Chengyan Wang

Ahjol Senbi, Tianyu Huang, Fei Lyu et al.

We explore the feasibility and potential of building a ground-truth-free evaluation model to assess the quality of segmentations generated by the Segment Anything Model (SAM) and its variants in medical imaging. This evaluation model estimates segmentation quality scores by analyzing the coherence and consistency between the input images and their corresponding segmentation predictions. Based on prior research, we frame the task of training this model as a regression problem within a supervised learning framework, using Dice scores (and optionally other metrics) along with mean squared error to compute the training loss. The model is trained utilizing a large collection of public datasets of medical images with segmentation predictions from SAM and its variants. We name this model EvanySeg (Evaluation of Any Segmentation in Medical Images). Our exploration of convolution-based models (e.g., ResNet) and transformer-based models (e.g., ViT) suggested that ViT yields better performance for this task. EvanySeg can be employed for various tasks, including: (1) identifying poorly segmented samples by detecting low-percentile segmentation quality scores; (2) benchmarking segmentation models without ground truth by averaging quality scores across test samples; (3) alerting human experts to poor-quality segmentation predictions during human-AI collaboration by applying a threshold within the score space; and (4) selecting the best segmentation prediction for each test sample at test time when multiple segmentation models are available, by choosing the prediction with the highest quality score. Models and code will be made available at https://github.com/ahjolsenbics/EvanySeg.

Qin Li, Yizhe Zhang, Yan Li et al.

The segmentation foundation model, e.g., Segment Anything Model (SAM), has attracted increasing interest in the medical image community. Early pioneering studies primarily concentrated on assessing and improving SAM's performance from the perspectives of overall accuracy and efficiency, yet little attention was given to the fairness considerations. This oversight raises questions about the potential for performance biases that could mirror those found in task-specific deep learning models like nnU-Net. In this paper, we explored the fairness dilemma concerning large segmentation foundation models. We prospectively curate a benchmark dataset of 3D MRI and CT scans of the organs including liver, kidney, spleen, lung and aorta from a total of 1056 healthy subjects with expert segmentations. Crucially, we document demographic details such as gender, age, and body mass index (BMI) for each subject to facilitate a nuanced fairness analysis. We test state-of-the-art foundation models for medical image segmentation, including the original SAM, medical SAM and SAT models, to evaluate segmentation efficacy across different demographic groups and identify disparities. Our comprehensive analysis, which accounts for various confounding factors, reveals significant fairness concerns within these foundational models. Moreover, our findings highlight not only disparities in overall segmentation metrics, such as the Dice Similarity Coefficient but also significant variations in the spatial distribution of segmentation errors, offering empirical evidence of the nuanced challenges in ensuring fairness in medical image segmentation.