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Assessing Reliability and Challenges of Uncertainty Estimations for Medical Image Segmentation

arXiv 1907.03338 ↗First posted 7 Jul 2019eess.IV cs.CVcited by 75

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Abstract (arXiv)

Despite the recent improvements in overall accuracy, deep learning systems still exhibit low levels of robustness. Detecting possible failures is critical for a successful clinical integration of these systems, where each data point corresponds to an individual patient. Uncertainty measures are a promising direction to improve failure detection since they provide a measure of a system's confidence. Although many uncertainty estimation methods have been proposed for deep learning, little is known on their benefits and current challenges for medical image segmentation. Therefore, we report results of evaluating common voxel-wise uncertainty measures with respect to their reliability, and limitations on two medical image segmentation datasets. Results show that current uncertainty methods perform similarly and although they are well-calibrated at the dataset level, they tend to be miscalibrated at subject-level. Therefore, the reliability of uncertainty estimates is compromised, highlighting the importance of developing subject-wise uncertainty estimations. Additionally, among the benchmarked methods, we found auxiliary networks to be a valid alternative to common uncertainty methods since they can be applied to any previously trained segmentation model.

Key facts. Cited by 75 papers in the map (data through 7 Oct 2026). First posted on arXiv 7 Jul 2019.

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Citing papers per year: 2021: 16; 2022: 16; 2023: 12; 2024: 11; 2025: 8; 2026: 12.

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  1. 2021Diffusion Models for Implicit Image Segmentation Ensemblescited by 198
  2. 2021Mutual Consistency Learning for Semi-supervised Medical Image Segmentationcited by 107
  3. 2021Inconsistency-aware Uncertainty Estimation for Semi-supervised Medical Image Segmentationcited by 61
  4. 2021Diminishing Uncertainty within the Training Pool: Active Learning for Medical Image Segmentationcited by 44
  5. 2021Local contrastive loss with pseudo-label based self-training for semi-supervised medical image segmentationcited by 43
  6. 2023Rethinking Semi-Supervised Medical Image Segmentation: A Variance-Reduction Perspectivecited by 43
  7. 2023A review of uncertainty quantification in medical image analysis: probabilistic and non-probabilistic methodscited by 39
  8. 2021Is segmentation uncertainty useful?cited by 37
  9. 2022TBraTS: Trusted Brain Tumor Segmentationcited by 30
  10. 2022Mine yOur owN Anatomy: Revisiting Medical Image Segmentation with Extremely Limited Labelscited by 30
  11. 2022Addressing Fairness Issues in Deep Learning-Based Medical Image Analysis: A Systematic Reviewcited by 27
  12. 2022On Calibrating Semantic Segmentation Models: Analyses and An Algorithmcited by 25
38 more
  1. 2021Medical Image Segmentation with Limited Supervision: A Review of Deep Network Modelscited by 21
  2. 2021Detecting when pre-trained nnU-Net models fail silently for Covid-19 lung lesion segmentationcited by 19
  3. 2022Efficient Bayesian Uncertainty Estimation for nnU-Netcited by 19
  4. 2021Towards Lower-Dose PET using Physics-Based Uncertainty-Aware Multimodal Learning with Robustness to Out-of-Distribution Datacited by 18
  5. 2021Robustness via Uncertainty-aware Cycle Consistencycited by 16
  6. 2023Evaluating the Fairness of Deep Learning Uncertainty Estimates in Medical Image Analysiscited by 15
  7. 2022Uncertainty-aware Multi-modal Learning via Cross-modal Random Network Predictioncited by 13
  8. 2022CRISP - Reliable Uncertainty Estimation for Medical Image Segmentationcited by 10
  9. 2024Cascaded Multi-path Shortcut Diffusion Model for Medical Image Translationcited by 9
  10. 2023Confidence Estimation Using Unlabeled Datacited by 8
  11. 2023Building Extraction from Remote Sensing Images via an Uncertainty-Aware Networkcited by 7
  12. 2023Uncertainty Estimation for Safety-critical Scene Segmentation via Fine-grained Reward Maximizationcited by 7
  13. 2022Theoretical analysis and experimental validation of volume bias of soft Dice optimized segmentation maps in the context of inherent uncertaintycited by 6
  14. 2024Test-time generative augmentation for medical image segmentationcited by 6
  15. 2024ReliOcc: Towards Reliable Semantic Occupancy Prediction via Uncertainty Learningcited by 6
  16. 2024A Review of Bayesian Uncertainty Quantification in Deep Probabilistic Image Segmentationcited by 6
  17. 2022Segmentation of Bruch's Membrane in retinal OCT with AMD using anatomical priors and uncertainty quantificationcited by 5
  18. 2023Understanding Calibration of Deep Neural Networks for Medical Image Classificationcited by 5
  19. 2025Aleatoric Uncertainty Medical Image Segmentation Estimation via Flow Matchingcited by 5
  20. 2021Interactive Medical Image Segmentation with Self-Adaptive Confidence Calibrationcited by 4
  21. 2022Uncertainty categories in medical image segmentation: a study of source-related diversitycited by 4
  22. 2023Confidence Contours: Uncertainty-Aware Annotation for Medical Semantic Segmentationcited by 4
  23. 2024From Registration Uncertainty to Segmentation Uncertaintycited by 4
  24. 2021Uncertainty-aware Generalized Adaptive CycleGANcited by 3
  25. 2023Towards Reliable Medical Image Segmentation by Modeling Evidential Calibrated Uncertaintycited by 3
  26. 2023Trustworthy Multi-phase Liver Tumor Segmentation via Evidence-based Uncertaintycited by 3
  27. 2023Test-time augmentation-based active learning and self-training for label-efficient segmentationcited by 3
  28. 2025Uncertainty-Supervised Interpretable and Robust Evidential Segmentationcited by 3
  29. 2026ORCE: Order-Aware Alignment of Verbalized Confidence in Large Language Modelscited by 3
  30. 2021Deep and Statistical Learning in Biomedical Imaging: State of the Art in 3D MRI Brain Tumor Segmentationcited by 2
  31. 2021Uncertainty Quantification in Medical Image Segmentation with Multi-decoder U-Netcited by 2
  32. 2022Suggestive Annotation of Brain MR Images with Gradient-guided Samplingcited by 2
  33. 2022Uncertainty Estimation for 3D Dense Prediction via Cross-Point Embeddingscited by 2
  34. 2024Estimation and Analysis of Slice Propagation Uncertainty in 3D Anatomy Segmentationcited by 2
  35. 2025Evidential Physics-Informed Neural Networks for Scientific Discoverycited by 2
  36. 2021Automated cross-sectional view selection in CT angiography of aortic dissections with uncertainty awareness and retrospective clinical annotationscited by 1
  37. 2022Exploring Structure-Wise Uncertainty for 3D Medical Image Segmentationcited by 1
  38. 2023Self-training with dual uncertainty for semi-supervised medical image segmentationcited by 1

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