RUFNet: Query-Guided Support Mask Refinement and Uncertainty Fusion based on Hybrid Mamba for Few-Shot Brain Tumor Segmentation

Dongyi He, Xiangkai Wang, Binbing Xu, Bin Jiang, Hongjie Yan, Weixiang Liu, Wai Ting Siok, Nizhuan Wang

Few-shot brain tumor segmentation remains challenging due to noisy support masks, inter-patient variations between support and query images, and the lack of pixel-wise confidence estimation. This study proposes RUFNet, a Hybrid Mamba-based few-shot framework that combines support mask refinement with uncertainty-aware posterior fusion. To preserve support-query dependencies with manageable cost, RUFNet adopts a Hybrid Mamba interaction backbone with linear complexity. To reduce support-mask noise, an Attention-Guided Mask Refinement module (AGMR) uses query features to recalibrate support masks and improve prototype consistency. To handle ambiguous predictions, an Uncertainty-Aware Posterior Fusion module (UAPF) estimates pixel-wise variance and adaptively balances few-shot predictions with query-aligned priors. On the Brain Tumor Segmentation Challenge (BraTS) 2020 dataset, RUFNet achieves Dice coefficients of 84.3% and 86.1% in the 1-way 1-shot and 1-way 5-shot settings, respectively, outperforming the compared state-of-the-art methods. These results suggest that Hybrid Mamba interaction, mask refinement and uncertainty modelling can improve the robustness of few-shot medical image segmentation. The official implementation code is available at https://github.com/hdy6438/RUFNet.