Energy-guided Dual Domain-invariant Prompting Framework with Fourier Regularization for Generalized Few-Shot Medical Segmentation

Precise segmentation of organ and tissue lesions is essential for clinical diagnosis and treatment. Despite the progress of deep learning and foundation segmentation models, their domain generalization capability remains limited particularly when dealing with cross-domain scenarios or unseen data, leading to significant performance degradation. Current medical SAM-based generalization methods face two primary challenges: First, existing prompt-tuning strategies inadequately capture key domain-invariant features; Second, the reliance on fully labeled source domain data is unrealistic in clinical practice. To address these challenges, we propose a novel Dual domain-Invariant Prompt Optimization (DIPO) enhanced by energy-guided augmentation and frequency consistency regularization for few-shot medical image segmentation generalization. Our approach introduces a multi-band momentum enhancement strategy to dynamically augment source data by leveraging diverse frequency bands of the Fourier amplitude spectrum. Furthermore, we integrate multiscale geometric representation-based non-subsampled shearlet transform and text prompts to strengthen the extraction of shape- and texture-related domain-invariant features. Finally, we employ frequency consistency regularization to refine model robustness using predictions from unlabeled data. Experimental results in prostate and fundus datasets demonstrate that our method significantly outperforms current state-of-the-art methods.