We Care Each Pixel: Calibrating on Medical Segmentation Model

Medical image segmentation is fundamental for computer-aided diagnostics, providing accurate delineation of anatomical structures and pathological regions. While common metrics such as Accuracy, DSC, IoU, and HD primarily quantify spatial agreement between predictions and ground-truth labels, they do not assess the calibration quality of segmentation models, which is crucial for clinical reliability. To address this limitation, we propose pixel-wise Expected Calibration Error (pECE), a novel metric that explicitly measures miscalibration at the pixel level, thereby ensuring both spatial precision and confidence reliability. We further introduce a morphological adaptation strategy that applies morphological operations to ground-truth masks before computing calibration losses, particularly benefiting margin-based losses such as Margin SVLS and NACL. Additionally, we present the Signed Distance Calibration Loss (SDC), which aligns boundary geometry with calibration objectives by penalizing discrepancies between predicted and ground-truth signed distance functions (SDFs). Extensive experiments demonstrate that our method not only enhances segmentation performance but also improves calibration quality, yielding more trustworthy confidence estimates. Code is available at: https://github.com/EagleAdelaide/SDC-Loss.