RESUMEN
Most segmentation losses are arguably variants of the Cross-Entropy (CE) or Dice losses. On the surface, these two categories of losses (i.e., distribution based vs. geometry based) seem unrelated, and there is no clear consensus as to which category is a better choice, with varying performances for each across different benchmarks and applications. Furthermore, it is widely argued within the medical-imaging community that Dice and CE are complementary, which has motivated the use of compound CE-Dice losses. In this work, we provide a theoretical analysis, which shows that CE and Dice share a much deeper connection than previously thought. First, we show that, from a constrained-optimization perspective, they both decompose into two components, i.e., a similar ground-truth matching term, which pushes the predicted foreground regions towards the ground-truth, and a region-size penalty term imposing different biases on the size (or proportion) of the predicted regions. Then, we provide bound relationships and an information-theoretic analysis, which uncover hidden region-size biases: Dice has an intrinsic bias towards specific extremely imbalanced solutions, whereas CE implicitly encourages the ground-truth region proportions. Our theoretical results explain the wide experimental evidence in the medical-imaging literature, whereby Dice losses bring improvements for imbalanced segmentation. It also explains why CE dominates natural-image problems with diverse class proportions, in which case Dice might have difficulty adapting to different region-size distributions. Based on our theoretical analysis, we propose a principled and simple solution, which enables to control explicitly the region-size bias. The proposed method integrates CE with explicit terms based on L1 or the KL divergence, which encourage segmenting region proportions to match target class proportions, thereby mitigating class imbalance but without losing generality. Comprehensive experiments and ablation studies over different losses and applications validate our theoretical analysis, as well as the effectiveness of explicit and simple region-size terms. The code is available at https://github.com/by-liu/SegLossBias .
RESUMEN
Glaucoma is a chronic neuro-degenerative condition that is one of the world's leading causes of irreversible but preventable blindness. The blindness is generally caused by the lack of timely detection and treatment. Early screening is thus essential for early treatment to preserve vision and maintain life quality. Colour fundus photography and Optical Coherence Tomography (OCT) are the two most cost-effective tools for glaucoma screening. Both imaging modalities have prominent biomarkers to indicate glaucoma suspects, such as the vertical cup-to-disc ratio (vCDR) on fundus images and retinal nerve fiber layer (RNFL) thickness on OCT volume. In clinical practice, it is often recommended to take both of the screenings for a more accurate and reliable diagnosis. However, although numerous algorithms are proposed based on fundus images or OCT volumes for the automated glaucoma detection, there are few methods that leverage both of the modalities to achieve the target. To fulfil the research gap, we set up the Glaucoma grAding from Multi-Modality imAges (GAMMA) Challenge to encourage the development of fundus & OCT-based glaucoma grading. The primary task of the challenge is to grade glaucoma from both the 2D fundus images and 3D OCT scanning volumes. As part of GAMMA, we have publicly released a glaucoma annotated dataset with both 2D fundus colour photography and 3D OCT volumes, which is the first multi-modality dataset for machine learning based glaucoma grading. In addition, an evaluation framework is also established to evaluate the performance of the submitted methods. During the challenge, 1272 results were submitted, and finally, ten best performing teams were selected for the final stage. We analyse their results and summarize their methods in the paper. Since all the teams submitted their source code in the challenge, we conducted a detailed ablation study to verify the effectiveness of the particular modules proposed. Finally, we identify the proposed techniques and strategies that could be of practical value for the clinical diagnosis of glaucoma. As the first in-depth study of fundus & OCT multi-modality glaucoma grading, we believe the GAMMA Challenge will serve as an essential guideline and benchmark for future research.