IVCVDec 17, 2025

In search of truth: Evaluating concordance of AI-based anatomy segmentation models

arXiv:2512.15921v1h-index: 69Has Code
Originality Synthesis-oriented
AI Analysis

This work addresses the challenge of model evaluation in medical imaging for researchers and practitioners, but it is incremental as it builds on existing tools and methods.

The researchers tackled the problem of evaluating AI-based anatomy segmentation models without ground truth annotations by introducing a practical framework that harmonizes and compares segmentations, demonstrating its utility on six models for 31 anatomical structures in CT scans, with results showing excellent agreement for some structures like lungs but issues for others like vertebrae and ribs.

Purpose AI-based methods for anatomy segmentation can help automate characterization of large imaging datasets. The growing number of similar in functionality models raises the challenge of evaluating them on datasets that do not contain ground truth annotations. We introduce a practical framework to assist in this task. Approach We harmonize the segmentation results into a standard, interoperable representation, which enables consistent, terminology-based labeling of the structures. We extend 3D Slicer to streamline loading and comparison of these harmonized segmentations, and demonstrate how standard representation simplifies review of the results using interactive summary plots and browser-based visualization using OHIF Viewer. To demonstrate the utility of the approach we apply it to evaluating segmentation of 31 anatomical structures (lungs, vertebrae, ribs, and heart) by six open-source models - TotalSegmentator 1.5 and 2.6, Auto3DSeg, MOOSE, MultiTalent, and CADS - for a sample of Computed Tomography (CT) scans from the publicly available National Lung Screening Trial (NLST) dataset. Results We demonstrate the utility of the framework in enabling automating loading, structure-wise inspection and comparison across models. Preliminary results ascertain practical utility of the approach in allowing quick detection and review of problematic results. The comparison shows excellent agreement segmenting some (e.g., lung) but not all structures (e.g., some models produce invalid vertebrae or rib segmentations). Conclusions The resources developed are linked from https://imagingdatacommons.github.io/segmentation-comparison/ including segmentation harmonization scripts, summary plots, and visualization tools. This work assists in model evaluation in absence of ground truth, ultimately enabling informed model selection.

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