Towards Reliable WMH Segmentation under Domain Shift: An Application Study using Maximum Entropy Regularization to Improve Uncertainty Estimation

Accurate segmentation of white matter hyperintensities (WMH) is crucial for clinical decision-making, particularly in the context of multiple sclerosis. However, domain shifts, such as variations in MRI machine types or acquisition parameters, pose significant challenges to model calibration and uncertainty estimation. This study investigates the impact of domain shift on WMH segmentation by proposing maximum-entropy regularization techniques to enhance model calibration and uncertainty estimation, with the purpose of identifying errors post-deployment using predictive uncertainty as a proxy measure that does not require ground-truth labels. To do this, we conducted experiments using a U-Net architecture to evaluate these regularization schemes on two publicly available datasets, assessing performance with the Dice coefficient, expected calibration error, and entropy-based uncertainty estimates. Our results show that entropy-based uncertainty estimates can anticipate segmentation errors, and that maximum-entropy regularization further strengthens the correlation between uncertainty and segmentation performance while also improving model calibration under domain shift.

Maximum Entropy on Erroneous Predictions (MEEP): Improving model calibration for medical image segmentation

Modern deep neural networks have achieved remarkable progress in medical image segmentation tasks. However, it has recently been observed that they tend to produce overconfident estimates, even in situations of high uncertainty, leading to poorly calibrated and unreliable models. In this work we introduce Maximum Entropy on Erroneous Predictions (MEEP), a training strategy for segmentation networks which selectively penalizes overconfident predictions, focusing only on misclassified pixels. In particular, we design a regularization term that encourages high entropy posteriors for wrong predictions, increasing the network uncertainty in complex scenarios. Our method is agnostic to the neural architecture, does not increase model complexity and can be coupled with multiple segmentation loss functions. We benchmark the proposed strategy in two challenging medical image segmentation tasks: white matter hyperintensity lesions in magnetic resonance images (MRI) of the brain, and atrial segmentation in cardiac MRI. The experimental results demonstrate that coupling MEEP with standard segmentation losses leads to improvements not only in terms of model calibration, but also in segmentation quality.