UCBound-Net is introduced, a continual segmentation framework that exploits Monte Carlo (MC) Dropout uncertainty as a spatial proxy for forgetting risk and outperforms baseline methods without requiring task-boundary supervision.
Abstract
Continual learning in clinical imaging faces a dual challenge: a model must assimilate knowledge from new anatomical domains while retaining representations learned from prior tasks, a problem known as catastrophic forgetting. Existing mitigation strategies, including regularization and knowledge distillation, treat all spatial regions equally, ignoring the fact that prediction uncertainty is strongly correlated with the propensity for forgetting. We introduce UCBound-Net, a continual segmentation framework that exploits Monte Carlo (MC) Dropout uncertainty as a spatial proxy for forgetting risk. Our method contributes three synergistic components: (i) uncertainty-weighted boundary distillation, which amplifies the knowledge transfer signal at high-entropy regions of the frozen teacher; (ii) uncertainty-calibration regularization, which explicitly penalizes overconfident erroneous predictions; and (iii) uncertainty-guided exemplar selection, a memory buffer that preferentially stores samples whose boundary regions exhibit the highest predictive entropy. Evaluated on a sequential domain-incremental benchmark comprising breast ultrasound (BUSI, Task 1) followed by thyroid ultrasound (TN3K, Task 2), UCBound-Net reduces forgetting relative to naive fine-tuning, achieving a backward transfer (BWT) of -0.098 compared with -0.173, while obtaining an average Dice Similarity Coefficient (DSC) of 0.755 across both tasks. The proposed framework outperforms baseline methods without requiring task-boundary supervision. An ablation study further demonstrates that each component contributes independently to forgetting mitigation, providing a practical pathway toward uncertainty-aware continual learning for clinical image segmentation.
This work proposes an uncertainty-aware efficient segmentation framework synergizing Mamba state-space models with evidential deep learning, employing a 2D-adapted selective state-space mechanism to capture long-range dependencies with linear complexity O(L), overcoming transformers' quadratic scaling.
A comprehensive survey of UQ techniques in medical image segmentation is presented, categorizing existing approaches into Bayesian methods, deep ensembles, deterministic methods, test-time data augmentation, and hybrid models, while treating foundation-model-based UQ as a separate cross-cutting category.
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Reciprocal Distillation with a Frozen Foundation Model (ReDi-FM), a novel framework with two core components: using structure-aware prompts from the source model to guide the frozen VFM to generate target-adapted supervision, and distilling the resulting knowledge back into the adapting model.
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A Dynamic Uncertainty-aware Network (DynU-Net) is proposed, a multi-task framework that adaptively balances segmentation and classification through learnable per-task uncertainty parameters that consistently outperforms both single-task and existing multi-task baselines.
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These findings expose a fundamental mismatch between the theoretical promise of aleatoric uncertainty and its practical behavior, and suggest that practitioners should not rely on entropy-based uncertainty as a proxy for clinical ambiguity in safety-critical applications.
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