Modeling annotator preference and stochastic annotation error for medical image segmentation
Open accessAbstract
Manual annotation of medical images is highly subjective, leading to inevitable annotation biases. Deep learning models may surpass human performance on a variety of tasks, but they may also mimic or amplify these biases. Although we can have multiple annotators and fuse their annotations to reduce stochastic errors, we cannot use this strategy to handle the bias caused by annotators' preferences. In this paper, we highlight the issue of annotator-related biases on medical image segmentation tasks, and propose a Preference-involved Annotation Distribution Learning (PADL) framework to address it from the perspective of modeling an annotator's preference and stochastic errors so as to produce not only a meta segmentation but also the annotator-specific segmentation. Under this framework, a stochastic error modeling (SEM) module estimates the meta segmentation map and average stochastic error map, and a series of human preference modeling (HPM) modules estimate each annotator's segmentation and the corresponding stochastic error. We evaluated our PADL framework on two medical image benchmarks with different imaging modalities, which have been annotated by multiple medical professionals, and achieved promising performance on all five medical image segmentation tasks. Code is available at https://github.com/Merrical/PADL.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Manual annotation of medical images is labor-intensive, time-consuming, and a significant bottleneck in developing and deploying medical imaging AI, requiring extensive domain expertise.
“Manual annotation of medical images is a labor-intensive and time-consuming process, posing a significant bottleneck in the development and deployment of robust medical imaging AI systems.”
From Beyond Manual Annotation: A Human-AI Collaborative Framework for Medical Image Segmentation Using Only "Better or Worse" Expert Feedback (2025) · cites this paper as [13]
The Introduction says medical-image annotation has “tremendous cost,” relies on observers’ expertise, and makes the large volume of accurate labels needed for CNN training difficult to obtain. This supports a costly bottleneck in model development, but the paper does not specifically say annotation is time-consuming or identify it as a bottleneck to deployment. (LLM, conf=0.82)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Deep Residual Learning for Image Recognition
He, K., Zhang, X., Ren, S., & Sun, J. (2016) · 2016 IEEE Conference on Computer Vision and Pattern Recognition (CVPR) · doi:10.1109/cvpr.2016.90 · Cited by 235,474 · see citing works
Flagged first, then by citations
Research works printed but not linked: 42
- Y. Xie, J. Zhang, Y. Xia, and Q. Wu, "Unified 2d and 3d pre-training for medical image classification and segmentation," arXiv preprint arXiv:2112.09356, 2021. · arXiv
- Y. Yang and S. Soatto, "FDA: Fourier domain adaptation for semantic segmentation," in Proceedings of the IEEE/CVF Conference on Com- puter Vision and Pattern Recognition, 2020, pp. 4085-4095.
- J. Zhang, Y. Xie, Y. Xia, and C. Shen, "DoDNet: Learning to segment multi-organ and tumors from multiple partially labeled datasets," in Proceedings of the IEEE/CVF Conference on Computer Vision and Pattern Recognition, 2021, pp. 1195-1204.
- S. Hu, Z. Liao, J. Zhang, and Y. Xia, "Domain and content adaptive convolution for domain generalization in medical image segmentation," arXiv preprint arXiv:2109.05676, 2021. · arXiv
- Q. Liu, Q. Dou, L. Yu, and P. A. Heng, "MS-Net: Multi-site network for improving prostate segmentation with heterogeneous mri data," IEEE Transactions on Medical Imaging, vol. 39, no. 9, pp. 2713-2724, 2020.
- O. Vincent, C. Gros, and J. Cohen-Adad, "Impact of individual rater style on deep learning uncertainty in medical imaging segmentation," arXiv preprint arXiv:2105.02197, 2021. · arXiv
- Z. Liao, Y. Xie, S. Hu, and Y. Xia, "Learning from ambiguous labels for lung nodule malignancy prediction," IEEE Transactions on Medical Imaging, 2022.
- M. C. Fu, R. A. Buerba, W. D. Long III, D. J. Blizzard, A. W. Lischuk, A. H. Haims, and J. N. Grauer, "Interrater and intrarater agreements of magnetic resonance imaging findings in the lumbar spine: Significant variability across degenerative conditions," The Spine Journal, vol. 14, no. 10, pp. 2442-2448, 2014.
- S. A. Taghanaki, N. Duggan, H. Ma, X. Hou, A. Celler, F. Benard, and G. Hamarneh, "Segmentation-free direct tumor volume and metabolic activity estimation from pet scans," Computerized Medical Imaging and Graphics, vol. 63, pp. 52-66, 2018.
- Z. Mirikharaji, K. Abhishek, S. Izadi, and G. Hamarneh, "D-LEMA: Deep learning ensembles from multiple annotations-application to skin lesion segmentation," Proceedings of the IEEE/CVF Conference on Computer Vision and Pattern Recognition Workshops, pp. 1837-1846, 2021.
- P. Suetens, "Fundamentals of medical imaging, 3rd edition," 2017.
- M. Guan, V. Gulshan, A. Dai, and G. Hinton, "Who said what: Modeling individual labelers improves classification," in Proceedings of the AAAI Conference on Artificial Intelligence, vol. 32, no. 1, 2018.
