Aleatoric uncertainty estimation with test-time augmentation for medical image segmentation with convolutional neural networks
This work addresses uncertainty estimation for medical image segmentation, which is crucial for clinical decision-making, but it is incremental as it builds on existing test-time augmentation and uncertainty methods.
The paper tackled the problem of uncertainty estimation in CNN-based medical image segmentation by proposing a test-time augmentation method for aleatoric uncertainty, which improved uncertainty estimation and reduced overconfident incorrect predictions compared to dropout-based methods, with experiments on fetal brain and brain tumor MRI segmentation showing better performance.
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.