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Towards reliable WMH segmentation under domain shift: An application study using maximum entropy regularization to

Franco Matzkin1, Agostina Larrazabal2, Diego H Milone1

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|July 4, 2025
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Summary

Maximum-entropy regularization enhances white matter hyperintensity (WMH) segmentation by improving uncertainty estimation. This helps identify segmentation errors in diverse clinical settings without needing ground-truth labels.

Keywords:
Domain shiftMaximum-entropy regularizationMedical image segmentationUncertainty estimationWhite matter hyperintensity

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Area of Science:

  • Medical imaging analysis
  • Deep learning for neuroimaging

Background:

  • Accurate white matter hyperintensity (WMH) segmentation is vital for neurological conditions like multiple sclerosis.
  • Domain shifts in MRI data (e.g., different machines or parameters) challenge model calibration and uncertainty estimation.
  • Predictive uncertainty can serve as a proxy to identify post-deployment errors without ground-truth labels.

Purpose of the Study:

  • To investigate the impact of domain shift on WMH segmentation accuracy.
  • To evaluate maximum-entropy regularization techniques for enhancing model calibration and uncertainty estimation in WMH segmentation.
  • To identify potential segmentation errors in clinical deployment using predictive uncertainty.

Main Methods:

  • Utilized a U-Net architecture for WMH segmentation.
  • Applied and evaluated maximum-entropy regularization schemes.
  • Tested on two public datasets: WMH Segmentation Challenge and 3D-MR-MS.
  • Assessed performance using Dice coefficient, Hausdorff distance, expected calibration error, and entropy-based uncertainty.

Main Results:

  • Entropy-based uncertainty estimates effectively predict segmentation errors across different data distributions.
  • Maximum-entropy regularization strengthens the link between uncertainty and segmentation performance.
  • Model calibration is improved under domain shift conditions.

Conclusions:

  • Maximum-entropy regularization enhances uncertainty estimation for WMH segmentation, especially under domain shift.
  • These methods enable reliable flagging of unreliable predictions without ground-truth annotations.
  • Improved model calibration supports safer deployment of deep learning in heterogeneous clinical environments.