An accurate and trustworthy deep learning approach for bladder tumor segmentation with uncertainty estimation

Although deep learning-based intelligent diagnosis of bladder cancer has achieved excellent performance, the reliability of neural network predicted results may not be evaluated. This study aims to explore a trustworthy AI-based tumor segmentation model, which not only outputs predicted results but also provides confidence information about the predictions.

This paper proposes a novel model for bladder tumor segmentation with uncertainty estimation (BSU), which is not merely able to effectively segment the lesion area but also yields an uncertainty map showing the confidence information of the segmentation results. In contrast to previous uncertainty estimation, we utilize test time augmentation (TTA) and test time dropout (TTD) to estimate aleatoric uncertainty and epistemic uncertainty in both internal and external datasets to explore the effects of both uncertainties on different datasets.

Our BSU model achieved the Dice coefficients of 0.766 and 0.848 on internal and external cystoscopy datasets, respectively, along with accuracy of 0.950 and 0.954. Compared to the state-of-the-art methods, our BSU model demonstrated superior performance, which was further validated by the statistically significance of the t-tests at the conventional level. Clinical experiments verified the practical value of uncertainty estimation in real-world bladder cancer diagnostics.

The proposed BSU model is able to visualize the confidence of the segmentation results, serving as a valuable addition for assisting urologists in enhancing both the precision and efficiency of bladder cancer diagnoses in clinical practice.