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.
Medical ultrasound (US) image segmentation faces significant challenges due to speckle noise, low-contrast boundaries, acoustic shadowing, and acquisition variation across operators and clinical centers. Although encoder-decoder and transformer-based networks have achieved strong performance, many methods recover boundary details through dense decoders or larger backbones, which may still produce over-smoothed contours or unstable predictions under external distribution shifts. In this article, we propose Risk-routed Implicit Boundary Refinement (RIBR), a compact segmentation framework that uses implicit neural representation as a risk-routed residual correction rather than an unconstrained full-mask predictor. RIBR combines boundary-refinement implicit residuals, risk-routed residual control, and geometry- and speckle-aware boundary regularization to refine uncertain contours while suppressing non-boundary oscillations. Evaluation on nine US datasets covering lymph nodes, breast lesions, thyroid nodules, and prostate shows that RIBR achieves the best overall macro-average and consistently reduces boundary error across grouped and organ-specific comparisons under a compact parameter budget. These findings suggest that controlled implicit residual learning is a practical strategy for resource-constrained and boundary-sensitive US segmentation. Source code is available at https://github.com/jinggqu/ribr.
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.
Reliable uncertainty estimation is critical for medical image segmentation, where automated contours feed downstream quantification and clinical decision support. Many strong uncertainty methods require repeated inference, while efficient single-forward-pass alternatives often provide weaker failure ranking or rely on restrictive feature-space assumptions. We present SegWithU, a post-hoc framework that augments a frozen pretrained segmentation backbone with a lightweight uncertainty head. SegWithU taps intermediate backbone features and models uncertainty as perturbation energy in a compact probe space using rank-1 posterior probes. It produces two voxel-wise uncertainty maps: a calibration-oriented map for probability tempering and a ranking-oriented map for error detection and selective prediction. Across ACDC, BraTS2024, and LiTS, SegWithU is the strongest and most consistent single-forward-pass baseline, achieving AUROC/AURC of 0.9838/2.4885, 0.9946/0.2660, and 0.9925/0.8193, respectively, while preserving segmentation quality. These results suggest that perturbation-based uncertainty modeling is an effective and practical route to reliability-aware medical segmentation. Source code is available at https://github.com/ProjectNeura/SegWithU.