The consideration of predictive uncertainty in medical imaging with deep learning is of utmost importance. We apply estimation of both aleatoric and epistemic uncertainty by variational Bayesian inference with Monte Carlo dropout to regression tasks and show that predictive uncertainty is systematically underestimated. We apply sigma scaling with a single scalar value; a simple, yet effective calibration method for both types of uncertainty. The performance of our approach is evaluated on a variety of common medical regression data sets using different state-of-the-art convolutional network architectures. In our experiments, sigma scaling is able to reliably recalibrate predictive uncertainty. It is easy to implement and maintains the accuracy. Well-calibrated uncertainty in regression allows robust rejection of unreliable predictions or detection of out-of-distribution samples. Our source code is available at: https://github.com/mlaves/well-calibrated-regression-uncertainty

In this work, we discuss epistemic uncertainty estimation obtained by Bayesian inference in diagnostic classifiers and show that the prediction uncertainty highly correlates with goodness of prediction. We train the ResNet-18 image classifier on a dataset of 84,484 optical coherence tomography scans showing four different retinal conditions. Dropout is added before every building block of ResNet, creating an approximation to a Bayesian classifier. Monte Carlo sampling is applied with dropout at test time for uncertainty estimation. In Monte Carlo experiments, multiple forward passes are performed to get a distribution of the class labels. The variance and the entropy of the distribution is used as metrics for uncertainty. Our results show strong correlation with ρ = 0.99 between prediction uncertainty and prediction error. Mean uncertainty of incorrectly diagnosed cases was significantly higher than mean uncertainty of correctly diagnosed cases. Modeling of the prediction uncertainty in computer-aided diagnosis with deep learning yields more reliable results and is therefore expected to increase patient safety. This will help to transfer such systems into clinical routine and to increase the acceptance of machine learning in diagnosis from the standpoint of physicians and patients.

In pathology and legal medicine, the histopathological and microbiological analysis of tissue samples from infected deceased is a valuable information for developing treatment strategies during a pandemic such as COVID-19. However, a conventional autopsy carries the risk of disease transmission and may be rejected by relatives. We propose minimally invasive biopsy with robot assistance under CT guidance to minimize the risk of disease transmission during tissue sampling and to improve accuracy. A flexible robotic system for biopsy sampling is presented, which is applied to human corpses placed inside protective body bags. An automatic planning and decision system estimates optimal insertion point. Heat maps projected onto the segmented skin visualize the distance and angle of insertions and estimate the minimum cost of a puncture while avoiding bone collisions. Further, we test multiple insertion paths concerning feasibility and collisions. A custom end effector is designed for inserting needles and extracting tissue samples under robotic guidance. Our robotic post-mortem biopsy (RPMB) system is evaluated in a study during the COVID-19 pandemic on 20 corpses and 10 tissue targets, 5 of them being infected with SARS-CoV-2. The mean planning time including robot path planning is 5.72±167s. Mean needle placement accuracy is 7.19± 422mm.