AUTHOR=Deng Feilin , Li Shangxuan , Yang Zizhu , Zhou Wu 

TITLE=Weakly supervised multiple-instance active learning for tooth-marked tongue recognition

JOURNAL=Frontiers in Physiology

VOLUME=Volume 16 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/physiology/articles/10.3389/fphys.2025.1598850

DOI=10.3389/fphys.2025.1598850

ISSN=1664-042X

ABSTRACT=IntroductionRecognizing a tooth-marked tongue has important clinical diagnostic value in traditional Chinese medicine. Current deep learning methods for tooth mark detection require extensive manual labeling and tongue segmentation, which is labor-intensive. Therefore, we propose a weakly supervised multipleinstance active learning model for tooth-marked tongue recognition, aiming to eliminate preprocessing segmentation and reduce the annotation workload while maintaining diagnostic accuracy.MethodWe propose a one-stage method tongenerate tooth mark instances that eliminates the need for pre-segmentation of the tongue. To make full use of unlabeled data, we introduce a semisupervised learning paradigm to pseudo-label unlabeled tongue images with high model confidence in active learning and incorporate them into the training set to improve the training efficiency of the active learning model. In addition, we propose an instance-level hybrid query method considering the diversity of tooth marks.ResultExperimental results on clinical tongue images verify the effectiveness of the proposed method, which achieves an accuracy of 93.88% for tooth-marked tongue recognition, outperforming the recently introduced weakly supervised approaches.ConclusionThe proposed method is effective with only a small amount of image-level annotation, and its performance is comparable to that of image-level annotation, instance-level annotation and pixel-level annotation, which require a large number of tooth markers. Our method significantly reduces the annotation cost of the binary classification task of traditional Chinese medicine tooth mark recognition.