- G. Chen, D. Xiang, B. Zhang, H. Tian, X. Yang, F. Shi, W. Zhu, B. Tian, and X. Chen, "Automatic pathological lung segmentation in low-dose CT image using eigenspace sparse shape composition," IEEE Transactions on Medical Imaging, vol. 38, no. 7, pp. 1736-1749, 2019.
- G. Li, C. Li, C. Zeng, P. Gao, and G. Xie, "Region focus network for joint optic disc and cup segmentation," in Proceedings of the AAAI Conference on Artificial Intelligence, vol. 34, no. 01, 2020, pp. 751-758.
- Q. Zhang, L. Liu, K. Ma, C. Zhuo, and Y. Zheng, "Cross-denoising network against corrupted labels in medical image segmentation with domain shift," in Proceedings of the International Joint Conference on Artificial Intelligence, 2020.
- H. Zhao, H. Li, and L. Cheng, "Improving retinal vessel segmentation with joint local loss by matting," Pattern Recognition, vol. 98, p. 107068, 2020.
- S. K. Warfield, K. H. Zou, and W. M. Wells, "Simultaneous truth and performance level estimation (STAPLE): An algorithm for the valida- tion of image segmentation," IEEE Transactions on Medical Imaging, vol. 23, no. 7, pp. 903-921, 2004.
- M. H. Jensen, D. R. Jørgensen, R. Jalaboi, M. E. Hansen, and M. A. Olsen, "Improving uncertainty estimation in convolutional neural net- works using inter-rater agreement," in International Conference on Med- ical Image Computing and Computer-Assisted Intervention. Springer, 2019, pp. 540-548.
- M. Monteiro, L. L. Folgoc, D. C. de Castro, N. Pawlowski, B. Marques, K. Kamnitsas, M. van der Wilk, and B. Glocker, "Stochastic segmen- tation networks: Modelling spatially correlated aleatoric uncertainty," Advances in Neural Information Processing Systems, 2020.
- Z. Mirikharaji, Y. Yan, and G. Hamarneh, "Learning to segment skin le- sions from noisy annotations," in Domain Adaptation and Representation Transfer and Medical Image Learning with Less Labels and Imperfect Data. Springer, 2019, pp. 207-215.
- W. Ji, S. Yu, J. Wu, K. Ma, C. Bian, Q. Bi, J. Li, H. Liu, L. Cheng, and Y. Zheng, "Learning calibrated medical image segmentation via multi- rater agreement modeling," in Proceedings of the IEEE/CVF Conference on Computer Vision and Pattern Recognition, 2021, pp. 12 341-12 351.
- V. Ribeiro, S. Avila, and E. Valle, "Handling inter-annotator agreement for automated skin lesion segmentation," arXiv preprint arXiv:1906.02415, 2019. · arXiv
- T. A. Lampert, A. Stumpf, and P. Ganc ¸arski, "An empirical study into annotator agreement, ground truth estimation, and algorithm evaluation," IEEE Transactions on Image Processing, vol. 25, no. 6, pp. 2557-2572, 2016.
- L. Xiao, Y. Li, L. Qv, X. Tian, Y. Peng, and S. K. Zhou, "Pathological image segmentation with noisy labels," arXiv preprint arXiv:2104.02602, 2021. · arXiv
- A. Jungo, R. Meier, E. Ermis, M. Blatti-Moreno, E. Herrmann, R. Wiest, and M. Reyes, "On the effect of inter-observer variability for a reliable estimation of uncertainty of medical image segmentation," in Interna- tional Conference on Medical Image Computing and Computer-Assisted Intervention. Springer, 2018, pp. 682-690.
- R. Tanno, A. Saeedi, S. Sankaranarayanan, D. C. Alexander, and N. Silberman, "Learning from noisy labels by regularized estimation of annotator confusion," in Proceedings of the IEEE/CVF Conference on Computer Vision and Pattern Recognition, 2019, pp. 11 244-11 253.
- L. Zhang, R. Tanno, M.-C. Xu, C. Jin, J. Jacob, O. Cicarrelli, F. Barkhof, and D. Alexander, "Disentangling human error from ground truth in segmentation of medical images," Advances in Neural Information Processing Systems, vol. 33, pp. 15 750-15 762, 2020.
- L. Zhang, R. Tanno, K. Bronik, C. Jin, P. Nachev, F. Barkhof, O. Ci- ccarelli, and D. C. Alexander, "Learning to segment when experts disagree," in International Conference on Medical Image Computing and Computer-Assisted Intervention. Springer, 2020, pp. 179-190.
- S. Kohl, B. Romera-Paredes, C. Meyer, J. De Fauw, J. R. Ledsam, K. Maier-Hein, S. Eslami, D. Jimenez Rezende, and O. Ronneberger, "A probabilistic u-net for segmentation of ambiguous images," Advances in Neural Information Processing Systems, vol. 31, 2018.
