From noisy labels to intrinsic structure: A geometric–structural dual-guided framework for noise-robust medical image segmentation

The effectiveness of convolutional neural networks in medical image segmentation relies on large-scale, high-quality annotations, which are costly and time-consuming to obtain. Even expert-labeled datasets inevitably contain noise arising from subjectivity and coarse delineations, which disrupt feature learning and adversely impact model performance. To address these challenges, this study proposes a Geometric–Structural Dual-Guided Network (GSD-Net), which integrates geometric and structural cues to improve robustness against noisy annotations. It incorporates a Geometric Distance-Aware module that dynamically adjusts pixel-level weights using geometric features, thereby strengthening supervision in reliable regions while suppressing noise. A Structure-Guided Label Refinement module further refines labels with structural priors, and a Knowledge Transfer module enriches supervision and improves sensitivity to local details. To comprehensively assess its effectiveness, we evaluated GSD-Net on six publicly available datasets: four containing three types of simulated label noise, and two with multi-expert annotations that reflect real-world subjectivity and labeling inconsistencies. Experimental results demonstrate that GSD-Net achieves state-of-the-art performance under noisy annotations, achieving improvements of 1.58% on Kvasir, 22.76% on Shenzhen, 8.87% on BU_SUC, and 1.77% on BraTS2020 under S_R simulated noise. The code of this study is available at https://github.com/ortonwang/GSD-Net .