Counterfactual Analysis of Extent Leakage from Annotation-Derived Prompts in Vision-Language Medical Image Segmentation

원문 초록

Text-guided segmentation models receive an image and a short caption about the lesion, and on public benchmarks the caption improves accuracy considerably. On colonoscopy and breast ultrasound, however, the size, count and location words of each caption were computed from the mask that later scores the prediction, and the chest X-ray captions were written by benchmark annotators. We tested what two published models take from them. On colonoscopy and chest X-ray, it is mostly the lesion's extent. Keeping only the size word or the lung-zone phrase recovers 84 to 98 percent of the improvement over an empty caption, and removing it loses 52 to 77 percent. The rest matters little, and a polyp called a rock is segmented just as well. We call this extent leakage. On breast ultrasound, nearly half the captions also name the diagnosis, which carries part of the benefit. Retraining on three datasets shows that models pick up this habit from their training captions, though only partly on breast ultrasound, and that it weakens their segmentation from the image alone. The leak can be measured without training a model, since caption words alone predict lesion area (coefficient of determination 0.54 to 0.77 on six of seven test sets). Without the test mask, the best method we tested, which estimates extent from the image, reaches 74.59 Dice on colonoscopy against the published 77.23. We propose an evaluation protocol that keeps what a caption says about the image apart from what it copies from the label.