Towards Voxel Spacing Consistency for Medical Image Segmentation

Volumetric medical image segmentation is essential for both preoperative diagnosis and intraoperative guidance. While recent years have witnessed rapid progress in segmentation architectures, comparatively little attention is paid to the physical voxel spacing of anatomical data. Indeed, volumetric image resampling is a ubiquitous preprocessing step before segmentation, yet its interaction with downstream segmentation has not been systematically exploited. In this work, we study the correlation between image resampling and segmentation, and propose Consispace, a semantic-aware resampling framework that achieves consistent voxel spacing in the axial direction while preserving anatomical and semantic consistency. Consispace introduces an ODE-based anatomical constraint to model inter-slice dynamics with a continuous interpolator, enabling faithful reconstruction under complex anatomical transitions beyond discrete interpolation. To further couple resampling with segmentation objectives, we leverage dense features from a pretrained vision model to build intra-slice semantic correlation maps and inject class-wise semantic consistency via feature reweighting during resampling. Both intra-slice and inter-slice constraints are integrated into an implicit neural network, supporting arbitrary-scale resampling. Extensive experiments on multiple datasets demonstrate that Consispace achieves superior reconstruction quality and perceptual fidelity, produces smoother inter-slice anatomy, and improves downstream segmentation performance when used as a preprocessing step.