Annotation-Free Representation Learning for Polyp Retrieval in Colonoscopy Videos

Learning robust representations of polyp tracklets is key to enabling multiple AI-assisted colonoscopy applications, from polyp characterization to automated reporting and retrieval. Supervised contrastive learning is an effective approach for learning such representations, but it typically relies on correct positive and negative definitions. Collecting these labels requires linking tracklets that depict the same underlying polyp entity throughout the video, which is costly and demands specialized clinical expertise. In this work, we leverage the sequential workflow of colonoscopy procedures to derive self-supervised associations from temporal structure. Since temporally derived associations are not guaranteed to be correct, we introduce a noise-aware contrastive loss to account for noisy associations. We demonstrate the effectiveness of the learned representations across multiple downstream tasks, including polyp retrieval and re-identification, size estimation, and histology classification. Our method outperforms prior self-supervised and supervised baselines, and matches or exceeds recent foundation models across all tasks, using a lightweight encoder trained on only 27 videos. Code is available at https://github.com/lparolari/ntssl.

Because dense frame-level annotation of colonoscopy videos is costly, we propose WSPolypNet, a weakly supervised framework for polyp localization using only video-level labels. WSPolypNet employs a 3D convolutional neural network trained with video-level supervision to generate class activation maps (CAMs), which identify candidate polyp regions without requiring frame-level spatial annotations. The CAM-derived localization cues are further enhanced using a multi-view strategy and provided to MedSAM2 as point prompts. MedSAM2 then propagates segmentation masks across the video, refining the coarse localization cues according to polyp boundaries. WSPolypNet achieved CorLoc scores of 47.80%, 43.68%, and 35.01% at IoU thresholds of 0.3, 0.5, and 0.7, respectively, compared with 36.87%, 33.72%, and 27.94% in the single-view setting. For small polyps, the multi-view strategy improved [email protected] from 16.01% to 30.97%. The framework also achieved a recall of 94.51%. These results demonstrate the potential of weakly supervised spatiotemporal learning to substantially reduce spatial annotation requirements for polyp localization in colonoscopy videos.

Accurate polyp segmentation in colonoscopy is essential for early colorectal cancer detection, yet real-world clinical environments pose persistent challenges such as motion blur, specular reflections, and illumination instability. Most existing methods are optimized on clean benchmark images and suffer noticeable performance degradation when deployed in authentic surgical scenarios. We propose DepthPolyp, a lightweight and robust segmentation framework based on pseudo-depth-guided multi-task learning and efficient feature modulation. The architecture combines hierarchical Ghost factorization for compact feature generation, Interleaved Shuffle Fusion for low-cost cross-scale interaction, and Dynamic Group Gating for adaptive group-wise feature weighting. Extensive experiments demonstrate that DepthPolyp achieves strong cross-dataset generalization when trained on degraded data and evaluated on both clean and noisy target domains, consistently outperforming lightweight baselines and remaining competitive with substantially larger models. In real surgical video evaluation on PolypGen, DepthPolyp achieves better segmentation performance than models up to $20\times$ larger while preserving real-time inference speed. With only 3.57M parameters and 0.86 GMACs, the proposed method runs at over 180 FPS on mobile devices, making it well suited for real-time deployment in resource-constrained clinical environments. Code and pretrained weights are available at: https://github.com/ReaganWu/DepthPolyp/