Generalizability vs. Robustness: Adversarial Examples for Medical Imaging
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Abstract (arXiv)
In this paper, for the first time, we propose an evaluation method for deep learning models that assesses the performance of a model not only in an unseen test scenario, but also in extreme cases of noise, outliers and ambiguous input data. To this end, we utilize adversarial examples, images that fool machine learning models, while looking imperceptibly different from original data, as a measure to evaluate the robustness of a variety of medical imaging models. Through extensive experiments on skin lesion classification and whole brain segmentation with state-of-the-art networks such as Inception and UNet, we show that models that achieve comparable performance regarding generalizability may have significant variations in their perception of the underlying data manifold, leading to an extensive performance gap in their robustness.
Key facts. Cited by 23 papers in the map (data through 7 Oct 2026). First posted on arXiv 23 Mar 2018.
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Citing papers per year: 2021: 6; 2022: 10; 2023: 2; 2024: 1; 2025: 3; 2026: 1.
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- 2022SegPGD: An Effective and Efficient Adversarial Attack for Evaluating and Boosting Segmentation Robustnesscited by 74
- 2021Enhancing MR Image Segmentation with Realistic Adversarial Data Augmentationcited by 20
- 2021Towards Evaluating the Robustness of Deep Diagnostic Models by Adversarial Attackcited by 15
- 2022The Extreme Cardiac MRI Analysis Challenge under Respiratory Motion (CMRxMotion)cited by 12
- 2021Enabling Data Diversity: Efficient Automatic Augmentation via Regularized Adversarial Trainingcited by 10
- 2022A.I. Robustness: a Human-Centered Perspective on Technological Challenges and Opportunitiescited by 8
- 2022Adversarially Robust Prototypical Few-shot Segmentation with Neural-ODEscited by 6
- 2022Private and Reliable Neural Network Inferencecited by 6
- 2023The Adversarial Consistency of Surrogate Risks for Binary Classificationcited by 6
- 2021Stress Test Evaluation of Biomedical Word Embeddingscited by 4
- 2022Adaptive Adversarial Training to Improve Adversarial Robustness of DNNs for Medical Image Segmentation and Detectioncited by 4
- 2022The Consistency of Adversarial Training for Binary Classificationcited by 3
11 more
- 2022On Evaluating Adversarial Robustness of Chest X-ray Classification: Pitfalls and Best Practicescited by 3
- 2022Holistic Approach to Measure Sample-level Adversarial Vulnerability and its Utility in Building Trustworthy Systemscited by 2
- 2023Can We Revitalize Interventional Healthcare with AI-XR Surgical Metaverses?cited by 2
- 2024Adversarial Consistency and the Uniqueness of the Adversarial Bayes Classifiercited by 2
- 2021Learning to Detect Adversarial Examples Based on Class Scorescited by 1
- 2021Medical Aegis: Robust adversarial protectors for medical imagescited by 1
- 2022AutoMO-Mixer: An automated multi-objective Mixer model for balanced, safe and robust prediction in medicinecited by 1
- 2025Adversarial Surrogate Risk Bounds for Binary Classificationcited by 1
- 2025Are Vision Transformer Representations Semantically Meaningful? A Case Study in Medical Imagingcited by 0
- 2025Intervention Efficiency and Perturbation Validation Framework: Capacity-Aware and Robust Clinical Model Selection under the Rashomon Effectcited by 0
- 2026Adversarial Robustness of Deep Learning-Based Thyroid Nodule Segmentation in Ultrasoundcited by 0
- 2026Adversarial Robustness of Deep Learning-Based Thyroid Nodule Segmentation in Ultrasound25 Feb 2026
- 2025Intervention Efficiency and Perturbation Validation Framework: Capacity-Aware and Robust Clinical Model Selection under the Rashomon Effect18 Nov 2025
- 2025Are Vision Transformer Representations Semantically Meaningful? A Case Study in Medical Imaging2 Jul 2025
- 2025Adversarial Surrogate Risk Bounds for Binary Classification11 Jun 2025
- 2024Adversarial Consistency and the Uniqueness of the Adversarial Bayes Classifier26 Apr 2024
