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Background: The trend towards large-scale studies including population imaging poses new challenges in terms of quality control (QC). This is a particular issue when automatic processing tools, e.g. image segmentation methods, are employed to derive quantitative measures or biomarkers for later analyses. Manual inspection and visual QC of each segmentation isn't feasible at large scale. However, it's important to be able to automatically detect when a segmentation method fails so as to avoid inclusion of wrong measurements into subsequent analyses which could lead to incorrect conclusions. Methods: To overcome this challenge, we explore an approach for predicting segmentation quality based on Reverse Classification Accuracy, which enables us to discriminate between successful and failed segmentations on a per-cases basis. We validate this approach on a new, large-scale manually-annotated set of 4,800 cardiac magnetic resonance scans. We then apply our method to a large cohort of 7,250 cardiac MRI on which we have performed manual QC. Results: We report results used for predicting segmentation quality metrics including Dice Similarity Coefficient (DSC) and surface-distance measures. As initial validation, we present data for 400 scans demonstrating 99% accuracy for classifying low and high quality segmentations using predicted DSC scores. As further validation we show high correlation between real and predicted scores and 95% classification accuracy on 4,800 scans for which manual segmentations were available. We mimic real-world application of the method on 7,250 cardiac MRI where we show good agreement between predicted quality metrics and manual visual QC scores. Conclusions: We show that RCA has the potential for accurate and fully automatic segmentation QC on a per-case basis in the context of large-scale population imaging as in the UK Biobank Imaging Study., Comment: 14 pages, 7 figures, Journal of Cardiovascular Magnetic Resonance

The variations in multi-center data in medical imaging studies have brought the necessity of domain adaptation. Despite the advancement of machine learning in automatic segmentation, performance often degrades when algorithms are applied on new data acquired from different scanners or sequences than the training data. Manual annotation is costly and time consuming if it has to be carried out for every new target domain. In this work, we investigate automatic selection of suitable subjects to be annotated for supervised domain adaptation using the concept of reverse classification accuracy (RCA). RCA predicts the performance of a trained model on data from the new domain and different strategies of selecting subjects to be included in the adaptation via transfer learning are evaluated. We perform experiments on a two-center MR database for the task of organ segmentation. We show that subject selection via RCA can reduce the burden of annotation of new data for the target domain., Comment: Accepted at the International Conference on Medical Imaging with Deep Learning (MIDL) 2018

When integrating computational tools such as automatic segmentation into clinical practice, it is of utmost importance to be able to assess the level of accuracy on new data, and in particular, to detect when an automatic method fails. However, this is difficult to achieve due to absence of ground truth. Segmentation accuracy on clinical data might be different from what is found through cross-validation because validation data is often used during incremental method development, which can lead to overfitting and unrealistic performance expectations. Before deployment, performance is quantified using different metrics, for which the predicted segmentation is compared to a reference segmentation, often obtained manually by an expert. But little is known about the real performance after deployment when a reference is unavailable. In this paper, we introduce the concept of reverse classification accuracy (RCA) as a framework for predicting the performance of a segmentation method on new data. In RCA we take the predicted segmentation from a new image to train a reverse classifier which is evaluated on a set of reference images with available ground truth. The hypothesis is that if the predicted segmentation is of good quality, then the reverse classifier will perform well on at least some of the reference images. We validate our approach on multi-organ segmentation with different classifiers and segmentation methods. Our results indicate that it is indeed possible to predict the quality of individual segmentations, in the absence of ground truth. Thus, RCA is ideal for integration into automatic processing pipelines in clinical routine and as part of large-scale image analysis studies., Comment: Accepted article to appear in IEEE Transactions on Medical Imaging 2017