ScribbleDose: Scribble-Guided Dose Prediction in Radiotherapy

Anatomical structure masks are widely adopted in radiotherapy dose prediction, as they provide explicit geometric constraints that facilitate structure-dose coupling. However, conventional manual delineation of these masks requires precise annotation of structure boundaries relevant to radiotherapy, which is time-consuming and labor-intensive. To address these limitations, we propose a scribble-guided dose prediction framework that relies solely on anatomical structures annotated with sparse scribbles. Specifically, we design a Scribble Completion Module (SCM) to generate dense anatomical masks by propagating sparse scribble labels to semantically similar voxels. During the propagation process, a supervoxel-based regularization is introduced to preserve geometric boundary consistency to ensure anatomical plausibility. Furthermore, we propose a Structure-Guided Dose Generation Module (SGDGM) to strengthen the correspondence between sparse structural cues and dose distribution. The completed dense masks derived from scribbles serve as structural guidance to condition dose prediction, forming a scribble-mask-dose learning pipeline under sparse annotation. Experiments on the GDP-HMM dataset demonstrate that ScribbleDose achieves competitive dose prediction performance using only sparse structural annotations. The source code and reannotated scribble annotations are publicly available at https://github.com/iCherishxixixi/ScribbleDose.