Deep Quantile Regression for Uncertainty Estimation in Unsupervised and Supervised Lesion Detection
This work addresses uncertainty quantification for lesion detection in clinical diagnosis, which is critical for surgical margins and treatment decisions, but it is incremental as it builds on existing quantile regression and VAE methods.
The paper tackles the problem of overconfident predictions in deep learning for lesion detection by proposing a quantile regression approach to estimate aleatoric uncertainty in both unsupervised and supervised settings, resulting in confidence intervals for lesion detection and segmentation that address variance underestimation in VAEs and capture expert disagreement in boundaries.
Despite impressive state-of-the-art performance on a wide variety of machine learning tasks, deep learning methods can produce over-confident predictions, particularly with limited training data. Therefore, quantifying uncertainty is particularly important in critical applications such as lesion detection and clinical diagnosis, where a realistic assessment of uncertainty is essential in determining surgical margins, disease status and appropriate treatment. In this work, we propose a novel approach that uses quantile regression for quantifying aleatoric uncertainty in both supervised and unsupervised lesion detection problems. The resulting confidence intervals can be used for lesion detection and segmentation. In the unsupervised setting, we combine quantile regression with the Variational AutoEncoder (VAE). Here we address the problem of quantifying uncertainty in the images that are reconstructed by the VAE as the basis for principled outlier or lesion detection. The VAE models the output as a conditionally independent Gaussian characterized by its mean and variance. Unfortunately, joint optimization of both mean and variance in the VAE leads to the well-known problem of shrinkage or underestimation of variance. Here we describe an alternative Quantile-Regression VAE (QR-VAE) that avoids this variance shrinkage problem by directly estimating conditional quantiles for the input image. Using the estimated quantiles, we compute the conditional mean and variance for the input image from which we then detect outliers by thresholding at a false-discovery-rate corrected p-value. In the supervised setting, we develop binary quantile regression (BQR) for the supervised lesion segmentation task. We show how BQR can be used to capture uncertainty in lesion boundaries in a manner that characterizes expert disagreement.