# Role of Image Acquisition and Patient Phenotype Variations in Automatic Segmentation Model Generalization

arXiv: https://arxiv.org/abs/2307.14482 · HTML: https://mlsanity.com/paper/2307.14482/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 1 of its 15 references that are in the map.
- First posted on arXiv 26 Jul 2023.

## Builds on (most cited first, 1 of 1)

- [Hidden Stratification Causes Clinically Meaningful Failures in Machine Learning for Medical Imaging](https://mlsanity.com/paper/1909.12475/) (2019)

## Abstract (arXiv)

Purpose: This study evaluated the out-of-domain performance and generalization capabilities of automated medical image segmentation models, with a particular focus on adaptation to new image acquisitions and disease type. Materials: Datasets from both non-contrast and contrast-enhanced abdominal CT scans of healthy patients and those with polycystic kidney disease (PKD) were used. A total of 400 images (100 non-contrast controls, 100 contrast controls, 100 non-contrast PKD, 100 contrast PKD) were utilized for training/validation of models to segment kidneys, livers, and spleens, and the final models were then tested on 100 non-contrast CT images of patients affected by PKD. Performance was evaluated using Dice, Jaccard, TPR, and Precision. Results: Models trained on a diverse range of data showed no worse performance than models trained exclusively on in-domain data when tested on in-domain data. For instance, the Dice similarity of the model trained on 25% from each dataset was found to be non-inferior to the model trained purely on in-domain data. Conclusions: The results indicate that broader training examples significantly enhances model generalization and out-of-domain performance, thereby improving automated segmentation tools' applicability in clinical settings. The study's findings provide a roadmap for future research to adopt a data-centric approach in medical image AI model development.