Dual-Student Adversarial Framework With Discriminator and Consistency-Driven Learning for Semi-Supervised Medical Image Segmentation

Semi-supervised medical image segmentation is essential for alleviating the cost of manual annotation in clinical applications. However, existing methods often suffer from unreliable pseudo-labels and confirmation bias in consistency-based training, which can lead to unstable optimization and degraded performance. To address these issues, a novel method named dual-Student adversarial framework with discriminator and consistency-driven learning for semi-supervised medical image segmentation is proposed. Specifically, an adversarial learning-based segmentation refinement (ALSR) module is designed to encourage prediction diversity between two student networks and leverage a shared discriminator for adversarial refinement of pseudo-labels. To further stabilize the consistency process, a residual exponential moving average (R-EMA) is applied in the uncertainty estimation with inter-instance consistency measurement (UIM) module to construct a robust teacher model, while noisy voxel predictions are selectively filtered based on uncertainty estimation. In addition, a Contrastive Representation Stabilization (CRS) module is developed to enhance voxel-level semantic alignment by performing contrastive learning only on confident regions, improving feature discriminability and structural consistency. Extensive experiments on benchmark datasets demonstrate that our method consistently outperforms prior state-of-the-art approaches.