# Pareto-Guided Optimization for Uncertainty-Aware Medical Image Segmentation

arXiv: https://arxiv.org/abs/2601.19365 · HTML: https://mlsanity.com/paper/2601.19365/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 33 of its 51 references that are in the map.
- First posted on arXiv 27 Jan 2026.

## Builds on (most cited first, 30 of 33)

- [Dropout as a Bayesian Approximation: Representing Model Uncertainty in Deep Learning](https://mlsanity.com/paper/1506.02142/) (2015)
- [What Uncertainties Do We Need in Bayesian Deep Learning for Computer Vision?](https://mlsanity.com/paper/1703.04977/) (2017)
- [V-Net: Fully Convolutional Neural Networks for Volumetric Medical Image Segmentation](https://mlsanity.com/paper/1606.04797/) (2016)
- [Multi-Task Learning Using Uncertainty to Weigh Losses for Scene Geometry and Semantics](https://mlsanity.com/paper/1705.07115/) (2017)
- [A Survey on Deep Learning in Medical Image Analysis](https://mlsanity.com/paper/1702.05747/) (2017)
- [Co-teaching: Robust Training of Deep Neural Networks with Extremely Noisy Labels](https://mlsanity.com/paper/1804.06872/) (2018)
- [When Does Label Smoothing Help?](https://mlsanity.com/paper/1906.02629/) (2019)
- [Aleatoric and Epistemic Uncertainty in Machine Learning: An Introduction to Concepts and Methods](https://mlsanity.com/paper/1910.09457/) (2019)
- [GradNorm: Gradient Normalization for Adaptive Loss Balancing in Deep Multitask Networks](https://mlsanity.com/paper/1711.02257/) (2017)
- [Swin UNETR: Swin Transformers for Semantic Segmentation of Brain Tumors in MRI Images](https://mlsanity.com/paper/2201.01266/) (2022)
- [Multi-Task Learning as Multi-Objective Optimization](https://mlsanity.com/paper/1810.04650/) (2018)
- [A Review of Uncertainty Quantification in Deep Learning: Techniques, Applications and Challenges](https://mlsanity.com/paper/2011.06225/) (2020)
- [DivideMix: Learning with Noisy Labels as Semi-supervised Learning](https://mlsanity.com/paper/2002.07394/) (2020)
- [Confident Learning: Estimating Uncertainty in Dataset Labels](https://mlsanity.com/paper/1911.00068/) (2019)
- [Aleatoric uncertainty estimation with test-time augmentation for medical image segmentation with convolutional neural networks](https://mlsanity.com/paper/1807.07356/) (2018)
- [Deep learning with noisy labels: exploring techniques and remedies in medical image analysis](https://mlsanity.com/paper/1912.02911/) (2019)
- [Confidence Calibration and Predictive Uncertainty Estimation for Deep Medical Image Segmentation](https://mlsanity.com/paper/1911.13273/) (2019)
- [PHiSeg: Capturing Uncertainty in Medical Image Segmentation](https://mlsanity.com/paper/1906.04045/) (2019)
- [HeMIS: Hetero-Modal Image Segmentation](https://mlsanity.com/paper/1607.05194/) (2016)
- [mmFormer: Multimodal Medical Transformer for Incomplete Multimodal Learning of Brain Tumor Segmentation](https://mlsanity.com/paper/2206.02425/) (2022)
- [Assessing Reliability and Challenges of Uncertainty Estimations for Medical Image Segmentation](https://mlsanity.com/paper/1907.03338/) (2019)
- [Hetero-Modal Variational Encoder-Decoder for Joint Modality Completion and Segmentation](https://mlsanity.com/paper/1907.11150/) (2019)
- [A Review of Uncertainty Estimation and its Application in Medical Imaging](https://mlsanity.com/paper/2302.08119/) (2023)
- [Understanding metric-related pitfalls in image analysis validation](https://mlsanity.com/paper/2302.01790/) (2023)
- [Pareto Set Learning for Expensive Multi-Objective Optimization](https://mlsanity.com/paper/2210.08495/) (2022)
- [Training Convolutional Networks with Noisy Labels](https://mlsanity.com/paper/1406.2080/) (2014)
- [Scalable Pareto Front Approximation for Deep Multi-Objective Learning](https://mlsanity.com/paper/2103.13392/) (2021)
- [Supervised Uncertainty Quantification for Segmentation with Multiple Annotations](https://mlsanity.com/paper/1907.01949/) (2019)
- [Self-Paced Contrastive Learning for Semi-supervised Medical Image Segmentation with Meta-labels](https://mlsanity.com/paper/2107.13741/) (2021)
- [Heteroscedastic Uncertainty Estimation Framework for Unsupervised Registration](https://mlsanity.com/paper/2312.00836/) (2023)

## Abstract (arXiv)

Uncertainty in medical image segmentation is inherently non-uniform, with boundary regions exhibiting substantially higher ambiguity than interior areas. Conventional training treats all pixels equally, leading to unstable optimization during early epochs when predictions are unreliable. We argue that this instability hinders convergence toward Pareto-optimal solutions and propose a region-wise curriculum strategy that prioritizes learning from certain regions and gradually incorporates uncertain ones, reducing gradient variance. Methodologically, we introduce a Pareto-consistent loss that balances trade-offs between regional uncertainties by adaptively reshaping the loss landscape and constraining convergence dynamics between interior and boundary regions; this guides the model toward Pareto-approximate solutions. To address boundary ambiguity, we further develop a fuzzy labeling mechanism that maintains binary confidence in non-boundary areas while enabling smooth transitions near boundaries, stabilizing gradients, and expanding flat regions in the loss surface. Experiments on brain metastasis and non-metastatic tumor segmentation show consistent improvements across multiple configurations, with our method outperforming traditional crisp-set approaches in all tumor subregions.