Impact of Adversarial Examples on Deep Learning Models for Biomedical Image Segmentation
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Abstract (arXiv)
Deep learning models, which are increasingly being used in the field of medical image analysis, come with a major security risk, namely, their vulnerability to adversarial examples. Adversarial examples are carefully crafted samples that force machine learning models to make mistakes during testing time. These malicious samples have been shown to be highly effective in misguiding classification tasks. However, research on the influence of adversarial examples on segmentation is significantly lacking. Given that a large portion of medical imaging problems are effectively segmentation problems, we analyze the impact of adversarial examples on deep learning-based image segmentation models. Specifically, we expose the vulnerability of these models to adversarial examples by proposing the Adaptive Segmentation Mask Attack (ASMA). This novel algorithm makes it possible to craft targeted adversarial examples that come with (1) high intersection-over-union rates between the target adversarial mask and the prediction and (2) with perturbation that is, for the most part, invisible to the bare eye. We lay out experimental and visual evidence by showing results obtained for the ISIC skin lesion segmentation challenge and the problem of glaucoma optic disc segmentation. An implementation of this algorithm and additional examples can be found at https://github.com/utkuozbulak/adaptive-segmentation-mask-attack.
Key facts. Cited by 26 papers in the map (data through 7 Oct 2026). First posted on arXiv 30 Jul 2019.
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Citing papers per year: 2021: 6; 2022: 7; 2023: 5; 2024: 6; 2025: 2.
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- 2022Proximal Splitting Adversarial Attacks for Semantic Segmentationcited by 23
- 2023Detecting Adversarial Data by Probing Multiple Perturbations Using Expected Perturbation Scorecited by 20
- 2023Survey on Adversarial Attack and Defense for Medical Image Analysis: Methods and Challengescited by 16
- 2021Towards Robust General Medical Image Segmentationcited by 14
- 2021MedRDF: A Robust and Retrain-Less Diagnostic Framework for Medical Pretrained Models Against Adversarial Attackcited by 9
- 2024Practical Region-level Attack against Segment Anything Modelscited by 9
- 2021IPatch: A Remote Adversarial Patchcited by 7
- 2024Defense Against Adversarial Attacks on No-Reference Image Quality Models with Gradient Norm Regularizationcited by 7
- 2022Adversarially Robust Prototypical Few-shot Segmentation with Neural-ODEscited by 6
- 2022Robust Prototypical Few-Shot Organ Segmentation with Regularized Neural-ODEscited by 5
- 2023A Certified Radius-Guided Attack Framework to Image Segmentation Modelscited by 5
- 2023A Review of Adversarial Attacks in Computer Visioncited by 5
14 more
- 2022Adaptive Adversarial Training to Improve Adversarial Robustness of DNNs for Medical Image Segmentation and Detectioncited by 4
- 2022NeuGuard: Lightweight Neuron-Guided Defense against Membership Inference Attackscited by 3
- 2023Adversarial Medical Image with Hierarchical Feature Hidingcited by 3
- 2021Learning Defense Transformers for Counterattacking Adversarial Examplescited by 2
- 2022Multiclass ASMA vs Targeted PGD Attack in Image Segmentationcited by 2
- 2024SoK: Security and Privacy Risks of Healthcare AIcited by 2
- 2024S2S2: Semantic Stacking for Robust Semantic Segmentation in Medical Imagingcited by 2
- 2025Exploring Patient Data Requirements in Training Effective AI Models for MRI-based Breast Cancer Classificationcited by 2
- 2021Adversarial Heart Attack: Neural Networks Fooled to Segment Heart Symbols in Chest X-Ray Imagescited by 1
- 2021Medical Aegis: Robust adversarial protectors for medical imagescited by 1
- 2022Exact Feature Collisions in Neural Networkscited by 0
- 2024Securing the Diagnosis of Medical Imaging: An In-depth Analysis of AI-Resistant Attackscited by 0
- 2024Adversarial Purification by Consistency-aware Latent Space Optimization on Data Manifoldscited by 0
- 2025Adversarial Attacks on Reinforcement Learning-based Medical Questionnaire Systems: Input-level Perturbation Strategies and Medical Constraint Validationcited by 0
- 2025Adversarial Attacks on Reinforcement Learning-based Medical Questionnaire Systems: Input-level Perturbation Strategies and Medical Constraint Validation5 Aug 2025
- 2025Exploring Patient Data Requirements in Training Effective AI Models for MRI-based Breast Cancer Classification22 Feb 2025
