Structure-Guided Self-Supervised Matching for One-Shot Medical Landmark Detection

Medical landmark detection usually requires accurate expert annotations, which are laborious and difficult to scale across anatomical regions. In this work, we study an extreme annotation-efficient setting where only a single annotated template image is available. We propose SGB-Match, a structure-guided coarse-to-fine self-supervised matching framework for one-shot medical landmark detection. The framework first learns dense anatomical correspondence from unlabeled augmented image pairs, and then transfers the landmark definition from the annotated template to each target image through feature matching. Different from standard contrastive correspondence learning, where negative candidates are penalized by a structure-agnostic rule, we introduce a structure-guided bias into the contrastive objective. The bias is constructed from relative distance and edge-aware anatomical cues, and explicitly reweights the negative gradients: nearby structure-relevant candidates are weakly repelled, while distant or structure-irrelevant negatives are strongly suppressed. As a result, the learned feature space better preserves local anatomical structures around template landmarks and reduces confusing responses from repeated textures. We further adopt a global-to-local design, where a global encoder provides coarse landmark localization and a local encoder refines the prediction in a cropped region. Extensive experiments on four 2D radiological landmark datasets demonstrate that SGB-Match achieves strong one-shot performance across both public and newly collected datasets and consistently benefits from both structure-guided bias and two-stage refinement.