US-JEPA: A Joint Embedding Predictive Architecture for Ultrasound

Self-supervised pre-training paradigm has gained increasing prominence for learning transferable representations in medical imaging, yet existing methods for ultrasound (US) images operate at the image or frame level, overlooking the anatomical context for clinical-aligned representation learning. In this work, we propose an anatomy-anchored ultrasound self-supervision framework ANAUS that shifts representation learning from generic visual regions to clinically meaningful anatomical structures. Utilizing a learnable latent prompt engine alongside a one-time domain adaptation on existing public image-mask pairs, we empower the LP-SAM module to achieve annotation-free anatomy delineation at scale. Building upon this anatomical grounding, we propose a dual-policy self-supervised learning paradigm consisting of inter-view semantics-aware anatomy-separating alignment and contextual core-region prediction to enhance representation learning. Specifically, the former enforces feature invariance within identical anatomical regions while promoting discriminability across distinct structures; the latter compels the model to reconstruct corrupted regions, thereby capturing fine-grained structural details. Extensive evaluations on six public datasets demonstrate that ANAUS consistently outstrips current state-of-the-art methods while maintaining the computational efficiency essential for clinical deployment. Code is available at https://github.com/zhcz328/ANAUS.

Self-supervised learning (SSL) can reduce the need for labelled medical images, but the choice of pretext objective remains unclear for lung ultrasound (LUS). Contrastive learning, masked reconstruction, and joint-embedding predictive architectures (JEPA) differ in the space in which their targets are defined, yet existing ultrasound studies compare them under different corpora, backbones, and evaluation protocols. We compare these three objective families using the same encoder backbone, pretraining corpus, optimisation schedule, and frozen-evaluation protocol. Encoders are pretrained on COVID-BLUeS LUS videos and evaluated with linear, $k$NN, and attentive probes at 5%, 10%, 50%, and 100% label budgets. Evaluation is performed on POCUS using patient-level five-fold cross-validation and on the independently acquired Mendeley-Uganda dataset, which is excluded from both pretraining and probe fitting. At the full label budget under linear probing, VideoMAE and V-JEPA achieve $66.5 \pm 13.1$ and $65.4 \pm 11.7$ balanced accuracy on POCUS, while MoCo achieves $42.1 \pm 1.2$. On Mendeley-Uganda, the ranking reverses: MoCo performs best at $62.7 \pm 1.0$, followed by VideoMAE at $53.8 \pm 2.8$, while V-JEPA falls near chance at $35.1 \pm 4.9$. These results show that POCUS probe accuracy alone does not identify the objective that transfers best across datasets. We also outline planned representation-level analyses to examine this reversal. Code is publicly available at https://github.com/moeinheidari7829/LUSVideoSSL.

A central difficulty in training Joint-Embedding Predictive Architectures (JEPAs) is preventing representation collapse. LeJEPA addresses this by enforcing an isotropic Gaussian target on the embeddings via Sketched Isotropic Gaussian Regularization (SIGReg). This target is in tension with the manifold hypothesis, which expects embeddings to concentrate on a low-dimensional subset of the ambient space. We propose \emph{UR-JEPA}, which targets a uniformly $n$-rectifiable measure of local tangent dimension $n$ at small scales, realized through a Gaussian-kernel smoothed Carleson-type square function $\mathcal{L}^{\text{CGLT}}$, with a complementary Jones $β$-number formulation. On Inet10, UR-JEPA($\mathcal{L}^{\text{CGLT}}$) attains $0.9141 \pm 0.0014$ for a $+0.83$,pp gain over LeJEPA($\mathcal{L}^{\text{SIGReg}}$) with $\sim 30\%$ lower seed standard deviation; on matched-recipe Galaxy10~SDSS, a single-seed ImageNet-$100$ run, and a $3$-seed EuroSAT remote-sensing run, the two methods lie in the same peak-accuracy band at convergence, with UR-JEPA retaining its lower-seed-variance signature. On EuroSAT the in-domain pair is competitive at $96.0$ to $96.1\%$ with large remote-sensing foundation-model transfer at a $25\times$ smaller backbone. The distinction is geometric: direct visualization of the projector output distribution shows that on all four datasets UR--JEPA($\mathcal{L}^{\text{CGLT}}$) produces a global PCA spectrum with a $4$ to $5$ order-of-magnitude drop at index $\sim 20$ to $25$ out of $D = 32$, while LeJEPA's spectrum is near-flat (top-to-bottom ratio at most $3.6$). Per-dimension marginals are simultaneously near-Gaussian for both methods (mean Shapiro-Wilk $W \in [0.992, 0.996]$) as a Diaconis-Freedman consequence. At matched accuracy the two regularizers therefore yield structurally distinct projected representations.