Pre-Deployment Robustness Stress Testing for CT Segmentation Systems Using Clinically Motivated Multi-Corruption Augmentation

Deep learning-based CT segmentation systems often achieve high accuracy on clean benchmark images, but their performance may degrade under heterogeneous clinical imaging conditions such as noise, resolution loss, contrast variation, intensity shift, and artifacts. This instability can limit reliable deployment in real-world medical imaging workflows. We propose Robustness via Augmented Multi-corruption Pipeline (RAMP), a robustness-oriented augmentation framework for CT segmentation. RAMP combines anatomically constrained spatial perturbations, CT intensity transformations, and stochastic multi-corruption composition to expose models to clinically plausible image degradation during training. Across two CT segmentation evaluation settings, RAMP achieved the strongest corrupted-image performance and the smallest clean-to-corrupted robustness gap. In the five-organ noisy evaluation benchmark, RAMP improved mean corrupted Dice from 0.610 to 0.753 and reduced the robustness gap from 0.264 to 0.064 compared with the nnU-Net baseline. In Abdomen1K, RAMP improved mean corrupted Dice from 0.633 to 0.789 and reduced the robustness gap from 0.290 to 0.070. Although RAMP did not achieve the highest clean-image Dice, it substantially mitigated worst-case segmentation collapse under severe image degradation. These results suggest that multi-corruption augmentation can serve as a practical pre-deployment strategy for improving the reliability of CT segmentation systems in heterogeneous clinical environments.