Evaluating the Impact of Radiographic Noise on Chest X-ray Semantic Segmentation and Disease Classification Using a Scalable Noise Injection Framework

Deep learning models are increasingly used for radiographic analysis, but their reliability is challenged by the stochastic noise inherent in clinical imaging. A systematic, cross-task understanding of how different noise types impact these models is lacking. Here, we evaluate the robustness of state-of-the-art convolutional neural networks (CNNs) to simulated quantum (Poisson) and electronic (Gaussian) noise in two key chest X-ray tasks: semantic segmentation and pulmonary disease classification. Using a novel, scalable noise injection framework, we applied controlled, clinically-motivated noise severities to common architectures (UNet, DeepLabV3, FPN; ResNet, DenseNet, EfficientNet) on public datasets (Landmark, ChestX-ray14). Our results reveal a stark dichotomy in task robustness. Semantic segmentation models proved highly vulnerable, with lung segmentation performance collapsing under severe electronic noise (Dice Similarity Coefficient drop of 0.843), signifying a near-total model failure. In contrast, classification tasks demonstrated greater overall resilience, but this robustness was not uniform. We discovered a differential vulnerability: certain tasks, such as distinguishing Pneumothorax from Atelectasis, failed catastrophically under quantum noise (AUROC drop of 0.355), while others were more susceptible to electronic noise. These findings demonstrate that while classification models possess a degree of inherent robustness, pixel-level segmentation tasks are far more brittle. The task- and noise-specific nature of model failure underscores the critical need for targeted validation and mitigation strategies before the safe clinical deployment of diagnostic AI.