arXiv:2509.12772eess.IVcs.AI2025-09中稿 · UNSURE, MICCAI

用多个专家模型提升内窥镜图像诊断的不确定性估计可靠性。

MEGAN: Mixture of Experts for Robust Uncertainty Estimation in Endoscopy Videos

  • 引入多专家门控网络,融合不同标注者训练的模型预测与不确定性。
  • 在溃疡性结肠炎评估中,F1得分提升3.5%,校准误差降低30.5%。
  • 适合医疗影像需高可靠性、低标注成本的临床研究场景。

可靠的不确定性量化(UQ)对医学AI至关重要。证据深度学习(EDL)能高效地在预测同时量化不确定性,优于蒙特卡洛丢弃和深度集成等传统方法。然而,这些方法通常依赖单一专家标注作为训练真值,忽视了医疗中的评分者间差异。为此,我们提出MEGAN:一种多专家门控网络,通过多个基于不同真值和建模策略训练的EDL模型,聚合预测与不确定性估计。其门控网络最优融合各模型输出,提升整体置信度与校准性。我们在溃疡性结肠炎(UC)内窥镜视频上广泛评测,以梅奥内镜亚评分(MES)为视觉标签,该任务存在显著评分者间差异。在大规模前瞻性临床试验中,MEGAN相比现有方法实现3.5%的F1分数提升和30.5%的期望校准误差(ECE)下降。此外,基于不确定性的样本分层显著降低了标注负担,可能提升临床试验效率与一致性。

原文摘要 · Abstract (English)

Reliable uncertainty quantification (UQ) is essential in medical AI. Evidential Deep Learning (EDL) offers a computationally efficient way to quantify model uncertainty alongside predictions, unlike traditional methods such as Monte Carlo (MC) Dropout and Deep Ensembles (DE). However, all these methods often rely on a single expert's annotations as ground truth for model training, overlooking the inter-rater variability in healthcare. To address this issue, we propose MEGAN, a Multi-Expert Gating Network that aggregates uncertainty estimates and predictions from multiple AI experts via EDL models trained with diverse ground truths and modeling strategies. MEGAN's gating network optimally combines predictions and uncertainties from each EDL model, enhancing overall prediction confidence and calibration. We extensively benchmark MEGAN on endoscopy videos for Ulcerative colitis (UC) disease severity estimation, assessed by visual labeling of Mayo Endoscopic Subscore (MES), where inter-rater variability is prevalent. In large-scale prospective UC clinical trial, MEGAN achieved a 3.5% improvement in F1-score and a 30.5% reduction in Expected Calibration Error (ECE) compared to existing methods. Furthermore, MEGAN facilitated uncertainty-guided sample stratification, reducing the annotation burden and potentially increasing efficiency and consistency in UC trials.

医疗AI不确定性估计多专家模型内窥镜

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