ActiveFreq: Integrating Active Learning and Frequency Domain Analysis for Interactive Segmentation

Interactive image segmentation is critical for efficient image annotation; however, existing methods often require many corrective clicks or rely on passive refinement schemes that converge slowly. We propose Uncertainty-Guided Cascade Forward Refinement (U-CFR), a novel inference-time framework that enables models to autonomously self-correct after each user interaction. U-CFR introduces a boundary-aware uncertainty score that fuses segmentation uncertainty, contour gradients, and explicit edge predictions to guide the placement of internal pseudo-clicks. These self-generated clicks target the most ambiguous boundary regions, providing strong corrective signals without additional manual input. To support this process, we design a dual-head network with a shared encoder-decoder backbone: a segmentation head ensures region consistency, while an edge head sharpens boundary alignment. In inference, U-CFR launches a cascade of refinement steps, where each stage leverages the uncertainty-driven pseudo-clicks to refine the mask progressively. Experiments on standard benchmark datasets demonstrate that the proposed U-CFR improves click efficiency, initial mask quality, and boundary accuracy. It reduces the required clicks by over 10% on challenging datasets like Berkeley and offers a more intelligent and efficient interactive annotation.

Interactive deep image segmentation enables efficient medical image annotation by iteratively refining predictions from user prompts, such as positive and negative clicks. Recent patch-based methods, including nnInteractive, achieve strong segmentation performance but remain limited in annotation workflows by high interaction latency, limited responsiveness to successive interactions, and the lack of support for reversible prompting. Furthermore, evaluation relies predominantly on simulated rather than controlled real-user interaction studies. We present SLIP, an end-to-end trainable framework for interactive 3D medical image segmentation that decouples image encoding from prompt-guided refinement. Image features are computed once and reused, while a lightweight patch memory bank maintains an interaction-aware segmentation state shared across patches. This representation enables prediction updates by propagating interaction context throughout the image, supports reversible prompting without recomputing image features, and substantially reduces interaction latency. By separating image representation from interactive reasoning, SLIP remains compatible with a wide range of image encoders. We train a single SLIP model for general interactive segmentation across diverse anatomical structures and imaging modalities. Beyond standard simulated evaluation, we conduct a controlled prospective user study comparing manual segmentation, nnInteractive, and SLIP across three clinical annotation tasks, six expert participants, and subjective usability measures, addressing the limited human validation of interactive segmentation methods. SLIP achieves SOTA interactive segmentation performance across 13 public datasets while providing lower interaction latency, greater responsiveness, support for reversible prompting, and higher user preference than existing approaches.

Recent advancements in deep learning-based interactive segmentation methods have significantly improved pathology image segmentation. Most existing approaches utilize user-provided positive and negative clicks to guide the segmentation process. However, these methods primarily rely on iterative global updates for refinement, which lead to redundant re-prediction and often fail to capture fine-grained structures or correct subtle errors during localized adjustments. To address this limitation, we propose the Click-based Local Refinement (Clore) pipeline, a simple yet efficient method designed to enhance interactive segmentation. The key innovation of Clore lies in its hierarchical interaction paradigm: the initial clicks drive global segmentation to rapidly outline large target regions, while subsequent clicks progressively refine local details to achieve precise boundaries. This approach not only improves the ability to handle fine-grained segmentation tasks but also achieves high-quality results with fewer interactions. Experimental results on four datasets demonstrate that Clore achieves the best balance between segmentation accuracy and interaction cost, making it an effective solution for efficient and accurate interactive pathology image segmentation.