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Stratification by Tumor Grade Groups in a Holistic Evaluation of Machine Learning for Brain Tumor Segmentation
Open accessAbstract
Accurate and consistent segmentation plays an important role in the diagnosis, treatment planning, and monitoring of both High Grade Glioma (HGG), including Glioblastoma Multiforme (GBM), and Low Grade Glioma (LGG). Accuracy of segmentation can be affected by the imaging presentation of glioma, which greatly varies between the two tumor grade groups. In recent years, researchers have used Machine Learning (ML) to segment tumor rapidly and consistently, as compared to manual segmentation. However, existing ML validation relies heavily on computing summary statistics and rarely tests the generalizability of an algorithm on clinically heterogeneous data. In this work, our goal is to investigate how to holistically evaluate the performance of ML algorithms on a brain tumor segmentation task. We address the need for rigorous evaluation of ML algorithms and present four axes of model evaluation—diagnostic performance, model confidence, robustness, and data quality. We perform a comprehensive evaluation of a glioma segmentation ML algorithm by stratifying data by specific tumor grade groups (GBM and LGG) and evaluate these algorithms on each of the four axes. The main takeaways of our work are—(1) ML algorithms need to be evaluated on out-of-distribution data to assess generalizability, reflective of tumor heterogeneity. (2) Segmentation metrics alone are limited to evaluate the errors made by ML algorithms and their describe their consequences. (3) Adoption of tools in other domains such as robustness (adversarial attacks) and model uncertainty (prediction intervals) lead to a more comprehensive performance evaluation. Such a holistic evaluation framework could shed light on an algorithm's clinical utility and help it evolve into a more clinically valuable tool.
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A focus on ensuring AI competence could increase end-users' confidence in AI, though it does not necessarily imply trust.
“For example, there is a particular focus on ensuring competence of AI (i.e., that it performs accurately and eciently) [20,41], which could potentially lead to increase in end-users' condence in AI [61] (though without necessarily always implying trust [39]).”
From Being Trustworthy is Not Enough: How Untrustworthy Artificial Intelligence (AI) Can Deceive the End-Users and Gain Their Trust (2023) · cites this paper as [41]
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Metadata
- Authors
- Prabhudesai, S., Wang, N. C., Ahluwalia, V., Huan, X., Bapuraj, J. R., Banovic, N., & Rao, A.
- Affiliations
- University of Michigan (US)
- Michigan Medicine (US)
- University of Pennsylvania (US)
- Corresponding author
- Prabhudesai, Snehal
- Wang, Nicholas Chandler
- Rao, Arvind
- ORCID
- Venue
- Frontiers in Neuroscience
- Publisher
- Frontiers Media SA
- Published
- 2021-10-06
- Volume
- 15
- Pages
- 740353-740353
- ISSN
- 1662-453X (ISSN-L)
- PMC
- PMC8526730
- OpenAlex
- W3204734566
- Cited by
- 13
- References
- 68
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 4 · 2023: 2 · 2022: 1
- FWCI
- 0.70
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Neuroscience (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- American Cancer Society (R37-CA214955, RSG-16-005-01)
- Topics
- Physical Sciences › Computer Science › Computer Vision and Pattern Recognition › Brain Tumor Detection and Classification
- Physical Sciences › Computer Science › Computer Vision and Pattern Recognition › Medical Image Segmentation Techniques
- Health Sciences › Medicine › Oncology › Glioma Diagnosis and Treatment
- Keywords
- brain tumor segmentation, glioblastoma, low-grade glioma, machine learning model evaluation, generalizability, out-of-distribution data, model robustness, adversarial attacks, model uncertainty, prediction intervals, diagnostic performance, data quality, tumor heterogeneity
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