Abstract:Accurate brain tumor segmentation from MRI scans is critical for diagnosis and treatment planning. Despite the strong performance of recent deep learning approaches, two fundamental limitations remain: (1) the lack of reliable uncertainty quantification in single-model predictions, which is essential for clinical deployment because the level of uncertainty may impact treatment decision-making, and (2) the under-utilization of rich information in radiology reports that can guide segmentation in ambiguous regions. In this paper, we propose the Disagreement-Guided Refinement Network (DGRNet), a novel framework that addresses both limitations through multi-view disagreement-based uncertainty estimation and text-conditioned refinement. DGRNet generates diverse predictions via four lightweight view-specific adapters attached to a shared encoder-decoder, enabling efficient uncertainty quantification within a single forward pass. Afterward, we build disagreement maps to identify regions of high segmentation uncertainty, which are then selectively refined according to clinical reports. Moreover, we introduce a diversity-preserving training strategy that combines pairwise similarity penalties and gradient isolation to prevent view collapse. The experimental results on the TextBraTS dataset show that DGRNet favorably improves state-of-the-art segmentation accuracy by 2.4% and 11% in main metrics Dice and HD95, respectively, while providing meaningful uncertainty estimates.
Abstract:Brain tumor segmentation remains challenging because the three standard sub-regions, i.e., whole tumor (WT), tumor core (TC), and enhancing tumor (ET), often exhibit ambiguous visual boundaries. Integrating radiological description texts with imaging has shown promise. However, most multimodal approaches typically compress a report into a single global text embedding shared across all sub-regions, overlooking their distinct clinical characteristics. We propose TextCSP (text-modulated soft cascade architecture), a hierarchical text-guided framework that builds on the TextBraTS baseline with three novel components: (1) a text-modulated soft cascade decoder that predicts WT->TC->ET in a coarse-to-fine manner consistent with their anatomical containment hierarchy. (2) sub-region-aware prompt tuning, which uses learnable soft prompts with a LoRA-adapted BioBERT encoder to generate specialized text representations tailored for each sub-region; (3) text-semantic channel modulators that convert the aforementioned representations into channel-wise refinement signals, enabling the decoder to emphasize features aligned with clinically described patterns. Experiments on the TextBraTS dataset demonstrate consistent improvements across all sub-regions against state-of-the-art methods by 1.7% and 6% on the main metrics Dice and HD95.