Semi-supervised medical image segmentation (SSMIS) uses consistency learning to regularize model training, which alleviates the burden of pixel-wise manual annotations. However, it often suffers from error supervision from low-quality pseudo labels. Vision-Language Model (VLM) has great potential to enhance pseudo labels by introducing text prompt guided multimodal supervision information. It nevertheless faces the cross-modal problem: the obtained messages tend to correspond to multiple targets. To address aforementioned problems, we propose a Dual Semantic Similarity-Supervised VLM (DuSSS) for SSMIS. Specifically, 1) a Dual Contrastive Learning (DCL) is designed to improve cross-modal semantic consistency by capturing intrinsic representations within each modality and semantic correlations across modalities. 2) To encourage the learning of multiple semantic correspondences, a Semantic Similarity-Supervision strategy (SSS) is proposed and injected into each contrastive learning process in DCL, supervising semantic similarity via the distribution-based uncertainty levels. Furthermore, a novel VLM-based SSMIS network is designed to compensate for the quality deficiencies of pseudo-labels. It utilizes the pretrained VLM to generate text prompt guided supervision information, refining the pseudo label for better consistency regularization. Experimental results demonstrate that our DuSSS achieves outstanding performance with Dice of 82.52%, 74.61% and 78.03% on three public datasets (QaTa-COV19, BM-Seg and MoNuSeg).
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