The number of international benchmarking competitions is steadily increasing in various fields of machine learning (ML) research and practice. So far, however, little is known about the common practice as well as bottlenecks faced by the community in tackling the research questions posed. To shed light on the status quo of algorithm development in the specific field of biomedical imaging analysis, we designed an international survey that was issued to all participants of challenges conducted in conjunction with the IEEE ISBI 2021 and MICCAI 2021 conferences (80 competitions in total). The survey covered participants' expertise and working environments, their chosen strategies, as well as algorithm characteristics. A median of 72% challenge participants took part in the survey. According to our results, knowledge exchange was the primary incentive (70%) for participation, while the reception of prize money played only a minor role (16%). While a median of 80 working hours was spent on method development, a large portion of participants stated that they did not have enough time for method development (32%). 25% perceived the infrastructure to be a bottleneck. Overall, 94% of all solutions were deep learning-based. Of these, 84% were based on standard architectures. 43% of the respondents reported that the data samples (e.g., images) were too large to be processed at once. This was most commonly addressed by patch-based training (69%), downsampling (37%), and solving 3D analysis tasks as a series of 2D tasks. K-fold cross-validation on the training set was performed by only 37% of the participants and only 50% of the participants performed ensembling based on multiple identical models (61%) or heterogeneous models (39%). 48% of the respondents applied postprocessing steps.

Today, deep convolutional neural networks (CNNs) have demonstrated state-of-the-art performance for medical image segmentation, on various imaging modalities and tasks. Despite early success, segmentation networks may still generate anatomically aberrant segmentations, with holes or inaccuracies near the object boundaries. To enforce anatomical plausibility, recent research studies have focused on incorporating prior knowledge such as object shape or boundary, as constraints in the loss function. Prior integrated could be low-level referring to reformulated representations extracted from the ground-truth segmentations, or high-level representing external medical information such as the organ's shape or size. Over the past few years, prior-based losses exhibited a rising interest in the research field since they allow integration of expert knowledge while still being architecture-agnostic. However, given the diversity of prior-based losses on different medical imaging challenges and tasks, it has become hard to identify what loss works best for which dataset. In this paper, we establish a benchmark of recent prior-based losses for medical image segmentation. The main objective is to provide intuition onto which losses to choose given a particular task or dataset. To this end, four low-level and high-level prior-based losses are selected. The considered losses are validated on 8 different datasets from a variety of medical image segmentation challenges including the Decathlon, the ISLES and the WMH challenge. Results show that whereas low-level prior-based losses can guarantee an increase in performance over the Dice loss baseline regardless of the dataset characteristics, high-level prior-based losses can increase anatomical plausibility as per data characteristics.