Beyond Euclidean Prototypes: Spectral Disentanglement and Geodesic Matching for Few-Shot Medical Image Segmentation

Few-Shot Medical Image Segmentation (FSMIS) aims to delineate novel anatomical targets from one or a few annotated support images, addressing the annotation scarcity in medical imaging. Notwithstanding recent advancements, current prototype-based methods are bottlenecked by two coupled limitations: 1) cue entanglement, where a single spatial-domain prototype is forced to summarise organ silhouette, parenchymal texture and boundary appearance simultaneously, so any support-query mismatch on one cue propagates indiscriminately to the others; and 2) topology-blind matching, where cosine similarity measures distance in the ambient Euclidean space and ignores the connectivity of the underlying feature manifold, causing fragmented activations inside low-contrast organs and leakage into neighbouring tissues. To this end, we propose Spectral-Geodesic Prototype Network (SGP-Net), built around a Spectral-Geodesic Prototype Module with two coupled components. A Spectral Prototype Bank (SPB) decomposes support and query features into low-, mid- and high-frequency bands via learnable radial Fourier filters, yielding three disentangled prototypes per class that separately encode shape, texture and boundary cues. A Geodesic Matcher (GM) then replaces cosine similarity with a differentiable heat-diffusion approximation of geodesic distance, propagating matching signals along a feature affinity graph so that on-manifold pixels accumulate consistent responses while off-manifold look-alikes are suppressed. Experiments on three public FSMIS benchmarks demonstrate that SGP-Net achieves competitive performance against recent state-of-the-art methods.