CTSCAN: Evaluation Leakage in Chest CT Segmentation and a Reproducible Patient-Disjoint Benchmark
For researchers in medical image segmentation, this work highlights a critical evaluation pitfall and provides a corrected benchmark to ensure fair comparison.
The authors demonstrate that patient-disjoint evaluation reduces chest CT segmentation performance by 69% relative in foreground Dice compared to slice-mixed evaluation, and provide a reproducible benchmark (CTSCAN) to prevent such evaluation leakage.
Reported chest CT segmentation performance can be strongly inflated when train and test partitions mix slices from the same study. We present CTSCAN, a reproducible multi-source chest CT benchmark and research stack designed to measure what survives under patient-disjoint evaluation. The current four-class artifact aggregates 89 cases from PleThora, MedSeg SIRM, and LongCIU, and we show that the original slice-PNG workflow induces near-complete case reuse across train, validation, and test. Using the playground environment, we run a multi-seed protocol sweep with the same FPN plus EfficientNet-B0 control configuration under slice-mixed and case-disjoint evaluation. Across 3 seeds and 12 epochs per seed, the slice-mixed protocol reaches 0.6665 foreground Dice and 0.5031 foreground IoU, whereas the case-disjoint protocol reaches 0.2066 Dice and 0.1181 IoU. Removing patient reuse therefore reduces foreground Dice by 0.4599 absolute (69.00% relative) and foreground IoU by 0.3850 absolute (76.52% relative). CTSCAN packages the corrected benchmark with deterministic split manifests, explicit weak-supervision controls, a scripted multi-seed protocol sweep, and reproducible figure generation, providing a reusable basis for patient-disjoint chest CT evaluation.