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Exploring Uncertainty Measures in Deep Networks for Multiple Sclerosis Lesion Detection and Segmentation (1808.01200v2)

Published 3 Aug 2018 in cs.CV

Abstract: Deep learning (DL) networks have recently been shown to outperform other segmentation methods on various public, medical-image challenge datasets [3,11,16], especially for large pathologies. However, in the context of diseases such as Multiple Sclerosis (MS), monitoring all the focal lesions visible on MRI sequences, even very small ones, is essential for disease staging, prognosis, and evaluating treatment efficacy. Moreover, producing deterministic outputs hinders DL adoption into clinical routines. Uncertainty estimates for the predictions would permit subsequent revision by clinicians. We present the first exploration of multiple uncertainty estimates based on Monte Carlo (MC) dropout [4] in the context of deep networks for lesion detection and segmentation in medical images. Specifically, we develop a 3D MS lesion segmentation CNN, augmented to provide four different voxel-based uncertainty measures based on MC dropout. We train the network on a proprietary, large-scale, multi-site, multi-scanner, clinical MS dataset, and compute lesion-wise uncertainties by accumulating evidence from voxel-wise uncertainties within detected lesions. We analyze the performance of voxel-based segmentation and lesion-level detection by choosing operating points based on the uncertainty. Empirical evidence suggests that uncertainty measures consistently allow us to choose superior operating points compared only using the network's sigmoid output as a probability.

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Authors (4)
  1. Tanya Nair (2 papers)
  2. Doina Precup (206 papers)
  3. Douglas L. Arnold (13 papers)
  4. Tal Arbel (41 papers)
Citations (408)

Summary

Insights into Uncertainty Measures in Deep Networks for Multiple Sclerosis Lesion Detection

The paper "Exploring Uncertainty Measures in Deep Networks for Multiple Sclerosis Lesion Detection and Segmentation" presents a detailed investigation into the application of uncertainty estimation in deep learning (DL) models for medical image analysis, specifically focusing on the segmentation and detection of Multiple Sclerosis (MS) lesions. Utilizing Monte Carlo (MC) dropout, the authors offer an analysis of various uncertainty measures to enhance the performance and reliability of convolutional neural networks (CNNs) in identifying MS lesions from MRI data.

Overview of Methodology

The core methodology involves developing a 3D CNN designed for MS lesion segmentation that incorporates uncertainty estimation through MC dropout—an approach that enables the model to output not just deterministic predictions but also provides confidence scores for those predictions. This is particularly pertinent in clinical settings where the consequences of diagnostic errors are significant. The network focuses on four types of uncertainty measures: predictive variance, MC sample variance, predictive entropy, and mutual information. Each measure is derived from different mathematical approximations intended to capture the confidence of the model's predictions.

Numerical Results and Analysis

The empirical paper leverages a proprietary dataset comprising over 1000 patient scans from a clinical trial setting, providing a robust evaluation environment. The results demonstrate that integrating uncertainty measures can identify more reliable segmentation boundaries and lesion detections, especially in cases involving small lesions which are often the most challenging to detect due to their diminished size. The paper reports that filtering predictions based on uncertainty significantly reduces false positives (FP) and false negatives (FN), with substantial improvements in true positive rates (TPR), particularly in detecting smaller lesions. For example, excluding just 2% of the most uncertain predictions resulted in performance gains.

Through ROC analysis, the paper illustrates that different uncertainty measures offer varying levels of filtration, with predictive variance yielding the highest retention accuracy albeit with the lowest retention rate. Such detailed statistical evaluation underscores that dropout-based uncertainty estimates are instrumental in enhancing the robustness of CNN predictions without burdening the model with additional parameters.

Practical Implications and Future Work

From a practical perspective, the integration of uncertainty measures proposes a viable pathway for streamlining DL tools into real-world clinical applications, offering clinicians a mechanism to quickly gauge the reliability of model predictions. This approach serves as a decision support tool, aiding in the assessment and refinement of segmentation outputs and potentially improving clinical trial results where precise lesion quantification is crucial.

The findings prompt further investigation into how these uncertainty measures can be generalized beyond MS lesion detection to other medical imaging tasks. Future research might focus on enhancing computational efficiency, adapting these techniques to larger and more diverse datasets, or exploring their integration with other forms of model uncertainty quantification such as ensemble methods. Such advances would significantly contribute to the broader goal of securing DL integration into clinical workflows, where predictive reliability is paramount.

In summary, this paper delivers substantial evidence for the benefits of employing uncertainty measures within CNN frameworks for medical imaging applications, highlighting their potential to bridge the gap between DL innovations and their routine use in healthcare settings. The research opens a critical dialogue about the reliability of DL systems in high-stakes environments, encouraging ongoing exploration and application of uncertainty principles to support more accurate and trusted medical image analysis.