Organizations: Mehta Family School of Data Science and Artificial Intelligence, Indian Institute of Technology Guwahati, India · Indian Institute of Information Technology, Design and Manufacturing,2026 Jabalpur, India
Abstract
Labeling medical images is a major bottleneck in the field of medical imaging, as it requires domain-specific expertise, and it gets further complicated due to variability across different medical centers and different imaging devices. Such heterogeneity introduces domain shifts and modality discrepancies, which limits the generalization of trained models. To address this important challenge, we propose an unsupervised domain adaptation framework that combines transfer learning with a Reproducing Kernel Hilbert Space based Maximum Mean Discrepancy loss for the alignment of source and target domains. By jointly optimizing classification and RKHS-MMD losses, the methodology enhances generalization to unannotated medical datasets while diminishing reliance on manual annotation. Experimental evaluations presented on two chest X-ray datasets, which are obtained from different medical centers, show outstanding improvements over models trained without adaptation. Furthermore, we perform a comparative study to see that RKHS-MMD performs better than the standard Maximum Mean Discrepancy in reducing modality gap, emphasizing its effectiveness for medical image classification and also its strong capability in advanced AI-driven medical diagnostics.
Domain shift remains a major obstacle to the reliable deployment of machine learning models in high-stakes environments such as healthcare. While Domain adaptation aims to mitigate these effects, existing approaches suffer from limited expressiveness of latent representations and a reliance on handcrafted, static augmentations. In this work, we address these limitations by proposing a novel deep learning architecture for Unsupervised Domain Adaptation (UDA), specifically optimized for medical image segmentation. Our framework, ADualVUOT, integrates a dual-encoder Variational Autoencoder (VAE) with Continuous Normalizing Flows (CNFs) to increase modeling flexibility and posterior expressiveness. To achieve domain alignment, we leverage Unbalanced Optimal Transport (UOT) through the Gaussian-Gromov-Wasserstein (GGW) distance, which handles structural and topological discrepancies between domains. Furthermore, we incorporate an adversarial augmentation scheme to synthesize worst-case compositions, thus enhancing model robustness. Extensive experiments on medical imaging benchmarks show significant gains over prior OT-based approaches.
Acquiring labeled medical image data is resource-intensive and a challenge further exacerbated in cross-domain scenarios where source and target datasets differ in imaging equipment, population, or clinical site. This study introduces XSSR (Cross-Domain Self-Supervised Representative Selection), a framework designed to minimize annotation effort in the target domain while maintaining robust segmentation performance. XSSR comprises three stages: first, a Masked Autoencoder (MAE) is trained on unlabeled source data to establish a shared embedding space without requiring target labels; second, a greedy selection algorithm scores unlabeled target samples based on a composite density, novelty, and diversity criterion; and third, a U-Net segmentation model is trained exclusively on the selected subset. The novelty-diversity trade-off parameter, alpha, is automatically calibrated by minimizing embedding-space coverage, eliminating manual tuning. We evaluate XSSR on three public benchmarks: Chest X-ray, RIGA+ retinal fundus imaging, and multi-site Prostate MRI, each under a fixed 5% annotation budget. XSSR achieves 99.3% of full-data performance on Chest X-ray using only 22 labeled samples, surpasses random selection by up to 2.5 Dice points on Prostate MRI, and consistently outperforms the CoreSet baseline by 0.4 to 1.2 Dice points across all datasets. Ablation studies indicate that diversity is the most influential scoring component, and per-site analysis shows that performance correlates with scanner similarity to the source domain.
Deploying unsupervised domain adaptation (UDA) in clinical practice requires choosing which algorithm to use and which of its trained models to ship. However, the deployment (target) domain is unlabeled, so models cannot be evaluated directly on it, leaving it unclear which to select. We address this by evaluating the complete UDA pipeline, considering both adaptation and label-free selection together. Our study covers eleven clinically relevant cross-domain scenarios from nine medical imaging datasets, with ten UDA algorithms and 13 label-free selection methods (validators), evaluating over 80,000 trained models in total. By this, we find that a capable adapted model usually exists, but identifying it without target labels is difficult: the validator-selected models leave a large and structural target performance gap to the best available one, with no evaluated validator consistently reliable. Towards closing it, we explore two strategies, ensembling and a small target-labeling budget; both narrow this gap but do not close it entirely. Overall, deployable UDA depends on the complete pipeline; addressing the less explored selection step could bring much of current UDA closer to clinical use.