Mix-up is a key technique for consistency regularization-based semi-supervised learning methods, generating strong-perturbed samples for strong-weak pseudo-supervision. Existing mix-up operations are performed either randomly or with predefined rules, such as replacing low-confidence patches with high-confidence ones. The former lacks control over the perturbation degree, leading to overfitting on randomly perturbed samples, while the latter tends to generate images with trivial perturbations, both of which limit the effectiveness of consistency learning. This paper aims to answer the following question: How can image mix-up perturbation be adaptively performed during training? To this end, we propose an Adaptive Mix algorithm (AdaMix) for image mix-up in a self-paced learning manner. Given that, in general, a model's performance gradually improves during training, AdaMix is equipped with a self-paced curriculum that, in the initial training stage, provides relatively simple perturbed samples and then gradually increases the difficulty of perturbed images by adaptively controlling the perturbation degree based on the model's learning state estimated by a self-paced regularize. We develop three frameworks with our AdaMix, i.e., AdaMix-ST, AdaMix-MT, and AdaMix-CT, for semi-supervised medical image segmentation. Extensive experiments on three public datasets, including both 2D and 3D modalities, show that the proposed frameworks are capable of achieving superior performance. For example, compared with the state-of-the-art, AdaMix-CT achieves relative improvements of 2.62% in Dice and 48.25% in average surface distance on the ACDC dataset with 10% labeled data. The results demonstrate that mix-up operations with dynamically adjusted perturbation strength based on the segmentation model's state can significantly enhance the effectiveness of consistency regularization.
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