Real-Time Self-Supervised Ultrasound Image Enhancement Using Test-Time Adaptation for Sophisticated Rotator Cuff Tear Diagnosis

Medical ultrasound imaging is a key diagnostic tool across various fields, with computer-aided diagnosis systems benefiting from advances in deep learning. However, its lower resolution and artifacts pose challenges, particularly for non-specialists. The simultaneous acquisition of degraded and high-quality images is infeasible, limiting supervised learning approaches. Additionally, self-supervised and zero-shot methods require extensive processing time, conflicting with the real-time demands of ultrasound imaging. Therefore, to address the aforementioned issues, we propose real-time ultrasound image enhancement via a self-supervised learning technique and a test-time adaptation for sophisticated rotational cuff tear diagnosis. The proposed approach learns from other domain image datasets and performs self-supervised learning on an ultrasound image during inference for enhancement. Our approach not only demonstrated superior ultrasound image enhancement performance compared to other state-of-the-art methods but also achieved an 18% improvement in the RCT segmentation performance.