Echocardiography plays a fundamental role in the extraction of clinical parameters (e.g. left ventricular volume and ejection fraction) required to determine the presence and severity of heart-related conditions. When deploying automated techniques for computing these parameters, uncertainty estimation is highly valuable for assessing their utility. Since clinical parameters are usually derived from segmentation maps, there is no clear path for converting pixel-wise uncertainty values into uncertainty estimates in the downstream clinical metric calculation. In this work, we propose a novel uncertainty estimation method based on contouring rather than segmentation. Our method explicitly predicts contour location uncertainty from which contour samples can be drawn. Finally, the sampled contours can be used to propagate uncertainty to clinical metrics. Our proposed method not only provides accurate uncertainty estimations for the task of contouring but also for the downstream clinical metrics on one public and two private cardiac ultrasound datasets containing a total of 1264 patients. Code is available at: https://github.com/ThierryJudge/contouring-uncertainty.

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