BTI-Net: Bidirectional Decoder-Level Task Interaction via Uncertainty-Aware Gating for Multi-Task Medical Image Analysis

Jointly learning to segment and classify medical images demands cross-task synergy, yet encoder-sharing architectures limit decoder reconstruction to task-private representations, permanently discarding the boundary cues and semantic priors each branch could supply to the other. This work introduces BTI-Net, which establishes bidirectional communication at every decoder level through two parallel pathways via Task Interaction Modules (TIM). Spatial boundary context is gated into the classification branch, while global semantic priors multiplicatively modulate the decoder, with refined features propagating progressively from coarse semantics to fine boundary detail across all four decoder resolutions. Since cross-task interaction is not equally reliable for every input, Uncertainty Proxy Attention (UPA) gates each TIM output per instance and per level using three signals that capture cross-task alignment, scene complexity, and prediction confidence, without external annotations or additional inference passes. Experiments on three medical benchmarks spanning ultrasound, dermoscopy, and brain MRI demonstrate consistent improvements in segmentation IoU and classification accuracy over both encoder-sharing and decoder-interaction baselines. Ablation confirms adaptive gating contributes +2.36 IoU over fixed bidirectional interaction, and classification accuracy improves by up to +2.26 points over the strongest multi-task baseline. UPA's uncertainty proxies serve as reliable single-pass task-failure signals without the overhead of stochastic sampling. Code: https://github.com/C-loud-Nine/BTI-Net_MTL