arXiv:2604.11798cs.CVcs.AI2026-04

用不确定性评估辅助放疗分割质检,精准定位需人工复核区域。

Budget-Aware Uncertainty for Radiotherapy Segmentation QA Using nnU-Net

  • 基于nnU-Net构建不确定性量化与校准框架,生成体素级不确定图。
  • 校准后检查点集成使误差与不确定性的匹配度提升,最高覆盖前5%高不确定区。
  • 适合临床部署中资源有限时的高效分割质量保障,尤其适用于复杂放疗方案。

精确勾画临床靶区(CTV)对放疗规划至关重要,但耗时且难以评估,尤其在全骨髓及淋巴结照射(TMLI)等复杂治疗中。尽管深度学习自动分割可减轻负担,但安全应用需可靠提示模型可能出错的位置。本文提出基于nnU-Net的预算感知不确定性驱动质量保证(QA)框架,结合不确定性量化与事后校准,生成基于预测熵的体素级不确定性图,指导针对性人工审查。对比温度缩放(TS)、深度集成(DE)、检查点集成(CE)和测试时增强(TTA),在TMLI场景下单独及组合评估。通过感兴趣区掩码校准指标与现实修订约束下的不确定-误差对齐性分析,以顶0-5%最不确定体素的AUC衡量可靠性。各配置下分割精度稳定,而TS显著改善校准效果。校准后的检查点集成使不确定-误差对齐最佳,所生成的不确定性图更一致地标识出需人工修正区域。整体表明,将校准与高效集成相结合,是实现放疗分割预算感知质量保障工作的可行策略。

原文摘要 · Abstract (English)

Accurate delineation of the Clinical Target Volume (CTV) is essential for radiotherapy planning, yet remains time-consuming and difficult to assess, especially for complex treatments such as Total Marrow and Lymph Node Irradiation (TMLI). While deep learning-based auto-segmentation can reduce workload, safe clinical deployment requires reliable cues indicating where models may be wrong. In this work, we propose a budget-aware uncertainty-driven quality assurance (QA) framework built on nnU-Net, combining uncertainty quantification and post-hoc calibration to produce voxel-wise uncertainty maps (based on predictive entropy) that can guide targeted manual review. We compare temperature scaling (TS), deep ensembles (DE), checkpoint ensembles (CE), and test-time augmentation (TTA), evaluated both individually and in combination on TMLI as a representative use case. Reliability is assessed through ROI-masked calibration metrics and uncertainty--error alignment under realistic revision constraints, summarized as AUC over the top 0-5% most uncertain voxels. Across configurations, segmentation accuracy remains stable, whereas TS substantially improves calibration. Uncertainty-error alignment improves most with calibrated checkpoint-based inference, leading to uncertainty maps that highlight more consistently regions requiring manual edits. Overall, integrating calibration with efficient ensembling seems a promising strategy to implement a budget-aware QA workflow for radiotherapy segmentation.

放疗分割不确定性质量评估nnU-Net

Thank you to arXiv for use of its open access interoperability. PaperDance 不是 arXiv 官方产品;中文卡片由大模型生成,请以原文为准。