Statistical Power in Image Segmentation: Relating Sample Size to Reference Standard Quality

Ideal reference standards for comparing segmentation algorithms balance trade-offs between the data set size, the costs of reference standard creation and the resulting accuracy. As reference standard quality impacts the likelihood of detecting significant improvements (i.e. the statistical power), we derived a sample size formula for segmentation accuracy comparison using an imperfect reference standard. We expressed this formula as a function of algorithm performance and reference standard quality (e.g. measured with a high quality reference standard on pilot data) to reveal the relationship between reference standard quality and statistical power, addressing key study design questions: (1) How many validation images are needed to compare segmentation algorithms? (2) How accurate should the reference standard be? The resulting formula predicted statistical power to within 2% of Monte Carlo simulations across a range of model parameters. A case study, using the PROMISE12 prostate segmentation data set, shows the practical use of the formula.