Journal Article DZNE-2025-00656

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PULASki: Learning inter-rater variability using statistical distances to improve probabilistic segmentation.

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2025
Elsevier Science Amsterdam [u.a.]

Medical image analysis 103, 103623 () [10.1016/j.media.2025.103623]

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Abstract: In the domain of medical imaging, many supervised learning based methods for segmentation face several challenges such as high variability in annotations from multiple experts, paucity of labelled data and class imbalanced datasets. These issues may result in segmentations that lack the requisite precision for clinical analysis and can be misleadingly overconfident without associated uncertainty quantification. This work proposes the PULASki method as a computationally efficient generative tool for biomedical image segmentation that accurately captures variability in expert annotations, even in small datasets. This approach makes use of an improved loss function based on statistical distances in a conditional variational autoencoder structure (Probabilistic UNet) , which improves learning of the conditional decoder compared to the standard cross-entropy particularly in class imbalanced problems. The proposed method was analysed for two structurally different segmentation tasks (intracranial vessel and multiple sclerosis (MS) lesion) and compare our results to four well-established baselines in terms of quantitative metrics and qualitative output. These experiments involve class-imbalanced datasets characterised by challenging features, including suboptimal signal-to-noise ratios and high ambiguity. Empirical results demonstrate the PULASKi method outperforms all baselines at the 5% significance level. Our experiments are also of the first to present a comparative study of the computationally feasible segmentation of complex geometries using 3D patches and the traditional use of 2D slices. The generated segmentations are shown to be much more anatomically plausible than in the 2D case, particularly for the vessel task. Our method can also be applied to a wide range of multi-label segmentation tasks and is useful for downstream tasks such as hemodynamic modelling (computational fluid dynamics and data assimilation), clinical decision making, and treatment planning.

Keyword(s): Humans (MeSH) ; Observer Variation (MeSH) ; Magnetic Resonance Imaging: methods (MeSH) ; Algorithms (MeSH) ; Image Interpretation, Computer-Assisted: methods (MeSH) ; Multiple Sclerosis: diagnostic imaging (MeSH) ; Supervised Machine Learning (MeSH) ; Conditional VAE ; Distribution distance ; Multiple sclerosis segmentation ; Probabilistic UNet ; Vessel segmentation

Classification:

Contributing Institute(s):
  1. Mixed Cerebral Pathologies and Cognitive Aging (AG Schreiber)
  2. Linking Imaging Projects (AG Speck)
Research Program(s):
  1. 353 - Clinical and Health Care Research (POF4-353) (POF4-353)

Appears in the scientific report 2025
Database coverage:
Medline ; Clarivate Analytics Master Journal List ; Current Contents - Engineering, Computing and Technology ; Ebsco Academic Search ; Essential Science Indicators ; IF >= 10 ; JCR ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection
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Document types > Articles > Journal Article
Institute Collections > MD DZNE > MD DZNE-AG Schreiber
Institute Collections > MD DZNE > MD DZNE-AG Speck
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 Record created 2025-06-02, last modified 2025-06-15


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