Deep learning is becoming increasingly popular and is being extensively used in the field of medical image analysis. However, the privacy sensitivity of medical data limits the availability of data, which constrains the advancement of medical image analysis and impedes collaboration across multiple centers. To address this problem, we propose a novel encoding-based framework, named Privacy-SF, aimed at implementing privacy-preserving segmentation for medical images. Our proposed segmentation framework consists of three CNN networks: 1) two encoding networks on the client side that encode medical images and their corresponding segmentation masks individually to remove the privacy features, 2) a unique mapping network that analyzes the content of encoded data and learns the mapping from the encoded image to the encoded mask. By sequentially encoding data and optimizing the mapping network, our approach ensures privacy protection for images and masks during both the training and inference phases of medical image analysis. Additionally, to further improve the segmentation performance, we carefully design augmentation strategies specifically for encoded data based on its sequence nature. Extensive experiments conducted on five datasets with different modalities demonstrate excellent performance in privacy-preserving segmentation and multi-center collaboration. Furthermore, the analysis of encoded data and the experiment of model inversion attacks validate the privacy-preserving capability of our approach.
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