arXiv:2510.06655eess.IVcs.LG2025-10中稿 · MICCAI 2025 ISIC W…被引 1

针对深肤色皮肤的皮炎图像分割难题,提出按肤型调阈值的方法,显著提升准确率。

Fitzpatrick Thresholding for Skin Image Segmentation

  • 按弗茨帕特克肤型调整分割阈值,实现模型无关的性能优化
  • 深肤色组(Fitz VI)分割性能提升最高达31% bIoU和24% Dice
  • 无需重训练、不改结构,低成本提升医疗影像公平性

准确估算皮炎(如银屑病)累及体表面积(BSA)对评估病情严重程度、制定初始治疗方案及监测疗效至关重要。现有皮炎图像分割方法在深肤色人群中的表现明显下降,可能影响医疗公平性。研究整合了来自六个公开图谱的银屑病数据集,标注了弗茨帕特克肤型,并为每张图像添加详细分割掩码。基于U-Net、ResU-Net和SETR-small的参考模型未使用肤型信息进行训练。在调参阶段,通过遍历决策阈值,选择(i)全局最优和(ii)按弗茨帕特克肤型分别最优的阈值,以最大化Dice和二值交并比(bIoU)。采用弗茨帕特克特定阈值后,最深肤色组(Fitz VI)的分割性能提升最高达+31% bIoU和+24% Dice(U-Net),ResU-Net和SETR-small也获得一致但较小的正向提升(分别为+25% / +18% 和 +17% / +11%)。由于基于Fitzpatrick-17k训练的肤型分类器准确率已超95%,肤型标注成本大幅降低。该方法简单、模型无关、无需架构修改或重训练,近乎零成本,可作为未来算法公平性的基准。

原文摘要 · Abstract (English)

Accurate estimation of the body surface area (BSA) involved by a rash, such as psoriasis, is critical for assessing rash severity, selecting an initial treatment regimen, and following clinical treatment response. Attempts at segmentation of inflammatory skin disease such as psoriasis perform markedly worse on darker skin tones, potentially impeding equitable care. We assembled a psoriasis dataset sourced from six public atlases, annotated for Fitzpatrick skin type, and added detailed segmentation masks for every image. Reference models based on U-Net, ResU-Net, and SETR-small are trained without tone information. On the tuning split we sweep decision thresholds and select (i) global optima and (ii) per Fitzpatrick skin tone optima for Dice and binary IoU. Adapting Fitzpatrick specific thresholds lifted segmentation performance for the darkest subgroup (Fitz VI) by up to +31 % bIoU and +24 % Dice on UNet, with consistent, though smaller, gains in the same direction for ResU-Net (+25 % bIoU, +18 % Dice) and SETR-small (+17 % bIoU, +11 % Dice). Because Fitzpatrick skin tone classifiers trained on Fitzpatrick-17k now exceed 95 % accuracy, the cost of skin tone labeling required for this technique has fallen dramatically. Fitzpatrick thresholding is simple, model-agnostic, requires no architectural changes, no re-training, and is virtually cost free. We demonstrate the inclusion of Fitzpatrick thresholding as a potential future fairness baseline.

皮肤分割公平性阈值优化医学图像

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