# Hierarchical Uncertainty Estimation for Medical Image Segmentation Networks

arXiv: https://arxiv.org/abs/2308.08465 · HTML: https://mlsanity.com/paper/2308.08465/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 13 of its 20 references that are in the map.
- First posted on arXiv 16 Aug 2023.

## Builds on (most cited first, 13 of 13)

- [U-Net: Convolutional Networks for Biomedical Image Segmentation](https://mlsanity.com/paper/1505.04597/) (2015)
- [Dropout as a Bayesian Approximation: Representing Model Uncertainty in Deep Learning](https://mlsanity.com/paper/1506.02142/) (2015)
- [Simple and Scalable Predictive Uncertainty Estimation using Deep Ensembles](https://mlsanity.com/paper/1612.01474/) (2016)
- [TransUNet: Transformers Make Strong Encoders for Medical Image Segmentation](https://mlsanity.com/paper/2102.04306/) (2021)
- [Attention U-Net: Learning Where to Look for the Pancreas](https://mlsanity.com/paper/1804.03999/) (2018)
- [Swin-Unet: Unet-like Pure Transformer for Medical Image Segmentation](https://mlsanity.com/paper/2105.05537/) (2021)
- [An Introduction to Variational Autoencoders](https://mlsanity.com/paper/1906.02691/) (2019)
- [A Review of Uncertainty Quantification in Deep Learning: Techniques, Applications and Challenges](https://mlsanity.com/paper/2011.06225/) (2020)
- [A Probabilistic U-Net for Segmentation of Ambiguous Images](https://mlsanity.com/paper/1806.05034/) (2018)
- [Flipout: Efficient Pseudo-Independent Weight Perturbations on Mini-Batches](https://mlsanity.com/paper/1803.04386/) (2018)
- [PHiSeg: Capturing Uncertainty in Medical Image Segmentation](https://mlsanity.com/paper/1906.04045/) (2019)
- [A Hierarchical Probabilistic U-Net for Modeling Multi-Scale Ambiguities](https://mlsanity.com/paper/1905.13077/) (2019)
- [Efficient Bayesian Uncertainty Estimation for nnU-Net](https://mlsanity.com/paper/2212.06278/) (2022)

## Abstract (arXiv)

Learning a medical image segmentation model is an inherently ambiguous task, as uncertainties exist in both images (noise) and manual annotations (human errors and bias) used for model training. To build a trustworthy image segmentation model, it is important to not just evaluate its performance but also estimate the uncertainty of the model prediction. Most state-of-the-art image segmentation networks adopt a hierarchical encoder architecture, extracting image features at multiple resolution levels from fine to coarse. In this work, we leverage this hierarchical image representation and propose a simple yet effective method for estimating uncertainties at multiple levels. The multi-level uncertainties are modelled via the skip-connection module and then sampled to generate an uncertainty map for the predicted image segmentation. We demonstrate that a deep learning segmentation network such as U-net, when implemented with such hierarchical uncertainty estimation module, can achieve a high segmentation performance, while at the same time provide meaningful uncertainty maps that can be used for out-of-distribution detection.