arXiv · 2607.21370
ASTRA-Net: Anatomy-Specific Transfer and Representation Alignment for Drug-Induced Sleep Endoscopy Segmentation
Abstract
Quantitative drug-induced sleep endoscopy (DISE) requires reliable airway boundaries at specific anatomical levels. Pixel-level DISE annotations are scarce, and manual contouring limits the scalability of quantitative assessment. To address this limitation, we developed ASTRA-Net for known-plane DISE segmentation with limited real annotations. Stage 1 aligned intermediate ConvNeXt-Base representations from 14,250 unlabeled virtual endoscopy frames derived from computed tomography and real DISE frames. Virtual images were used only for feature alignment. Stage 2 fine-tuned four independent UNet++ decoders on 401 real annotated frames. Structured zero-mask supervision constrained incompatible plane outputs and invalid frames. Six alignment configurations used maximum mean discrepancy, domain adversarial learning, or both objectives. On a hold-out evaluation set of 100 frames, the five-model MMD-only segmentation ensemble achieved a mean Dice of 0.8927, with a 95% image-level bootstrap interval of 0.8631 to 0.9160. The mean intersection over union was 0.8239. A classification- enabled variant of the same alignment configuration reached a restricted four-plane top-1 accuracy of 0.92 on the same hold-out frames. These results indicate that ASTRA-Net can support frame-level, plane-specific DISE boundary delineation when real annotations are limited.
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Suhua Sun, Yuqiao Wang, Sheng Liu, Rui Fan, Jiajun Wang, Ruoyan Xu, Yixin Chen, Tao Li, Yan Yan. 2026-07-23. ASTRA-Net: Anatomy-Specific Transfer and Representation Alignment for Drug-Induced Sleep Endoscopy Segmentation. https://arxiv.org/abs/2607.21370
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