Uncertain but Useful: Leveraging CNN Training Variability into Data Augmentation

Deep networks segment brain tumours accurately in-distribution, but can fail silently when the input differs from their training data. That risk is central to clinical deployment and is the premise of the BraTS-GoAT generalizability task. We ask not only how well a model segments, but whether its uncertainty knows when it is wrong. On BraTS-GoAT (Task 3) we train a 5-fold cross-validated nnU-Net baseline (one held-out prediction per case) and a 3-seed deep ensemble. Both are evaluated for calibration and error detection on a per-region relevant mask, aggregated per case. In-distribution the 3-seed ensemble improves modestly over the already strong single model on the same held-out split, with the clearest gain in calibration. The separation appears under shift. In a controlled robustness study using graded synthetic corruptions as a proxy for acquisition shift, the single model's confidence stays flat while its accuracy and calibration degrade. Inter-member disagreement instead rises steeply, about a quarter to a third above the clean condition, several times the single model's response. On the official validation leaderboard the 5-fold ensemble of those folds attains whole-tumour Dice 0.87. The generalization gap is concentrated on the harder regions, with a characteristic failure of missing small, satellite lesions on unseen cohorts. In the synthetic study, disagreement among the 3-seed members is a more sensitive case-level indicator of acquisition shift than single-model confidence. Its per-voxel error localisation weakens as severity grows. The contribution is a rigorous, honest reliability comparison rather than a claim that any one uncertainty method dominates.

Purpose: To investigate whether contrast-informed data augmentation and domain-adversarial training improve the adult-to-neonatal generalization of the E2E-VarNet. Methods: Three training regimes were investigated: (1) adult-only training with unaugmented adult data, (2) mixed training with paired unaugmented and neonatal-informed augmented adult data, and (3) mixed training with a domain-adversarial objective. Models were trained on retrospectively undersampled multi-coil adult T2-weighted brain MR data and evaluated on neonatal and adult test data at acceleration factors $R=4$ and $R=8$ using quantitative metrics and qualitative evaluation. Feature analyses assessed whether domain-adversarial training altered the latent representations of unaugmented adult, augmented adult, and neonatal test samples. Results: Mixed training (Mixed) and mixed domain-adversarial training (Mixed-DAT) outperformed unaugmented adult-only training (Unaug-Only) when evaluated on neonatal data. At R=4, Mixed-DAT achieved the best performance (SSIM = 0.924 +/- 0.027, PSNR = 33.98 +/- 1.15 dB). At R=8, Mixed-DAT performed best when measured using SSIM (0.848 +/- 0.031 vs. 0.766 +/- 0.037 for Unaug-Only and 0.814 +/- 0.035 for Mixed) and Mixed performed best when measured using PSNR (29.56 +/- 0.83 dB vs. 26.26 +/- 0.78 dB for Unaug-Only and 29.43 +/- 0.83 dB for Mixed-DAT). Qualitative assessment of t-SNE plots suggested that Mixed-DAT increased the overlap among the latent representations of the unaugmented adult, augmented adult, and neonatal test data. Conclusion: Contrast-informed augmentation and domain-adversarial training improved adult-to-neonatal generalization of deep learning-based MR reconstruction. These findings suggest that contrast-informed data augmentation combined with adversarial training may improve robustness to domain shift in undersampled neonatal MR reconstruction.

The Segment Anything Model (SAM) exhibits strong zero-shot performance on natural images but suffers from domain shift and overconfidence when applied to medical volumes. We propose \textbf{CalSAM}, a lightweight adaptation framework that (i) reduces encoder sensitivity to domain shift via a \emph{Feature Fisher Information Penalty} (FIP) computed on 3D feature maps and (ii) penalizes overconfident voxel-wise errors through a \emph{Confidence Misalignment Penalty} (CMP). The combined loss, $\mathcal{L}_{\mathrm{CalSAM}}$ fine-tunes only the mask decoder while keeping SAM's encoders frozen. On cross-center and scanner-shift evaluations, CalSAM substantially improves accuracy and calibration: e.g., on the BraTS scanner split (Siemens$\to$GE) CalSAM shows a $+7.4\%$ relative improvement in $\mathrm{DSC}$ (80.1% vs.\ 74.6%), a $-26.9\%$ reduction in $\mathrm{HD95}$ (4.6 mm vs.\ 6.3 mm), and a $-39.5\%$ reduction in $\mathrm{ECE}$ (5.2% vs.\ 8.6%). On ATLAS-C (motion corruptions), CalSAM achieves a $+5.3\%$ relative improvement in $\mathrm{DSC}$ (75.9%) and a $-32.6\%$ reduction in $\mathrm{ECE}$ (5.8%). Ablations show FIP and CMP contribute complementary gains ($p<0.01$), and the Fisher penalty incurs a modest $\sim$15% training-time overhead. CalSAM therefore delivers improved domain generalization and better-calibrated uncertainty estimates for brain MRI segmentation, while retaining the computational benefits of freezing SAM's encoder.