现对生物医学显微图像的加强识别，该方法在大规模和复杂的生物医学显微图像无监督训练中优于 SimCLR 和 BYOL 方法，同时可用于多模态医学图像分析和半监督学习中。

基于知识的自监督预训练学习框架，提升生物医学显微镜图像识别