Rethinking Model Calibration through Spectral Entropy Regularization in Medical Image Segmentation

Deep neural networks for medical image segmentation often produce overconfident predictions, posing clinical risks due to miscalibrated uncertainty estimates. In this work, we rethink model calibration from a frequency-domain perspective and identify two critical factors causing miscalibration: spectral bias, where models overemphasize low-frequency components, and confidence saturation, which suppresses overall power spectral density in confidence maps. To address these challenges, we propose a novel frequency-aware calibration framework integrating spectral entropy regularization and power spectral smoothing. The spectral entropy term promotes a balanced frequency spectrum and enhances overall spectral power, enabling better modeling of high-frequency boundary and low-frequency structural uncertainty. The smoothing module stabilizes frequency-wise statistics across training batches, reducing sample-specific fluctuations. Extensive experiments on six public medical imaging datasets and multiple segmentation architectures demonstrate that our approach consistently improves calibration metrics without sacrificing segmentation accuracy.