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This research introduces a reference-free framework that leverages cross-model agreement between independent neural networks to detect silent failures in real-time polyp segmentation during colonoscopy. By demonstrating that architectural diversity and random initialization significantly enhance reliability signals, the study offers a practical method for ensuring safety in medical AI deployments without requiring ground-truth annotations at inference time.
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Cross-Model Agreement as a Deployment-Time Reliability Signal for Automatic Polyp Segmentation

arXiv3 min read

arXiv:2609.10495v1 Announce Type: cross Abstract: In real-time colonoscopy, ground-truth annotations are unavailable at inference, so polyp segmentation models can fail silently. We propose Referee-Based Quality Estimation (RBQE), a reference-free framework measuring agreement between a primary segmentation model and an independently trained referee on the same image. RBQE is evaluated on a standardized 1,223-image external benchmark drawn from four public datasets, using four referee configurations chosen to separate two design axes: referee independence and architectural diversity. Using a common Agreement Dice descriptor, a same-architecture referee differing from the primary model only in random initialization already yields a useful reliability signal (ROC-AUC = 0.923), showing that independent training alone is sufficient. Cross-architecture referees improve further: SegFormer-B0 achieves the strongest performance (ROC-AUC = 0.960), significantly outperforming the same-architecture control and UNet++, and exceeding a representative Test-Time Augmentation baseline by 0.055 ROC-AUC under an identical protocol, whereas a prompt-coupled MedSAM referee underperforms despite maximal architectural diversity. Because empty-mask agreement is trivially separable, we also report a restricted evaluation excluding such cases: ROC-AUC falls to 0.876 (SegFormer-B0, 1,046 images) and 0.783 (same-architecture control, 975 images), yet RBQE's margin over both baselines widens on this identical subset. RBQE additionally increases the mean Dice of retained predictions as low-agreement cases are progressively rejected, supporting selective prediction, and requires only one additional deterministic referee forward pass at inference. Our study therefore supports cross-model agreement as a practical, interpretable reliability framework for automated polyp segmentation.

Abstract:In real-time colonoscopy, ground-truth annotations are unavailable at inference, so polyp segmentation models can fail silently. We propose Referee-Based Quality Estimation (RBQE), a reference-free framework measuring agreement between a primary segmentation model and an independently trained referee on the same image. RBQE is evaluated on a standardized 1,223-image external benchmark drawn from four public datasets, using four referee configurations chosen to separate two design axes: referee independence and architectural diversity. Using a common Agreement Dice descriptor, a same-architecture referee differing from the primary model only in random initialization already yields a useful reliability signal (ROC-AUC = 0.923), showing that independent training alone is sufficient. Cross-architecture referees improve further: SegFormer-B0 achieves the strongest performance (ROC-AUC = 0.960), significantly outperforming the same-architecture control and UNet++, and exceeding a representative Test-Time Augmentation baseline by 0.055 ROC-AUC under an identical protocol, whereas a prompt-coupled MedSAM referee underperforms despite maximal architectural diversity. Because empty-mask agreement is trivially separable, we also report a restricted evaluation excluding such cases: ROC-AUC falls to 0.876 (SegFormer-B0, 1,046 images) and 0.783 (same-architecture control, 975 images), yet RBQE's margin over both baselines widens on this identical subset. RBQE additionally increases the mean Dice of retained predictions as low-agreement cases are progressively rejected, supporting selective prediction, and requires only one additional deterministic referee forward pass at inference. Our study therefore supports cross-model agreement as a practical, interpretable reliability framework for automated polyp segmentation.

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

arXiv:2609.10495 [cs.CV]

(or arXiv:2609.10495v1 [cs.CV] for this version)

https://doi.org/10.48550/arXiv.2609.10495 Focus to learn more arXiv-issued DOI via DataCite (pending registration)

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