# Validation of musculoskeletal segmentation model with uncertainty estimation for bone and muscle assessment in hip-to-knee clinical CT images

arXiv: https://arxiv.org/abs/2409.02770 · HTML: https://mlsanity.com/paper/2409.02770/

## Key facts

- Cited by 1 papers in the map (data through 14 Oct 2026).
- Builds on 15 of its 55 references that are in the map.
- First posted on arXiv 4 Sep 2024.

## Builds on (most cited first, 15 of 15)

- [An Image is Worth 16x16 Words: Transformers for Image Recognition at Scale](https://mlsanity.com/paper/2010.11929/) (2020)
- [Batch Normalization: Accelerating Deep Network Training by Reducing Internal Covariate Shift](https://mlsanity.com/paper/1502.03167/) (2015)
- [Dropout as a Bayesian Approximation: Representing Model Uncertainty in Deep Learning](https://mlsanity.com/paper/1506.02142/) (2015)
- [Deeper, Broader and Artier Domain Generalization](https://mlsanity.com/paper/1710.03077/) (2017)
- [UNETR: Transformers for 3D Medical Image Segmentation](https://mlsanity.com/paper/2103.10504/) (2021)
- [Swin UNETR: Swin Transformers for Semantic Segmentation of Brain Tumors in MRI Images](https://mlsanity.com/paper/2201.01266/) (2022)
- [TotalSegmentator: robust segmentation of 104 anatomical structures in CT images](https://mlsanity.com/paper/2208.05868/) (2022)
- [Confidence Calibration and Predictive Uncertainty Estimation for Deep Medical Image Segmentation](https://mlsanity.com/paper/1911.13273/) (2019)
- [Deep Learning to Segment Pelvic Bones: Large-scale CT Datasets and Baseline Models](https://mlsanity.com/paper/2012.08721/) (2020)
- [Automated Muscle Segmentation from Clinical CT using Bayesian U-Net for Personalized Musculoskeletal Modeling](https://mlsanity.com/paper/1907.08915/) (2019)
- [Efficient Bayesian Uncertainty Estimation for nnU-Net](https://mlsanity.com/paper/2212.06278/) (2022)
- [Cross-Vendor CT Image Data Harmonization Using CVH-CT](https://mlsanity.com/paper/2110.09693/) (2021)
- [Large-Scale Analysis of Iliopsoas Muscle Volumes in the UK Biobank](https://mlsanity.com/paper/2008.05217/) (2020)
- [Hybrid Representation-Enhanced Sampling for Bayesian Active Learning in Musculoskeletal Segmentation of Lower Extremities](https://mlsanity.com/paper/2307.13986/) (2023)
- [Automatic hip osteoarthritis grading with uncertainty estimation from computed tomography using digitally-reconstructed radiographs](https://mlsanity.com/paper/2401.00159/) (2023)

## Built on by (most cited first, 1 of 1)

- [LegSegNet: A Public Deep Learning System for Lower Extremity CT Tissue Segmentation and Quantification](https://mlsanity.com/paper/2605.30829/) (2026)

## Abstract (arXiv)

Deep learning-based image segmentation has allowed for the fully automated, accurate, and rapid analysis of musculoskeletal (MSK) structures from medical images. However, current approaches were either applied only to 2D cross-sectional images, addressed few structures, or were validated on small datasets, which limit the application in large-scale databases. This study aimed to validate an improved deep learning model for volumetric MSK segmentation of the hip and thigh with uncertainty estimation from clinical computed tomography (CT) images. Databases of CT images from multiple manufacturers/scanners, disease status, and patient positioning were used. The segmentation accuracy, and accuracy in estimating the structures volume and density, i.e., mean HU, were evaluated. An approach for segmentation failure detection based on predictive uncertainty was also investigated. The model has shown an overall improvement with respect to all segmentation accuracy and structure volume/density evaluation metrics. The predictive uncertainty yielded large areas under the receiver operating characteristic (AUROC) curves (AUROCs>=.95) in detecting inaccurate and failed segmentations. The high segmentation and muscle volume/density estimation accuracy, along with the high accuracy in failure detection based on the predictive uncertainty, exhibited the model's reliability for analyzing individual MSK structures in large-scale CT databases.