Sampling image segmentations for uncertainty quantification

In this paper, we introduce a method to automatically produce plausible image segmentation samples from a single expert segmentation. A probability distribution of image segmentation boundaries is defined as a Gaussian process, which leads to segmentations which are spatially coherent and consistent with the presence of salient borders in the image. The proposed approach is computationally efficient, and generates visually plausible samples. The variability between the samples is mainly governed by a parameter which may be correlated with a simple Dice's coefficient, or easily set by the user from the definition of probable regions of interest. The method is extended to the case of several neighboring structures, but also to account for under or over segmentation, and the presence of excluded regions. We also detail a method to sample segmentations with more general non-stationary covariance functions which relies on supervoxels. Furthermore, we compare the generated segmentation samples with several manual clinical segmentations of a brain tumor. Finally, we show how this approach can have useful applications in the field of uncertainty quantification, and an illustration is provided in radiotherapy planning, where segmentation sampling is applied to both the clinical target volume and the organs at risk. (C) 2016 Published by Elsevier B.V.