UHR-Net: An Uncertainty-Aware Hypergraph Refinement Network for Medical Image Segmentation

Accurate skin lesion segmentation is vital for dermoscopic Computer-Aided Diagnosis. However, visual ambiguity and morphological irregularity often defeat spatial modeling, necessitating multi-domain architectures. Existing paradigms frequently overlook the active use of prediction uncertainty, leading to deterministic frameworks that suffer from blind cross-domain fusion and overfit to label noise. To address these issues, we propose the Uncertainty-Guided Dual-Domain Network (UGDD-Net). UGDD-Net introduces a novel "Glance-and-Gaze" mechanism to transform uncertainty into an active guiding signal. Specifically, the Uncertainty-Guided Bi-directional Feature Fusion (UGBFF) module uses pixel-level uncertainty to modulate spatial-spectral interactions. The Uncertainty-Guided Graph Refinement (UGGR) module constructs a topology-aware graph to propagate reliable semantic consensus and refine uncertain nodes. Finally, the Uncertainty-Guided Margin-Adaptive Loss (UGML) enforces strict constraints on confident pixels while relaxing penalties on uncertain ones to improve statistical calibration. Extensive experiments on ISIC2017, ISIC2018, PH2, and HAM10000 datasets demonstrate that UGDD-Net achieves state-of-the-art performance, especially on "Hard Samples". Our uncertainty maps align with expert inter-observer variability, providing robust interpretability for human-machine collaborative diagnosis.

Accurate biomedical image segmentation requires not only high global overlap but also reliable delineation of clinically meaningful boundaries. In blood-smear microscopy, cytoplasm and nucleus contours provide the structural basis for downstream morphology analysis; however, deep segmentation models may remain uncertain or overconfident near ambiguous boundary regions even when achieving strong Dice scores. This work proposes a Reliability-Aware Boundary Refinement Network (RABR-Net), a two-stage framework for trustworthy image segmentation. A strong UNet++ EfficientNet-B4 base segmenter first produces initial class probabilities and logits. Predictive entropy, test-time augmentation variance, margin uncertainty, probability gradients, and soft boundary cues are then combined into a boundary-aware reliability representation. This representation guides a gated residual refiner that selectively corrects uncertain boundary pixels while preserving confident regions of the base prediction. The framework is evaluated using overlap accuracy, class-wise Dice, Boundary Dice, HD95/ASSD, calibration, risk--coverage analysis, robustness under image perturbations, qualitative correction maps, and paired statistical testing. On the held-out test set, the proposed method improves Dice from 0.9602 to 0.9614, Boundary Dice from 0.3448 to 0.3611, and HD95 from 3.0354 to 2.8274 compared with the cached base prediction. Statistical analysis confirms significant improvements in Dice, Boundary Dice, and HD95. Qualitative results show that the learned gate concentrates around uncertain cytoplasm and nucleus boundaries, and correction maps confirm localized boundary refinement. Although calibration does not automatically improve after refinement, the proposed framework provides an interpretable and reliability-focused strategy for boundary-sensitive biomedical image segmentation.

Image segmentation remains fundamentally limited by boundary ambiguity arising from sampling-induced information loss and inherent uncertainty in pixel-wise labeling. Although encoder-decoder architectures such as U-Net achieve strong performance, they often produce overconfident predictions that fail to capture transition-region ambiguity. To address this issue, we propose \textbf{NoiseUNet}, a simple yet effective framework that injects bounded perturbations into skip connections to regularize cross-scale feature fusion. This mechanism enforces robustness to local feature variations and promotes boundary-aware representations. Theoretically, the perturbation induces an implicit fuzzification effect, yielding soft, data-driven memberships without requiring explicit fuzzy modeling. We further introduce \textbf{ThyR}, a real-world thyroid ultrasound dataset with inherently ambiguous boundaries. Experiments demonstrate that NoiseUNet consistently improves both segmentation accuracy and boundary fidelity.