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A Large Scale Benchmark for Test Time Adaptation Methods in Medical Image Segmentation

2025-12-02 · Wenjing Yu, Shuo Jiang, Yifei Chen, Shuo Chang, Yuanhan Wang, Beining Wu, Jie Dong, Mingxuan Liu, Shenghao Zhu, Feiwei Qin, Changmiao Wang, Qiyuan Tian arxiv

Test time Adaptation is a promising approach for mitigating domain shift in medical image segmentation; however, current evaluations remain limited in terms of modality coverage, task diversity, and methodological consistency. We present MedSeg-TTA, a comprehensive benchmark that examines twenty representative adaptation methods across seven imaging modalities, including MRI, CT, ultrasound, pathology, dermoscopy, OCT, and chest X-ray, under fully unified data preprocessing, backbone configuration, and test time protocols. The benchmark encompasses four significant adaptation paradigms: Input-level Transformation, Feature-level Alignment, Output-level Regularization, and Prior Estimation, enabling the first systematic cross-modality comparison of their reliability and applicability. The results show that no single paradigm performs best in all conditions. Input-level methods are more stable under mild appearance shifts. Feature-level and Output-level methods offer greater advantages in boundary-related metrics, whereas prior-based methods exhibit strong modality dependence. Several methods degrade significantly under large inter-center and inter-device shifts, which highlights the importance of principled method selection for clinical deployment. MedSeg-TTA provides standardized datasets, validated implementations, and a public leaderboard, establishing a rigorous foundation for future research on robust, clinically reliable test-time adaptation. All source codes and open-source datasets are available at https://github.com/wenjing-gg/MedSeg-TTA.

📄 PDF Abstract BibTeX arXiv:2512.02497

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Tasks

Medical Image Segmentation Test-time Adaptation

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