  Deep-learning has proved in recent years to be a powerful tool for image
analysis and is now widely used to segment both 2D and 3D medical images.
Deep-learning segmentation frameworks rely not only on the choice of network
architecture but also on the choice of loss function. When the segmentation
process targets rare observations, a severe class imbalance is likely to occur
between candidate labels, thus resulting in sub-optimal performance. In order
to mitigate this issue, strategies such as the weighted cross-entropy function,
the sensitivity function or the Dice loss function, have been proposed. In this
work, we investigate the behavior of these loss functions and their sensitivity
to learning rate tuning in the presence of different rates of label imbalance
across 2D and 3D segmentation tasks. We also propose to use the class
re-balancing properties of the Generalized Dice overlap, a known metric for
segmentation assessment, as a robust and accurate deep-learning loss function
for unbalanced tasks.
