mlsanityData to 7 Oct 2026

Metrics reloaded: Recommendations for image analysis validation

arXiv 2206.01653 ↗First posted 3 Jun 2022cs.CVcited by 190

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Abstract (arXiv)

Increasing evidence shows that flaws in machine learning (ML) algorithm validation are an underestimated global problem. Particularly in automatic biomedical image analysis, chosen performance metrics often do not reflect the domain interest, thus failing to adequately measure scientific progress and hindering translation of ML techniques into practice. To overcome this, our large international expert consortium created Metrics Reloaded, a comprehensive framework guiding researchers in the problem-aware selection of metrics. Following the convergence of ML methodology across application domains, Metrics Reloaded fosters the convergence of validation methodology. The framework was developed in a multi-stage Delphi process and is based on the novel concept of a problem fingerprint - a structured representation of the given problem that captures all aspects that are relevant for metric selection, from the domain interest to the properties of the target structure(s), data set and algorithm output. Based on the problem fingerprint, users are guided through the process of choosing and applying appropriate validation metrics while being made aware of potential pitfalls. Metrics Reloaded targets image analysis problems that can be interpreted as a classification task at image, object or pixel level, namely image-level classification, object detection, semantic segmentation, and instance segmentation tasks. To improve the user experience, we implemented the framework in the Metrics Reloaded online tool, which also provides a point of access to explore weaknesses, strengths and specific recommendations for the most common validation metrics. The broad applicability of our framework across domains is demonstrated by an instantiation for various biological and medical image analysis use cases.

Key facts. Cited by 190 papers in the map (data through 7 Oct 2026). Builds on 35 of its 135 references that are in the map. First posted on arXiv 3 Jun 2022.

Builds on

35 of 135 references.

References · 35

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23 more
  1. 2019Hidden Stratification Causes Clinically Meaningful Failures in Machine Learning for Medical Imagingcited by 215
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Cited by year (2026 to 7 Oct)

Citing papers per year: 2022: 9; 2023: 16; 2024: 56; 2025: 47; 2026: 62.

190 papers.

