Statistical Management of the False Discovery Rate in Medical Instance Segmentation Based on Conformal Risk Control

Instance segmentation plays a pivotal role in medical image analysis by enabling precise localization and delineation of lesions, tumors, and anatomical structures. Although deep learning models such as Mask R-CNN and BlendMask have achieved remarkable progress, their application in high-risk medical scenarios remains constrained by confidence calibration issues, which may lead to misdiagnosis. To address this challenge, we propose a robust quality control framework based on conformal prediction theory. This framework innovatively constructs a risk-aware dynamic threshold mechanism that adaptively adjusts segmentation decision boundaries according to clinical requirements.Specifically, we design a calibration-aware loss function that dynamically tunes the segmentation threshold based on a user-defined risk level α. Utilizing exchangeable calibration data, this method ensures that the expected FNR or FDR on test data remains below α with high probability. The framework maintains compatibility with mainstream segmentation models (e.g., Mask R-CNN, BlendMask+ResNet-50-FPN) and datasets (PASCAL VOC format) without requiring architectural modifications. Empirical results demonstrate that we rigorously bound the FDR metric marginally over the test set via our developed calibration framework.