Comparative evaluation of uncertainty estimation and decomposition methods on liver segmentation.

PURPOSE: Deep neural networks need to be able to indicate error likelihood via reliable estimates of their predictive uncertainty when used in high-risk scenarios, such as medical decision support. This work contributes a systematic overview of state-of-the-art approaches for decomposing predictive uncertainty into aleatoric and epistemic components, and a comprehensive comparison for Bayesian neural networks (BNNs) between mutual information decomposition and the explicit modelling of both uncertainty types via an additional loss-attenuating neuron. METHODS: Experiments are performed in the context of liver segmentation in CT scans. The quality of the uncertainty decomposition in the resulting uncertainty maps is qualitatively evaluated, and quantitative behaviour of decomposed uncertainties is systematically compared for different experiment settings with varying training set sizes, label noise, and distribution shifts. RESULTS: Our results show the mutual information decomposition to robustly yield meaningful aleatoric and epistemic uncertainty estimates, while the activation of the loss-attenuating neuron appears noisier with non-trivial convergence properties. We found that the addition of a heteroscedastic neuron does not significantly improve segmentation performance or calibration, while slightly improving the quality of uncertainty estimates. CONCLUSIONS: Mutual information decomposition is simple to implement, has mathematically pleasing properties, and yields meaningful uncertainty estimates that behave as expected under controlled changes to our data set. The additional extension of BNNs with loss-attenuating neurons provides no improvement in terms of segmentation performance or calibration in our setting, but marginal benefits regarding the quality of decomposed uncertainties.

Suitability of DNN-based vessel segmentation for SIRT planning.

PURPOSE: The segmentation of the hepatic arteries (HA) is essential for state-of-the-art pre-interventional planning of selective internal radiation therapy (SIRT), a treatment option for malignant tumors in the liver. In SIRT a catheter is placed through the aorta into the tumor-feeding hepatic arteries, injecting small beads filled with radiation emitting material for local radioembolization. In this study, we evaluate the suitability of a deep neural network (DNN) based vessel segmentation for SIRT planning. METHODS: We applied our DNN-based HA segmentation on 36 contrast-enhanced computed tomography (CT) scans from the arterial contrast agent phase and rated its segmentation quality as well as the overall image quality. Additionally, we applied a traditional machine learning algorithm for HA segmentation as comparison to our deep learning (DL) approach. Moreover, we assessed by expert ratings whether the produced HA segmentations can be used for SIRT planning. RESULTS: The DL approach outperformed the traditional machine learning algorithm. The DL segmentation can be used for SIRT planning in [Formula: see text] of the cases, while the reference segmentations, which were manually created by experienced radiographers, are sufficient in [Formula: see text]. Seven DL cases cannot be used for SIRT planning while the corresponding reference segmentations are sufficient. However, there are two DL segmentations usable for SIRT, where the reference segmentations for the same cases were rated as insufficient. CONCLUSIONS: HA segmentation is a difficult and time-consuming task. DL-based methods have the potential to support and accelerate the pre-interventional planning of SIRT therapy.

Improving automatic liver tumor segmentation in late-phase MRI using multi-model training and 3D convolutional neural networks.

Automatic liver tumor segmentation can facilitate the planning of liver interventions. For diagnosis of hepatocellular carcinoma, dynamic contrast-enhanced MRI (DCE-MRI) can yield a higher sensitivity than contrast-enhanced CT. However, most studies on automatic liver lesion segmentation have focused on CT. In this study, we present a deep learning-based approach for liver tumor segmentation in the late hepatocellular phase of DCE-MRI, using an anisotropic 3D U-Net architecture and a multi-model training strategy. The 3D architecture improves the segmentation performance compared to a previous study using a 2D U-Net (mean Dice 0.70 vs. 0.65). A further significant improvement is achieved by a multi-model training approach (0.74), which is close to the inter-rater agreement (0.78). A qualitative expert rating of the automatically generated contours confirms the benefit of the multi-model training strategy, with 66 % of contours rated as good or very good, compared to only 43 % when performing a single training. The lesion detection performance with a mean F1-score of 0.59 is inferior to human raters (0.76). Overall, this study shows that correctly detected liver lesions in late-phase DCE-MRI data can be automatically segmented with high accuracy, but the detection, in particular of smaller lesions, can still be improved.