- 2023The Adversarial Consistency of Surrogate Risks for Binary Classification17 May 2023
- 2023Can We Revitalize Interventional Healthcare with AI-XR Surgical Metaverses?25 Mar 2023
- 2022On Evaluating Adversarial Robustness of Chest X-ray Classification: Pitfalls and Best Practices15 Dec 2022
- 2022Private and Reliable Neural Network Inference27 Oct 2022
- 2022A.I. Robustness: a Human-Centered Perspective on Technological Challenges and Opportunities17 Oct 2022
- 2022The Extreme Cardiac MRI Analysis Challenge under Respiratory Motion (CMRxMotion)12 Oct 2022
- 2022Adversarially Robust Prototypical Few-shot Segmentation with Neural-ODEs7 Oct 2022
11 more
- 2022SegPGD: An Effective and Efficient Adversarial Attack for Evaluating and Boosting Segmentation Robustness25 Jul 2022
- 2022The Consistency of Adversarial Training for Binary Classification18 Jun 2022
- 2022Adaptive Adversarial Training to Improve Adversarial Robustness of DNNs for Medical Image Segmentation and Detection2 Jun 2022
- 2022Holistic Approach to Measure Sample-level Adversarial Vulnerability and its Utility in Building Trustworthy Systems5 May 2022
- 2022AutoMO-Mixer: An automated multi-objective Mixer model for balanced, safe and robust prediction in medicine4 Mar 2022
- 2021Medical Aegis: Robust adversarial protectors for medical images22 Nov 2021
- 2021Enhancing MR Image Segmentation with Realistic Adversarial Data Augmentation7 Aug 2021
- 2021Stress Test Evaluation of Biomedical Word Embeddings24 Jul 2021
- 2021Learning to Detect Adversarial Examples Based on Class Scores9 Jul 2021
- 2021Enabling Data Diversity: Efficient Automatic Augmentation via Regularized Adversarial Training30 Mar 2021
- 2021Towards Evaluating the Robustness of Deep Diagnostic Models by Adversarial Attack5 Mar 2021
- 2022SegPGD: An Effective and Efficient Adversarial Attack for Evaluating and Boosting Segmentation Robustnesscited by 74
- 2021Enhancing MR Image Segmentation with Realistic Adversarial Data Augmentationcited by 20
- 2021Towards Evaluating the Robustness of Deep Diagnostic Models by Adversarial Attackcited by 15
- 2022The Extreme Cardiac MRI Analysis Challenge under Respiratory Motion (CMRxMotion)cited by 12
- 2021Enabling Data Diversity: Efficient Automatic Augmentation via Regularized Adversarial Trainingcited by 10
- 2022A.I. Robustness: a Human-Centered Perspective on Technological Challenges and Opportunitiescited by 8
- 2022Adversarially Robust Prototypical Few-shot Segmentation with Neural-ODEscited by 6
- 2022Private and Reliable Neural Network Inferencecited by 6
- 2023The Adversarial Consistency of Surrogate Risks for Binary Classificationcited by 6
- 2021Stress Test Evaluation of Biomedical Word Embeddingscited by 4
- 2022Adaptive Adversarial Training to Improve Adversarial Robustness of DNNs for Medical Image Segmentation and Detectioncited by 4
- 2022The Consistency of Adversarial Training for Binary Classificationcited by 3
12 most cited of 23 All 23 (JSON)
- 2026Adversarial Robustness of Deep Learning-Based Thyroid Nodule Segmentation in Ultrasound25 Feb 2026
- 2025Intervention Efficiency and Perturbation Validation Framework: Capacity-Aware and Robust Clinical Model Selection under the Rashomon Effect18 Nov 2025
- 2025Are Vision Transformer Representations Semantically Meaningful? A Case Study in Medical Imaging2 Jul 2025
- 2025Adversarial Surrogate Risk Bounds for Binary Classification11 Jun 2025
- 2024Adversarial Consistency and the Uniqueness of the Adversarial Bayes Classifier26 Apr 2024
- 2023The Adversarial Consistency of Surrogate Risks for Binary Classification17 May 2023
- 2023Can We Revitalize Interventional Healthcare with AI-XR Surgical Metaverses?25 Mar 2023
- 2022On Evaluating Adversarial Robustness of Chest X-ray Classification: Pitfalls and Best Practices15 Dec 2022
- 2022Private and Reliable Neural Network Inference27 Oct 2022
- 2022A.I. Robustness: a Human-Centered Perspective on Technological Challenges and Opportunities17 Oct 2022
- 2022The Extreme Cardiac MRI Analysis Challenge under Respiratory Motion (CMRxMotion)12 Oct 2022
- 2022Adversarially Robust Prototypical Few-shot Segmentation with Neural-ODEs7 Oct 2022
12 newest of 23 All 23 (JSON)