Partially-supervised multi-organ medical image segmentation aims to develop a unified semantic segmentation model by utilizing multiple partially-labeled datasets, with each dataset providing labels for a single class of organs. However, the limited availability of labeled foreground organs and the absence of supervision to distinguish unlabeled foreground organs from the background pose a significant challenge, which leads to a distribution mismatch between labeled and unlabeled pixels. Although existing pseudo-labeling methods can be employed to learn from both labeled and unlabeled pixels, they are prone to performance degradation in this task, as they rely on the assumption that labeled and unlabeled pixels have the same distribution. In this paper, to address the problem of distribution mismatch, we propose a labeled-to-unlabeled distribution alignment (LTUDA) framework that aligns feature distributions and enhances discriminative capability. Specifically, we introduce a cross-set data augmentation strategy, which performs region-level mixing between labeled and unlabeled organs to reduce distribution discrepancy and enrich the training set. Besides, we propose a prototype-based distribution alignment method that implicitly reduces intra-class variation and increases the separation between the unlabeled foreground and background. This can be achieved by encouraging consistency between the outputs of two prototype classifiers and a linear classifier. Extensive experimental results on the AbdomenCT-1K dataset and a union of four benchmark datasets (including LiTS, MSD-Spleen, KiTS, and NIH82) demonstrate that our method outperforms the state-of-the-art partially-supervised methods by a considerable margin, and even surpasses the fully-supervised methods. The source code is publicly available at https://github.com/xjiangmed/LTUDA.

本研究针对部分监督多脏器医学图像分割中标记和未标记像素之间分布不匹配的问题，提出了一种标记到未标记分布对齐框架（LTUDA）。通过交叉集数据增强策略和基于原型的分布对齐方法，显著提高了模型在分割任务中的性能，有效降低了未标记前景与背景之间的差异。

面向部分监督的多脏器医学图像分割的标记到未标记分布对齐