UniAda: Domain Unifying and Adapting Network for Generalizable Medical Image Segmentation.

Learning a generalizable medical image segmentation model is an important but challenging task since the unseen (testing) domains may have significant discrepancies from seen (training) domains due to different vendors and scanning protocols. Existing segmentation methods, typically built upon domain generalization (DG), aim to learn multi-source domain-invariant features through data or feature augmentation techniques, but the resulting models either fail to characterize global domains during training or cannot sense unseen domain information during testing. To tackle these challenges, we propose a domain Unifying and Adapting network (UniAda) for generalizable medical image segmentation, a novel "unifying while training, adapting while testing" paradigm that can learn a domain-aware base model during training and dynamically adapt it to unseen target domains during testing. First, we propose to unify the multi-source domains into a global inter-source domain via a novel feature statistics update mechanism, which can sample new features for the unseen domains, facilitating the training of a domain base model. Second, we leverage the uncertainty map to guide the adaptation of the trained model for each testing sample, considering the specific target domain may be outside the global inter-source domain. Extensive experimental results on two public cross-domain medical datasets and one in-house cross-domain dataset demonstrate the strong generalization capacity of the proposed UniAda over state-of-the-art DG methods. The source code of our UniAda is available at https://github.com/ZhouZhang233/UniAda.