Feature-Spectral Fragility in Segmentation: Dataset Dependence, Architecture-Specific Localization, and Spectral Correlates

Model robustness against natural image corruptions is essential for safety-critical applications. While existing methods primarily focus on implicit representation learning, we provide the first systematic exploration of computational pathways to explicitly characterize internal robustness. We identify a progressive decay of robust features across network layers and establish a functional dependency between the prevalence of these features and model performance. To exploit these insights, we propose Suppress and Diversify (S&D), a non-intrusive refinement approach that enhances robustness by dynamically selecting robust pathways and diversifying them through symmetry-preserving transformations. S&D is architecture-agnostic, parameter-free, and incurs zero test-time overhead. Extensive evaluations across eight benchmarks demonstrate that S&D consistently improves performance across multiple vision tasks, diverse backbones, and complex real-world scenarios, highlighting its broad efficacy and scalability.

Foundation segmentation models such as the Segment Anything Model (SAM) have demonstrated strong generalization across natural images; however, their robustness under clinically realistic medical imaging domain shifts remains insufficiently quantified. We present a systematic slice-level robustness audit of SAM (ViT-B) for spleen segmentation in abdominal CT using 1,051 nonempty slices from 41 volumes in the Medical Segmentation Decathlon. A standardized ground-truth-derived bounding-box protocol was used to isolate encoder robustness from prompt uncertainty. Controlled perturbations simulating inter-scanner variability, including Gaussian noise, blur, contrast scaling, gamma correction, and resolution mismatch, were applied across ten conditions. The clean baseline achieved a mean Dice score of 0.9145 (95% CI: [0.909, 0.919]) with a failure rate of 0.67%. Across all perturbations, the absolute mean ΔDice remained below 0.01. Paired Wilcoxon signed-rank tests with Benjamini-Hochberg false discovery rate correction identified statistically significant but small-magnitude changes under selected conditions, while McNemar analysis showed no significant increase in failure probability. These findings indicate that SAM exhibits stable segmentation behavior under moderate CT domain shifts, supporting its role as a robust foundation baseline for medical image segmentation research. As health digital twins increasingly incorporate foundation segmentation models for anatomical modeling and organ-level monitoring, formal characterization of robustness under real-world imaging variability is a necessary step toward trustworthy deployment.

Accurate medical image segmentation requires effective modeling of both global anatomical structures and fine-grained boundary details. Recent state space models (e.g., Vision Mamba) offer efficient long-range dependency modeling. However, their one-dimensional serialization weakens local spatial continuity and high-frequency representation. To this end, we propose SpectralMamba-UNet, a novel frequency-disentangled framework to decouple the learning of structural and textural information in the spectral domain. Our Spectral Decomposition and Modeling (SDM) module applies discrete cosine transform to decompose low- and high-frequency features, where low frequency contributes to global contextual modeling via a frequency-domain Mamba and high frequency preserves boundary-sensitive details. To balance spectral contributions, we introduce a Spectral Channel Reweighting (SCR) mechanism to form channel-wise frequency-aware attention, and a Spectral-Guided Fusion (SGF) module to achieve adaptively multi-scale fusion in the decoder. Experiments on five public benchmarks demonstrate consistent improvements across diverse modalities and segmentation targets, validating the effectiveness and generalizability of our approach.