CVFeb 17, 2025

Safeguarding AI in Medical Imaging: Post-Hoc Out-of-Distribution Detection with Normalizing Flows

arXiv:2502.11638v31 citationsh-index: 7Has CodeIEEE journal of biomedical and health informatics
Originality Highly original
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This addresses a critical safety issue for clinical imaging workflows by providing a practical safeguard without requiring model retraining.

The paper tackles the problem of detecting out-of-distribution data in AI-driven medical imaging to prevent diagnostic errors, proposing a post-hoc normalizing flow-based method that achieves an AUROC of 84.61% on MedOOD and 93.8% on MedMNIST, outperforming existing methods.

In AI-driven medical imaging, the failure to detect out-of-distribution (OOD) data poses a severe risk to clinical reliability, potentially leading to critical diagnostic errors. Current OOD detection methods often demand impractical retraining or modifications to pre-trained models, hindering their adoption in regulated clinical environments. To address this challenge, we propose a post-hoc normalizing flow-based approach that seamlessly integrates with existing pre-trained models without altering their weights. We evaluate the approach on our in-house-curated MedOOD dataset, designed to capture clinically relevant distribution shifts, and on the MedMNIST benchmark. The proposed method achieves an AUROC of 84.61% on MedOOD, outperforming ViM (80.65%) and MDS (80.87%), and reaches 93.8% AUROC on MedMNIST, surpassing ViM (88.08%) and ReAct (87.05%). This combination of strong performance and post-hoc integration capability makes our approach a practical and effective safeguard for clinical imaging workflows. The model and code to build OOD datasets are publicly accessible at https://github.com/dlotfi/MedOODFlow.

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