# DGRNet: Disagreement-Guided Refinement for Uncertainty-Aware Brain Tumor Segmentation

arXiv: https://arxiv.org/abs/2603.21086 · HTML: https://mlsanity.com/paper/2603.21086/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 13 of its 25 references that are in the map.
- First posted on arXiv 22 Mar 2026.

## Builds on (most cited first, 13 of 13)

- [U-Net: Convolutional Networks for Biomedical Image Segmentation](https://mlsanity.com/paper/1505.04597/) (2015)
- [BioBERT: a pre-trained biomedical language representation model for biomedical text mining](https://mlsanity.com/paper/1901.08746/) (2019)
- [Sharpness-Aware Minimization for Efficiently Improving Generalization](https://mlsanity.com/paper/2010.01412/) (2020)
- [Swin UNETR: Swin Transformers for Semantic Segmentation of Brain Tumors in MRI Images](https://mlsanity.com/paper/2201.01266/) (2022)
- [MONAI: An open-source framework for deep learning in healthcare](https://mlsanity.com/paper/2211.02701/) (2022)
- [Aleatoric uncertainty estimation with test-time augmentation for medical image segmentation with convolutional neural networks](https://mlsanity.com/paper/1807.07356/) (2018)
- [LViT: Language meets Vision Transformer in Medical Image Segmentation](https://mlsanity.com/paper/2206.14718/) (2022)
- [NestedFormer: Nested Modality-Aware Transformer for Brain Tumor Segmentation](https://mlsanity.com/paper/2208.14876/) (2022)
- [VividMed: Vision Language Model with Versatile Visual Grounding for Medicine](https://mlsanity.com/paper/2410.12694/) (2024)
- [MedSAM3: Delving into Segment Anything with Medical Concepts](https://mlsanity.com/paper/2511.19046/) (2025)
- [VoxTell: Free-Text Promptable Universal 3D Medical Image Segmentation](https://mlsanity.com/paper/2511.11450/) (2025)
- [Sparse Bayesian Networks: Efficient Uncertainty Quantification in Medical Image Analysis](https://mlsanity.com/paper/2406.06946/) (2024)
- [TextBraTS: Text-Guided Volumetric Brain Tumor Segmentation with Innovative Dataset Development and Fusion Module Exploration](https://mlsanity.com/paper/2506.16784/) (2025)

## Abstract (arXiv)

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.