UNIVERS: Learning UNIversal Voxel-wise Embedding via Randomized Synthesis for generalizable one-shot landmark localization

One-shot landmark localization in volume scans with varying fields of view (FOVs) is challenging. While existing self-supervised learning methods have shown promising performance, they rely on contrastive learning built upon augmented views of the same image, which inherently limits their generalization in cross-modality scenarios. This motivates research on cross-modality embedding learning using paired multi-modality images. However, existing methods suffer from not only limited training data, but also the requirement of multi-stage iterative training. To address these limitations, we propose UNIVERS, an end-to-end trainable framework that learns UNIversal Voxel-wise Embedding via Randomized Synthesis. Our framework leverages diverse pseudo-data synthesized from organ shape templates, with randomization applied to semantic layout, visual appearance, FOV, and spatial pose. Coupled with cross-domain discriminative voxel-wise contrastive learning, this domain randomization strategy forces the network to disregard domain-specific biases and learn features that are robust against variations in imaging contrast, resolution, and spatial context. Consequently, the trained model enables one-shot landmark localization in multi-modality volume scans with arbitrary FOVs. In this study, the efficacy of the proposed method is demonstrated by applying it to the task of localizing the adrenal glands, which are paired, small, and irregular endocrine organs. In particular, comprehensive experiments are conducted on three challenging adrenal gland datasets. The experimental results demonstrate that UNIVERS consistently outperforms the state-of-the-art (SOTA) one-shot landmark localization approaches, with particularly prominent advantages in cross-modality scenarios. The source code is publicly available at https://github.com/Kendra9999/UNIVERS.