No Arabic abstract
Despite the state-of-the-art performance for medical image segmentation, deep convolutional neural networks (CNNs) have rarely provided uncertainty estimations regarding their segmentation outputs, e.g., model (epistemic) and image-based (aleatoric) uncertainties. In this work, we analyze these different types of uncertainties for CNN-based 2D and 3D medical image segmentation tasks. We additionally propose a test-time augmentation-based aleatoric uncertainty to analyze the effect of different transformations of the input image on the segmentation output. Test-time augmentation has been previously used to improve segmentation accuracy, yet not been formulated in a consistent mathematical framework. Hence, we also propose a theoretical formulation of test-time augmentation, where a distribution of the prediction is estimated by Monte Carlo simulation with prior distributions of parameters in an image acquisition model that involves image transformations and noise. We compare and combine our proposed aleatoric uncertainty with model uncertainty. Experiments with segmentation of fetal brains and brain tumors from 2D and 3D Magnetic Resonance Images (MRI) showed that 1) the test-time augmentation-based aleatoric uncertainty provides a better uncertainty estimation than calculating the test-time dropout-based model uncertainty alone and helps to reduce overconfident incorrect predictions, and 2) our test-time augmentation outperforms a single-prediction baseline and dropout-based multiple predictions.
Machine learning plays an increasingly significant role in many aspects of our lives (including medicine, transportation, security, justice and other domains), making the potential consequences of false predictions increasingly devastating. These consequences may be mitigated if we can automatically flag such false predictions and potentially assign them to alternative, more reliable mechanisms, that are possibly more costly and involve human attention. This suggests the task of detecting errors, which we tackle in this paper for the case of visual classification. To this end, we propose a novel approach for classification confidence estimation. We apply a set of semantics-preserving image transformations to the input image, and show how the resulting image sets can be used to estimate confidence in the classifiers prediction. We demonstrate the potential of our approach by extensively evaluating it on a wide variety of classifier architectures and datasets, including ResNext/ImageNet, achieving state of the art performance. This paper constitutes a significant revision of our earlier work in this direction (Bahat & Shakhnarovich, 2018).
Accurate medical image segmentation is essential for diagnosis and treatment planning of diseases. Convolutional Neural Networks (CNNs) have achieved state-of-the-art performance for automatic medical image segmentation. However, they are still challenged by complicated conditions where the segmentation target has large variations of position, shape and scale, and existing CNNs have a poor explainability that limits their application to clinical decisions. In this work, we make extensive use of multiple attentions in a CNN architecture and propose a comprehensive attention-based CNN (CA-Net) for more accurate and explainable medical image segmentation that is aware of the most important spatial positions, channels and scales at the same time. In particular, we first propose a joint spatial attention module to make the network focus more on the foreground region. Then, a novel channel attention module is proposed to adaptively recalibrate channel-wise feature responses and highlight the most relevant feature channels. Also, we propose a scale attention module implicitly emphasizing the most salient feature maps among multiple scales so that the CNN is adaptive to the size of an object. Extensive experiments on skin lesion segmentation from ISIC 2018 and multi-class segmentation of fetal MRI found that our proposed CA-Net significantly improved the average segmentation Dice score from 87.77% to 92.08% for skin lesion, 84.79% to 87.08% for the placenta and 93.20% to 95.88% for the fetal brain respectively compared with U-Net. It reduced the model size to around 15 times smaller with close or even better accuracy compared with state-of-the-art DeepLabv3+. In addition, it has a much higher explainability than existing networks by visualizing the attention weight maps. Our code is available at https://github.com/HiLab-git/CA-Net
Deep neural networks are known to be data-driven and label noise can have a marked impact on model performance. Recent studies have shown great robustness to classic image recognition even under a high noisy rate. In medical applications, learning from datasets with label noise is more challenging since medical imaging datasets tend to have asymmetric (class-dependent) noise and suffer from high observer variability. In this paper, we systematically discuss and define the two common types of label noise in medical images - disagreement label noise from inconsistency expert opinions and single-target label noise from wrong diagnosis record. We then propose an uncertainty estimation-based framework to handle these two label noise amid the medical image classification task. We design a dual-uncertainty estimation approach to measure the disagreement label noise and single-target label noise via Direct Uncertainty Prediction and Monte-Carlo-Dropout. A boosting-based curriculum training procedure is later introduced for robust learning. We demonstrate the effectiveness of our method by conducting extensive experiments on three different diseases: skin lesions, prostate cancer, and retinal diseases. We also release a large re-engineered database that consists of annotations from more than ten ophthalmologists with an unbiased golden standard dataset for evaluation and benchmarking.
The medical image is characterized by the inter-class indistinction, high variability, and noise, where the recognition of pixels is challenging. Unlike previous self-attention based methods that capture context information from one level, we reformulate the self-attention mechanism from the view of the high-order graph and propose a novel method, namely Hierarchical Attention Network (HANet), to address the problem of medical image segmentation. Concretely, an HA module embedded in the HANet captures context information from neighbors of multiple levels, where these neighbors are extracted from the high-order graph. In the high-order graph, there will be an edge between two nodes only if the correlation between them is high enough, which naturally reduces the noisy attention information caused by the inter-class indistinction. The proposed HA module is robust to the variance of input and can be flexibly inserted into the existing convolution neural networks. We conduct experiments on three medical image segmentation tasks including optic disc/cup segmentation, blood vessel segmentation, and lung segmentation. Extensive results show our method is more effective and robust than the existing state-of-the-art methods.
In medical image segmentation, it is difficult to mark ambiguous areas accurately with binary masks, especially when dealing with small lesions. Therefore, it is a challenge for radiologists to reach a consensus by using binary masks under the condition of multiple annotations. However, these areas may contain anatomical structures that are conducive to diagnosis. Uncertainty is introduced to study these situations. Nevertheless, the uncertainty is usually measured by the variances between predictions in a multiple trial way. It is not intuitive, and there is no exact correspondence in the image. Inspired by image matting, we introduce matting as a soft segmentation method and a new perspective to deal with and represent uncertain regions into medical scenes, namely medical matting. More specifically, because there is no available medical matting dataset, we first labeled two medical datasets with alpha matte. Secondly, the matting method applied to the natural image is not suitable for the medical scene, so we propose a new architecture to generate binary masks and alpha matte in a row. Thirdly, the uncertainty map is introduced to highlight the ambiguous regions from the binary results and improve the matting performance. Evaluated on these datasets, the proposed model outperformed state-of-the-art matting algorithms by a large margin, and alpha matte is proved to be a more efficient labeling form than a binary mask.