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  1. 2022UNETR++: Delving into Efficient and Accurate 3D Medical Image Segmentationcited by 112
  2. 2025MedSAM2: Segment Anything in 3D Medical Images and Videoscited by 88
  3. 2023Large-Vocabulary Segmentation for Medical Images with Text Promptscited by 60
  4. 2023FUTURE-AI: International consensus guideline for trustworthy and deployable artificial intelligence in healthcarecited by 59
  5. 2024TotalSegmentator MRI: Robust Sequence-independent Segmentation of Multiple Anatomic Structures in MRIcited by 58
  6. 2023Understanding metric-related pitfalls in image analysis validationcited by 57
  7. 2023The TopCoW Challenge -- Topology-Aware Circle of Willis Segmentation for CT and MR Angiographycited by 48
  8. 2024Skeleton Recall Loss for Connectivity Conserving and Resource Efficient Segmentation of Thin Tubular Structurescited by 43
  9. 2023The Multi-modality Cell Segmentation Challenge: Towards Universal Solutionscited by 39
  10. 2024Centerline Boundary Dice Loss for Vascular Segmentationcited by 27
  11. 2023Deep Interactive Segmentation of Medical Images: A Systematic Review and Taxonomycited by 26
  12. 2024Generative AI for Synthetic Data Across Multiple Medical Modalities: A Systematic Review of Recent Developments and Challengescited by 24
38 more
  1. 2024PitVQA: Image-grounded Text Embedding LLM for Visual Question Answering in Pituitary Surgerycited by 22
  2. 2022Labeling instructions matter in biomedical image analysiscited by 20
  3. 2024Similarity and Quality Metrics for MR Image-To-Image Translationcited by 20
  4. 2024Automatic Organ and Pan-cancer Segmentation in Abdomen CT: the FLARE 2023 Challengecited by 20
  5. 2023Fixing Overconfidence in Dynamic Neural Networkscited by 19
  6. 2024Fr'echet Radiomic Distance (FRD): A Versatile Metric for Comparing Medical Imaging Datasetscited by 19
  7. 2024A study of why we need to reassess full reference image quality assessment with medical imagescited by 16
  8. 2023Surgical Tattoos in Infrared: A Dataset for Quantifying Tissue Tracking and Mappingcited by 15
  9. 2024UU-Mamba: Uncertainty-aware U-Mamba for Cardiac Image Segmentationcited by 15
  10. 2022Class Adaptive Network Calibrationcited by 13
  11. 2023Jaccard Metric Losses: Optimizing the Jaccard Index with Soft Labelscited by 12
  12. 2024Comparative Benchmarking of Failure Detection Methods in Medical Image Segmentation: Unveiling the Role of Confidence Aggregationcited by 12
  13. 2024xLSTM-UNet can be an Effective 2D & 3D Medical Image Segmentation Backbone with Vision-LSTM (ViL) better than its Mamba Counterpartcited by 12
  14. 2025Full Conformal Adaptation of Medical Vision-Language Modelscited by 9
  15. 2022Approaching Peak Ground Truthcited by 8
  16. 2023Tackling Bias in the Dice Similarity Coefficient: Introducing nDSC for White Matter Lesion Segmentationcited by 8
  17. 2024A Robust Ensemble Algorithm for Ischemic Stroke Lesion Segmentation: Generalizability and Clinical Utility Beyond the ISLES Challengecited by 8
  18. 2024TBConvL-Net: A Hybrid Deep Learning Architecture for Robust Medical Image Segmentationcited by 8
  19. 2024PSFHS Challenge Report: Pubic Symphysis and Fetal Head Segmentation from Intrapartum Ultrasound Imagescited by 8
  20. 2024Longitudinal Segmentation of MS Lesions via Temporal Difference Weightingcited by 8
  21. 2024Data Augmentation for Surgical Scene Segmentation with Anatomy-Aware Diffusion Modelscited by 8
  22. 2024Every Component Counts: Rethinking the Measure of Success for Medical Semantic Segmentation in Multi-Instance Segmentation Taskscited by 8
  23. 2022Brain tumour segmentation with incomplete imaging datacited by 7
  24. 2024Tissue Concepts: supervised foundation models in computational pathologycited by 7
  25. 2025Few-Shot, Now for Real: Medical VLMs Adaptation without Balanced Sets or Validationcited by 7
  26. 2024BraTS-Path Challenge: Assessing Heterogeneous Histopathologic Brain Tumor Sub-regionscited by 6
  27. 2024Quality Assured: Rethinking Annotation Strategies in Imaging AIcited by 6
  28. 2024Visual Prompt Engineering for Vision Language Models in Radiologycited by 6
  29. 2024Mask of truth: model sensitivity to unexpected regions of medical imagescited by 6
  30. 2025Adding Chocolate to Mint: Mitigating Metric Interference in Machine Translationcited by 6
  31. 2025Comparative validation of surgical phase recognition, instrument keypoint estimation, and instrument instance segmentation in endoscopy: Results of the PhaKIR 2024 challengecited by 6
  32. 2025MM-DINOv2: Adapting Foundation Models for Multi-Modal Medical Image Analysiscited by 6
  33. 2025Longitudinal Flow Matching for Trajectory Modelingcited by 6
  34. 2022Neural Network Compression by Joint Sparsity Promotion and Redundancy Reductioncited by 5
  35. 2023Semantic segmentation of surgical hyperspectral images under geometric domain shiftscited by 5
  36. 2023Dice Semimetric Losses: Optimizing the Dice Score with Soft Labelscited by 5
  37. 2024Real-World Federated Learning in Radiology: Hurdles to overcome and Benefits to gaincited by 5
  38. 2024MIST: A Simple and Scalable End-To-End 3D Medical Imaging Segmentation Frameworkcited by 5

50 most cited of 190 All 190 (JSON)