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. Herein, the completed dense masks derived from scribbles serve as structural guidance to condition the dose prediction network. This scribble-mask-dose consistency encourages high-dose concentration within target volumes while effectively sparing surrounding organs-at-risk. Extensive experiments on the open-source GDP-HMM dataset demonstrate that the proposed method maintains superior dose prediction performance while substantially reducing annotation cost, providing a practical paradigm for dose prediction under sparse structural annotation. The code and reannotated scribbles are made publicly available at https://github.com/iCherishxixixi/ScribbleDose.