Medical image analysis techniques have been employed in diagnosing and screening clinical diseases. However, both poor medical image quality and illumination style inconsistency increase uncertainty in clinical decision-making, potentially resulting in clinician misdiagnosis. The majority of current image enhancement methods primarily concentrate on enhancing medical image quality by leveraging high-quality reference images, which are challenging to collect in clinical applications. In this study, we address image quality enhancement within a fully self-supervised learning setting, wherein neither high-quality images nor paired images are required. To achieve this goal, we investigate the potential of self-supervised learning combined with domain adaptation to enhance the quality of medical images without the guidance of high-quality medical images. We design a Domain Adaptation Self-supervised Quality Enhancement framework, called DASQE. More specifically, we establish multiple domains at the patch level through a designed rule-based quality assessment scheme and style clustering. To achieve image quality enhancement and maintain style consistency, we formulate the image quality enhancement as a collaborative self-supervised domain adaptation task for disentangling the low-quality factors, medical image content, and illumination style characteristics by exploring intrinsic supervision in the low-quality medical images. Finally, we perform extensive experiments on six benchmark datasets of medical images, and the experimental results demonstrate that DASQE attains state-of-the-art performance. Furthermore, we explore the impact of the proposed method on various clinical tasks, such as retinal fundus vessel/lesion segmentation, nerve fiber segmentation, polyp segmentation, skin lesion segmentation, and disease classification. The results demonstrate that DASQE is advantageous for diverse downstream image analysis tasks.
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