Matias Cosarinsky

Matias Cosarinsky, Ramiro Billot, Lucas Mansilla et al.

Assessing the quality of automatic image segmentation is crucial in clinical practice, but often very challenging due to the limited availability of ground truth annotations. Reverse Classification Accuracy (RCA) is an approach that estimates the quality of new predictions on unseen samples by training a segmenter on those predictions, and then evaluating it against existing annotated images. In this work, we introduce Conformal In-Context RCA, a novel method for automatically estimating segmentation quality with statistical guarantees in the absence of ground-truth annotations, which consists of two main innovations. First, In-Context RCA, which leverages recent in-context learning models for image segmentation and incorporates retrieval-augmentation techniques to select the most relevant reference images. This approach enables efficient quality estimation with minimal reference data while avoiding the need of training additional models. Second, we introduce Conformal RCA, which extends both the original RCA framework and In-Context RCA to go beyond point estimation. Using tools from split conformal prediction, Conformal RCA produces prediction intervals for segmentation quality providing statistical guarantees that the true score lies within the estimated interval with a user-specified probability. Validated across 10 different medical imaging tasks in various organs and modalities, our methods demonstrate robust performance and computational efficiency, offering a promising solution for automated quality control in clinical workflows, where fast and reliable segmentation assessment is essential. The code is available at https://github.com/mcosarinsky/Conformal-In-Context-RCA.

Matias Cosarinsky, Nicolas Gaggion, Rodrigo Echeveste et al.

In this work, we study uncertainty estimation for anatomical landmark-based segmentation on chest X-rays. Inspired by hybrid neural network architectures that combine standard image convolutional encoders with graph-based generative decoders, and leveraging their variational latent space, we derive two complementary measures: (i) latent uncertainty, captured directly from the learned distribution parameters, and (ii) predictive uncertainty, obtained by generating multiple stochastic output predictions from latent samples. Through controlled corruption experiments we show that both uncertainty measures increase with perturbation severity, reflecting both global and local degradation. We demonstrate that these uncertainty signals can identify unreliable predictions by comparing with manual ground-truth, and support out-of-distribution detection on the CheXmask dataset. More importantly, we release CheXmask-U (huggingface.co/datasets/mcosarinsky/CheXmask-U), a large scale dataset of 657,566 chest X-ray landmark segmentations with per-node uncertainty estimates, enabling researchers to account for spatial variations in segmentation quality when using these anatomical masks. Our findings establish uncertainty estimation as a promising direction to enhance robustness and safe deployment of landmark-based anatomical segmentation methods in chest X-ray. A fully working interactive demo of the method is available at huggingface.co/spaces/matiasky/CheXmask-U and the source code at github.com/mcosarinsky/CheXmask-U.

Jingchen Zou, Jianqiang Li, Gabriel Jimenez et al.

The performance of medical image segmentation models is usually evaluated using metrics like the Dice score and Hausdorff distance, which compare predicted masks to ground truth annotations. However, when applying the model to unseen data, such as in clinical settings, it is often impractical to annotate all the data, making the model's performance uncertain. To address this challenge, we propose the Segmentation Performance Evaluator (SPE), a framework for estimating segmentation models' performance on unlabeled data. This framework is adaptable to various evaluation metrics and model architectures. Experiments on six publicly available datasets across six evaluation metrics including pixel-based metrics such as Dice score and distance-based metrics like HD95, demonstrated the versatility and effectiveness of our approach, achieving a high correlation (0.956$\pm$0.046) and low MAE (0.025$\pm$0.019) compare with real Dice score on the independent test set. These results highlight its ability to reliably estimate model performance without requiring annotations. The SPE framework integrates seamlessly into any model training process without adding training overhead, enabling performance estimation and facilitating the real-world application of medical image segmentation algorithms. The source code is publicly available