A General-Purpose Dual-Path Interaction Framework for Multi-View Medical Image Segmentation: Alleviating Data Volume Dependency in Small-Sample Regimes

Shuhuan Wang, Yuanyuan Cui, Pengju Wang, Huimin Guo, Ling Yue +8

The performance of medical image segmentation depends on a large amount of annotated data, and most segmentation models experience a significant drop in performance in low-sample-size scenarios. Existing semi-supervised and weakly supervised methods rely on specific network architectures, while traditional multi-view-assisted segmentation methods require strictly paired samples, which limits their clinical applications. To address these issues, we propose DPIF, a general-purpose plug-and-play dual-path interaction framework compatible with arbitrary encoder-decoder segmentation networks, which leverages cross-view anatomical complementarity to reduce annotation reliance. DPIF first performs Sinkhorn optimal transport-based cross-view distribution alignment to establish global semantic correspondence without sample-level pairing. It then adopts conditional mutual information-guided feature decoupling to enable bidirectional knowledge transfer only within the shared semantic space, suppressing view-specific noise. Finally, persistent homology-based topological regularization encodes anatomical invariants as unsupervised priors to mitigate overfitting. Experiments were conducted…