Michela Antonelli, Annika Reinke, Spyridon Bakas, Keyvan Farahani, Bennett A Landman, Geert Litjens, Bjoern Menze, Olaf Ronneberger, Ronald M Summers, Bram van Ginneken, Michel Bilello, Patrick Bilic, Patrick F Christ, Richard KG Do, Marc J Gollub, Stephan H Heckers, Henkjan Huisman, William R Jarnagin, Maureen K McHugo, Sandy Napel, Jennifer S Goli Pernicka, Kawal Rhode, Catalina Tobon-Gomez, Eugene Vorontsov, James A Meakin, Sebastien Ourselin, Manuel Wiesenfarth, Pablo Arbelaez, Byeonguk Bae, Sihong Chen, Laura Daza, Jianjiang Feng, Baochun He, Fabian Isensee, Yuanfeng Ji, Fucang Jia, Namkug Kim, Ildoo Kim, Dorit Merhof, Akshay Pai, Beomhee Park, Mathias Perslev, Ramin Rezaiifar, Oliver Rippel, Ignacio Sarasua, Wei Shen, Jaemin Son, Christian Wachinger, Liansheng Wang, Yan Wang, Yingda Xia, Daguang Xu, Zhanwei Xu, Yefeng Zheng, Amber L Simpson, Lena Maier-Hein, M Jorge Cardoso
International challenges have become the de facto standard for comparative assessment of image analysis algorithms given a specific task. Segmentation is so far the most widely investigated medical image processing task, but the various segmentation challenges have typically been organized in isolation, such that algorithm development was driven by the need to tackle a single specific clinical problem. We hypothesized that a method capable of performing well on multiple tasks will generalize well to a previously unseen task and potentially outperform a custom-designed solution. To investigate the hypothesis, we organized the Medical Segmentation Decathlon (MSD) – a biomedical image analysis challenge, in which algorithms compete in a multitude of both tasks and modalities. The underlying data set was designed to explore the axis of difficulties typically encountered when dealing with medical images, such as small data sets, unbalanced labels, multi-site data and small objects. The MSD challenge confirmed that algorithms with a consistent good performance on a set of tasks preserved their good average performance on a different set of previously unseen tasks. Moreover, by monitoring the MSD winner for two years, we found that this algorithm continued generalizing well to a wide range of other clinical problems, further confirming our hypothesis. Three main conclusions can be drawn from this study: (1) state-of-the-art image segmentation algorithms are mature, accurate, and generalize well when retrained on unseen tasks; (2) consistent algorithmic performance across multiple tasks is a strong surrogate of algorithmic generalizability; (3) the training of accurate AI segmentation models is now commoditized to non AI experts.