- 2024S2S2: Semantic Stacking for Robust Semantic Segmentation in Medical Imaging17 Dec 2024
- 2024Adversarial Purification by Consistency-aware Latent Space Optimization on Data Manifolds11 Dec 2024
- 2024SoK: Security and Privacy Risks of Healthcare AI11 Sep 2024
- 2024Securing the Diagnosis of Medical Imaging: An In-depth Analysis of AI-Resistant Attacks1 Aug 2024
- 2024Practical Region-level Attack against Segment Anything Models12 Apr 2024
- 2024Defense Against Adversarial Attacks on No-Reference Image Quality Models with Gradient Norm Regularization18 Mar 2024
- 2023Adversarial Medical Image with Hierarchical Feature Hiding4 Dec 2023
- 2023A Review of Adversarial Attacks in Computer Vision15 Aug 2023
- 2023Detecting Adversarial Data by Probing Multiple Perturbations Using Expected Perturbation Score25 May 2023
- 2023A Certified Radius-Guided Attack Framework to Image Segmentation Models5 Apr 2023
14 more
- 2023Survey on Adversarial Attack and Defense for Medical Image Analysis: Methods and Challenges24 Mar 2023
- 2022Adversarially Robust Prototypical Few-shot Segmentation with Neural-ODEs7 Oct 2022
- 2022Robust Prototypical Few-Shot Organ Segmentation with Regularized Neural-ODEs26 Aug 2022
- 2022Multiclass ASMA vs Targeted PGD Attack in Image Segmentation3 Aug 2022
- 2022Proximal Splitting Adversarial Attacks for Semantic Segmentation14 Jun 2022
- 2022NeuGuard: Lightweight Neuron-Guided Defense against Membership Inference Attacks11 Jun 2022
- 2022Adaptive Adversarial Training to Improve Adversarial Robustness of DNNs for Medical Image Segmentation and Detection2 Jun 2022
- 2022Exact Feature Collisions in Neural Networks31 May 2022
- 2021MedRDF: A Robust and Retrain-Less Diagnostic Framework for Medical Pretrained Models Against Adversarial Attack29 Nov 2021
- 2021Medical Aegis: Robust adversarial protectors for medical images22 Nov 2021
- 2021Towards Robust General Medical Image Segmentation9 Jul 2021
- 2021IPatch: A Remote Adversarial Patch30 Apr 2021
- 2021Adversarial Heart Attack: Neural Networks Fooled to Segment Heart Symbols in Chest X-Ray Images31 Mar 2021
- 2021Learning Defense Transformers for Counterattacking Adversarial Examples13 Mar 2021
- 2022Proximal Splitting Adversarial Attacks for Semantic Segmentationcited by 23
- 2023Detecting Adversarial Data by Probing Multiple Perturbations Using Expected Perturbation Scorecited by 20
- 2023Survey on Adversarial Attack and Defense for Medical Image Analysis: Methods and Challengescited by 16
- 2021Towards Robust General Medical Image Segmentationcited by 14
- 2021MedRDF: A Robust and Retrain-Less Diagnostic Framework for Medical Pretrained Models Against Adversarial Attackcited by 9
- 2024Practical Region-level Attack against Segment Anything Modelscited by 9
- 2021IPatch: A Remote Adversarial Patchcited by 7
- 2024Defense Against Adversarial Attacks on No-Reference Image Quality Models with Gradient Norm Regularizationcited by 7
- 2022Adversarially Robust Prototypical Few-shot Segmentation with Neural-ODEscited by 6
- 2022Robust Prototypical Few-Shot Organ Segmentation with Regularized Neural-ODEscited by 5
- 2023A Certified Radius-Guided Attack Framework to Image Segmentation Modelscited by 5
- 2023A Review of Adversarial Attacks in Computer Visioncited by 5
12 most cited of 24 All 24 (JSON)
- 2025Adversarial Attacks on Reinforcement Learning-based Medical Questionnaire Systems: Input-level Perturbation Strategies and Medical Constraint Validation5 Aug 2025
- 2025Exploring Patient Data Requirements in Training Effective AI Models for MRI-based Breast Cancer Classification22 Feb 2025
- 2024S2S2: Semantic Stacking for Robust Semantic Segmentation in Medical Imaging17 Dec 2024
- 2024SoK: Security and Privacy Risks of Healthcare AI11 Sep 2024
- 2024Securing the Diagnosis of Medical Imaging: An In-depth Analysis of AI-Resistant Attacks1 Aug 2024
- 2024Practical Region-level Attack against Segment Anything Models12 Apr 2024
- 2024Defense Against Adversarial Attacks on No-Reference Image Quality Models with Gradient Norm Regularization18 Mar 2024
- 2023Adversarial Medical Image with Hierarchical Feature Hiding4 Dec 2023
- 2023A Review of Adversarial Attacks in Computer Vision15 Aug 2023
- 2023Detecting Adversarial Data by Probing Multiple Perturbations Using Expected Perturbation Score25 May 2023
- 2023A Certified Radius-Guided Attack Framework to Image Segmentation Models5 Apr 2023
- 2023Survey on Adversarial Attack and Defense for Medical Image Analysis: Methods and Challenges24 Mar 2023
12 newest of 24 All 24 (JSON)