This paper provides a rigorous, self-contained investigation of consensus segmentation. We derive the mathematical foundations from first principles -- the generative model, EM algorithm, Van Leemput's marginalization analysis, identifiability conditions, Spatial STAPLE, and deep variational formulations -- and validate each theoretical prediction through controlled experiments. The central finding is sobering: under common conditions, STAPLE reduces to thresholded majority voting, suffers 95% EM suboptimality, and collapses under class imbalance. These are not edge cases but typical scenarios in medical imaging. Majority voting -- simple, non-parametric, and robust -- is a surprisingly strong baseline that the field has perhaps too hastily dismissed in favor of more "sophisticated" methods. At the same time, the deep consensus model demonstrates that the consensus problem is not inherently difficult -- it becomes tractable when the image is used alongside the labels. And conformal prediction shows that formal uncertainty guarantees are achievable and practical. We hope this work encourages practitioners to critically evaluate their consensus methods rather than applying STAPLE by default, and provides the mathematical and empirical foundation for more principled approaches.
Radiomic features derived from medical images and segmentation masks are used to support decision making in clinical imaging pipelines. In practice, these features are often computed from predicted masks, but segmentation models can be overconfident or poorly calibrated, making d…
Arrhythmogenic left ventricular cardiomyopathy is a genetic myocardial disease difficult to diagnose due to the lack of gold standard criteria. Simultaneous PET/MR imaging, combined with multiparametric quantitative analysis, could facilitate the identification of different profi…
Jointly learning to segment and classify medical images demands cross-task synergy, yet encoder-sharing architectures limit decoder reconstruction to task-private representations, permanently discarding the boundary cues and semantic priors each branch could supply to the other.…
Cloud-based deep learning enables large-scale medical image analysis but raises significant privacy concerns when sensitive patient images are outsourced for model development. Image disguising has recently emerged as a promising privacy-enhancing technology (PET) that transforms…
Validating Explainable Artificial Intelligence (XAI) methods in medical imaging requires ground-truth data with known locations of informative features. However, current approaches rely on expert annotations, which are prone to labeling errors, or on hand-crafted artificial pertu…
Deploying a medical imaging model that must later accommodate a modality it has never seen is a recurring practical problem: retraining the shared representation is expensive and destroys performance on the modalities already in service. We study this \emph{onboarding} problem un…