Quality control for more reliable integration of deep learning-based image segmentation into medical workflows

Abstract

Machine learning algorithms underpin modern diagnostic-aiding software, whichhas proved valuable in clinical practice, particularly in radiology. However,inaccuracies, mainly due to the limited availability of clinical samples fortraining these algorithms, hamper their wider applicability, acceptance, andrecognition amongst clinicians. We present an analysis of state-of-the-artautomatic quality control (QC) approaches that can be implemented within thesealgorithms to estimate the certainty of their outputs. We validated the mostpromising approaches on a brain image segmentation task identifying whitematter hyperintensities (WMH) in magnetic resonance imaging data. WMH are acorrelate of small vessel disease common in mid-to-late adulthood and areparticularly challenging to segment due to their varied size, anddistributional patterns. Our results show that the aggregation of uncertaintyand Dice prediction were most effective in failure detection for this task.Both methods independently improved mean Dice from 0.82 to 0.84. Our workreveals how QC methods can help to detect failed segmentation cases andtherefore make automatic segmentation more reliable and suitable for clinicalpractice.<br

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