A quality assurance framework for real-time monitoring of deep learning
  segmentation models in radiotherapy
Xiyao Jin Yao Hao Jessica Hilliard Zhehao Zhang Maria A. Thomas Hua Li Abhinav K. Jha Geoffrey D. Hugo
To safely deploy deep learning models in the clinic, a quality assurance
framework is needed for routine or continuous monitoring of input-domain shift
and the models' performance without ground truth contours. In this work,
cardiac substructure segmentation was used as an example task to establish a QA
framework. A benchmark dataset consisting of Computed Tomography (CT) images
along with manual cardiac delineations of 241 patients were collected,
including one 'common' image domain and five 'uncommon' domains. Segmentation
models were tested on the benchmark dataset for an initial evaluation of model
capacity and limitations. An image domain shift detector was developed by
utilizing a trained Denoising autoencoder (DAE) and two hand-engineered
features. Another Variational Autoencoder (VAE) was also trained to estimate
the shape quality of the auto-segmentation results. Using the extracted
features from the image/segmentation pair as inputs, a regression model was
trained to predict the per-patient segmentation accuracy, measured by Dice
coefficient similarity (DSC). The framework was tested across 19 segmentation
models to evaluate the generalizability of the entire framework.
  As results, the predicted DSC of regression models achieved a mean absolute
error (MAE) ranging from 0.036 to 0.046 with an averaged MAE of 0.041. When
tested on the benchmark dataset, the performances of all segmentation models
were not significantly affected by scanning parameters: FOV, slice thickness
and reconstructions kernels. For input images with Poisson noise, CNN-based
segmentation models demonstrated a decreased DSC ranging from 0.07 to 0.41,
while the transformer-based model was not significantly affected.