- T. Falk, D. Mai, R. Bensch, Ö. C ¸ic ¸ek, A. Abdulkadir, Y. Marrakchi, A. Böhm, J. Deubner, Z. Jäckel, K. Seiwald et al., "U-Net: Deep learning for cell counting, detection, and morphometry," Nature Methods, vol. 16, no. 1, pp. 67-70, 2019.
- D. P. Kingma and M. Welling, "Auto-encoding variational bayes," In International Conference on Learning Representations, 2014.
- S. Hu, D. Worrall, S. Knegt, B. Veeling, H. Huisman, and M. Welling, "Supervised uncertainty quantification for segmentation with multiple annotations," in International Conference on Medical Image Computing and Computer-Assisted Intervention. Springer, 2019, pp. 137-145.
- S. A. Kohl, B. Romera-Paredes, K. H. Maier-Hein, D. J. Rezende, S. Eslami, P. Kohli, A. Zisserman, and O. Ronneberger, "A hierarchical probabilistic u-net for modeling multi-scale ambiguities," arXiv preprint arXiv:1905.13077, 2019. · arXiv
- C. F. Baumgartner, K. C. Tezcan, K. Chaitanya, A. M. Hötker, U. J. Muehlematter, K. Schawkat, A. S. Becker, O. Donati, and E. Konukoglu, "PHiSeg: Capturing uncertainty in medical image segmentation," in International Conference on Medical Image Computing and Computer- Assisted Intervention. Springer, 2019, pp. 119-127.
- E. Kassapis, G. Dikov, D. K. Gupta, and C. Nugteren, "Calibrated adver- sarial refinement for stochastic semantic segmentation," in Proceedings of the IEEE/CVF International Conference on Computer Vision, October 2021, pp. 7057-7067.
- X. Liu, F. Xing, T. Marin, G. E. Fakhri, and J. Woo, "Variational inference for quantifying inter-observer variability in segmentation of anatomical structures," arXiv preprint arXiv:2201.07106, 2022. · arXiv
- I. Goodfellow, J. Pouget-Abadie, M. Mirza, B. Xu, D. Warde-Farley, S. Ozair, A. Courville, and Y. Bengio, "Generative adversarial nets," Advances in Neural Information Processing Systems, vol. 27, 2014.
- J. Deng, W. Dong, R. Socher, L.-J. Li, K. Li, and L. Fei-Fei, "Ima- genet: A large-scale hierarchical image database," in Proceedings of the IEEE/CVF Conference on Computer Vision and Pattern Recognition. Ieee, 2009, pp. 248-255.
- S. Woo, J. Park, J.-Y. Lee, and I. S. Kweon, "CBAM: Convolutional block attention module," in Proceedings of the European Conference on Computer Vision, 2018, pp. 3-19.
- A. Almazroa, S. Alodhayb, E. Osman, E. Ramadan, M. Hummadi, M. Dlaim, M. Alkatee, K. Raahemifar, and V. Lakshminarayanan, "Agreement among ophthalmologists in marking the optic disc and optic cup in fundus images," International Ophthalmology, vol. 37, no. 3, pp. 701-717, 2017.
- S. Yu, D. Xiao, S. Frost, and Y. Kanagasingam, "Robust optic disc and cup segmentation with deep learning for glaucoma detection," Computerized Medical Imaging and Graphics, vol. 74, pp. 61-71, 2019.
- D. P. Kingma and J. Ba, "Adam: A method for stochastic optimization," In International Conference on Learning Representations, 2015.
Cited by
Sorted by citations
- Authors
- Liao, Z., Hu, S., Xie, Y., & Xia, Y.
- Affiliations
- Northwestern Polytechnical University (CN)
- The University of Adelaide (AU)
- Corresponding author
- Xia, Yong
- Venue
- Medical Image Analysis
- Publisher
- Elsevier BV
- Published
- 2024-02
- Volume
- 92
- Pages
- 103028
- ISSN
- 1361-8415 (ISSN-L)
- OpenAlex
- W4388776289
- Cited by
- 35
- References
- 1
- Citations by year
- 2026: 11 · 2025: 16 · 2024: 4 · 2023: 2 · 2022: 2
- FWCI
- 3.00
- Type
- journal article
- Language
- en
- Open access
- green
- arxiv.org
- Licence
- Locations
- Medical Image Analysis (publishedVersion)
- PubMed (publishedVersion)
- arXiv (Cornell University) (submittedVersion, cc-by-nc-nd)
- arXiv (Cornell University)
- Funders
- Northwestern University
- National Natural Science Foundation of China (2021J052, 62171377)
- Northwestern Polytechnical University
- Natural Science Foundation of Ningbo (2021J052)
- Topics
- Physical Sciences › Computer Science › Computer Vision and Pattern Recognition › Medical Image Segmentation Techniques
- Physical Sciences › Computer Science › Computer Vision and Pattern Recognition › Advanced Neural Network Applications
- Health Sciences › Medicine › Health Informatics › Artificial Intelligence in Healthcare and Education
- Keywords
- medical image segmentation, annotator bias
- MeSH terms
- Humans, Image Processing, Computer-Assisted, Benchmarking
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review