GRAFNet: Multiscale Retinal Processing via Guided Cortical Attention Feedback for Enhancing Medical Image Polyp Segmentation

Accurate polyp segmentation in colonoscopy is essential for cancer prevention but remains challenging due to: (1) high morphological variability (from flat to protruding lesions), (2) strong visual similarity to normal structures such as folds and vessels, and (3) the need for robust multi-scale detection. Existing deep learning approaches suffer from unidirectional processing, weak multi-scale fusion, and the absence of anatomical constraints, often leading to false positives (over-segmentation of normal structures) and false negatives (missed subtle flat lesions). We propose GRAFNet, a biologically inspired architecture that emulates the hierarchical organisation of the human visual system. GRAFNet integrates three key modules: (1) a Guided Asymmetric Attention Module (GAAM) that mimics orientation-tuned cortical neurones to emphasise polyp boundaries, (2) a MultiScale Retinal Module (MSRM) that replicates retinal ganglion cell pathways for parallel multi-feature analysis, and (3) a Guided Cortical Attention Feedback Module (GCAFM) that applies predictive coding for iterative refinement. These are unified in a Polyp Encoder-Decoder Module (PEDM) that enforces spatial-semantic consistency via resolution-adaptive feedback. Extensive experiments on five public benchmarks (Kvasir-SEG, CVC-300, CVC-ColonDB, CVC-Clinic, and PolypGen) demonstrate consistent state-of-the-art performance, with 3-8% Dice improvements and 10-20% higher generalisation over leading methods, while offering interpretable decision pathways. This work establishes a paradigm in which neural computation principles bridge the gap between AI accuracy and clinically trustworthy reasoning. Code is available at https://github.com/afofanah/GRAFNet.