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This paper presents UCompCXR, a novel compositional deep learning framework designed to resolve the "lost in the middle" problem of overlapping medical devices in chest X-rays. By leveraging graph-based clustering and uncertainty-aware Gaussian estimation, the model significantly improves device detection rates while maintaining calibrated confidence intervals for catheter tip localization. The approach demonstrates that decomposing complex scenes into local fragments before reassembling them yields superior clinical safety metrics compared to standard multi-task baselines.
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Uncertainty-Aware Compositional Localization and Placement Assessment of Catheters and Tubes in Chest X-Rays

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arXiv:2608.11288v2 Announce Type: replace-cross Abstract: Assessing catheter and tube placement on chest X-rays is safety-critical yet tedious and error-prone. Current deep learning methods either classify placement globally -- losing track of which device is where -- or segment all devices into a single mask, making per-device assessment impossible when catheters overlap. We introduce UCompCXR, a compositional framework that detects local catheter fragments, associates them into device instances via graph-based clustering, fuses per-fragment tip predictions through precision-weighted Gaussian estimation, and classifies placement per device. On the RANZCR CLiP dataset (30,083 images, 5-fold patient-level CV with bootstrap CIs), UCompCXR detects 26% more devices than a strong multi-task baseline sharing the same MobileNetV3 backbone, with 75% fewer false positives and well-calibrated tip uncertainty (95% coverage = 0.948). The aggregate tip error rises -- but only because the model finds devices the baseline misses entirely, especially nasogastric tubes. On matched devices, catastrophic localization failures drop substantially. At 2.27M parameters in a single forward pass, the model is deployable on resource-constrained clinical hardware.

Abstract:Assessing catheter and tube placement on chest X-rays is safety-critical yet tedious and error-prone. Current deep learning methods either classify placement globally -- losing track of which device is where -- or segment all devices into a single mask, making per-device assessment impossible when catheters overlap. We introduce UCompCXR, a compositional framework that detects local catheter fragments, associates them into device instances via graph-based clustering, fuses per-fragment tip predictions through precision-weighted Gaussian estimation, and classifies placement per device. On the RANZCR CLiP dataset (30,083 images, 5-fold patient-level CV with bootstrap CIs), UCompCXR detects 26% more devices than a strong multi-task baseline sharing the same MobileNetV3 backbone, with 75% fewer false positives and well-calibrated tip uncertainty (95% coverage = 0.948). The aggregate tip error rises -- but only because the model finds devices the baseline misses entirely, especially nasogastric tubes. On matched devices, catastrophic localization failures drop substantially. At 2.27M parameters in a single forward pass, the model is deployable on resource-constrained clinical hardware.

Image and Video Processing (eess.IV); Computer Vision and Pattern Recognition (cs.CV); Machine Learning (cs.LG)

I.4.6; I.2.10; I.4.9; J.3

arXiv:2608.11288 [eess.IV]

(or arXiv:2608.11288v2 [eess.IV] for this version)

https://doi.org/10.48550/arXiv.2608.11288 Focus to learn more arXiv-issued DOI via DataCite

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