SGDC: Structurally-Guided Dynamic Convolution for Medical Image Segmentation

Accurate medical image segmentation is fundamental to precision medicine, yet robust delineation remains challenging under heterogeneous appearances, ambiguous boundaries, and large anatomical variability. Similar intensity and texture patterns between targets and surrounding tissues often lead to blurred activations and unreliable separation. We attribute these failures to representation collapse during encoding and insufficient fine grained multi scale decoding. To address these issues, we propose Med DisSeg, a dispersion driven medical image segmentation framework that jointly improves representation learning and anatomical delineation. Med DisSeg combines a lightweight Dispersive Loss with adaptive attention for fine grained structure segmentation. The Dispersive Loss enlarges inter sample margins by treating in batch hidden representations as negative pairs, producing well dispersed and boundary aware embeddings with negligible overhead. Based on these enhanced representations, the encoder strengthens structure sensitive responses, while the decoder performs adaptive multi scale calibration to preserve complementary local texture and global shape information. Extensive experiments on five datasets spanning three imaging modalities demonstrate consistent state of the art performance. Moreover, Med DisSeg achieves competitive results on multi organ CT segmentation, supporting its robustness and cross task applicability.

Small object segmentation in medical imaging is primarily hindered by class imbalance and inherent boundary complexity. Consequently, conventional global networks frequently fail to detect sparse targets or suffer from severe edge degradation. To overcome these limitations, we propose the Detection-guided Cropping Segmentation Network (DCSNet), an end-to-end framework that transforms global dense prediction into a localized refinement process. This framework integrates two core components, namely Detection-guided Hierarchical Cropping (DGHC) and Multiscale Feature Aggregation (MSFA). The DGHC module leverages region proposals to dynamically extract object-centric features, effdataectively filtering out massive background interference to mitigate class imbalance. Subsequently, the MSFA module operates strictly within these purified regions, synergizing a Transformer encoder with a pixel-adaptive fusion strategy. This mechanism dynamically aggregates multiscale features to capture both semantic context and fine-grained details for sharp boundary delineation. Extensive experiments across three diverse medical datasets demonstrate that DCSNet significantly outperforms existing state-of-the-art methods, yielding substantial improvements in boundary precision and offering a highly robust solution for clinical micro-lesion segmentation.

Medical image segmentation is crucial for computer-aided diagnosis, which necessitates understanding both coarse morphological and semantic structures, as well as carving fine boundaries. The morphological and semantic structures in medical images are beneficial and stable clues for target understanding. While the fine boundaries of medical targets (like tumors and lesions) are usually ambiguous and noisy since lesion overlap, annotation uncertainty, and so on, making it not reliable to serve as early supervision. However, existing methods simultaneously learn coarse structures and fine boundaries throughout the training process. In this paper, we propose a structure and progress-aware diffusion (SPAD) for medical image segmentation, which consists of a semantic-concentrated diffusion (ScD) and a boundary-centralized diffusion (BcD) modulated by a progress-aware scheduler (PaS). Specifically, the semantic-concentrated diffusion introduces anchor-preserved target perturbation, which perturbs pixels within a medical target but preserves unaltered areas as semantic anchors, encouraging the model to infer noisy target areas from the surrounding semantic context. The boundary-centralized diffusion introduces progress-aware boundary noise, which blurs unreliable and ambiguous boundaries, thus compelling the model to focus on coarse but stable anatomical morphology and global semantics. Furthermore, the progress-aware scheduler gradually modulates noise intensity of the ScD and BcD forming a coarse-to-fine diffusion paradigm, which encourage focusing on coarse morphological and semantic structures during early target understanding stages and gradually shifting to fine target boundaries during later contour adjusting stages.