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Bound-Aware Per-Organ Recall Risk Control for Multi-Organ CT Segmentation under Clinical Domain Shift

arXiv:2608.18193v1 Announce Type: new Abstract: Distribution-free risk control adds organ-specific recall guarantees to frozen segmentation. We calibrate per-organ thresholds for an AMOS-trained nnU-Net, audit transfer to RAOS, and estimate local re-certification cost using case-level voxel false-negative rate (FNR). The AMOS control passes, but $7/12$ organs exceed $\alpha{=}0.10$ after transfer; smaller calibration sets can mask exceedances with conservative or vacuous thresholds. Risk-Controlling Prediction Sets (RCPS) give high-probability control of population-mean risk, whereas Conformal Risk Control (CRC) gives weaker expectation control. Both require exchangeability; fixed and global thresholds give no per-organ guarantee. The Waudby--Smith--Ramdas (WSR) betting bound re-certifies six Tier-1 organs with 25 local cases, versus 30--40 for Hoeffding--Bentkus (HB). CRC needs 10--15 but has a heavier individual-case tail. No Tier-2 organ meets our illustrative precision criterion with 25 cases.

SourcearXiv Computer VisionAuthor: Souraj Adhikary, Negar Chabi, Andre Mastmeyer

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[Submitted on 18 Aug 2026]

Title:Bound-Aware Per-Organ Recall Risk Control for Multi-Organ CT Segmentation under Clinical Domain Shift

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Abstract:Distribution-free risk control adds organ-specific recall guarantees to frozen segmentation. We calibrate per-organ thresholds for an AMOS-trained nnU-Net, audit transfer to RAOS, and estimate local re-certification cost using case-level voxel false-negative rate (FNR). The AMOS control passes, but $7/12$ organs exceed $\alpha{=}0.10$ after transfer; smaller calibration sets can mask exceedances with conservative or vacuous thresholds. Risk-Controlling Prediction Sets (RCPS) give high-probability control of population-mean risk, whereas Conformal Risk Control (CRC) gives weaker expectation control. Both require exchangeability; fixed and global thresholds give no per-organ guarantee. The Waudby--Smith--Ramdas (WSR) betting bound re-certifies six Tier-1 organs with 25 local cases, versus 30--40 for Hoeffding--Bentkus (HB). CRC needs 10--15 but has a heavier individual-case tail. No Tier-2 organ meets our illustrative precision criterion with 25 cases.

Comments: 12 pages, 4 figures, 2 tables

Subjects:

Computer Vision and Pattern Recognition (cs.CV); Artificial Intelligence (cs.AI); Machine Learning (cs.LG)

ACM classes: I.4.6; G.3; J.3

Cite as: arXiv:2608.18193 [cs.CV]

(or arXiv:2608.18193v1 [cs.CV] for this version)

https://doi.org/10.48550/arXiv.2608.18193

arXiv-issued DOI via DataCite (pending registration)

Journal reference: MICCAI-UNSURE 2026

Submission history

From: Andre Mastmeyer [view email] [v1] Tue, 18 Aug 2026 15:01:53 UTC (968 KB)

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