Abstract

Evidence from recent research shows that automatic visual evaluation (AVE) of photographic images of the uterine cervix using deep learning-based algorithms presents a viable solution for improving cervical cancer screening by visual inspection with acetic acid (VIA). However, a significant performance determinant in AVE is the photographic image quality. While this includes image sharpness and focus, an important criterion is the localization of the cervix region. Deep learning networks have been successfully applied for object localization and segmentation in images, providing impetus for studying their use for fine contour segmentation of the cervix. In this paper, we present an evaluation of two state-of-the-art deep learning-based object localization and segmentation methods, viz., Mask R-convolutional neural network (CNN) and MaskX R-CNN, for automatic cervix segmentation using three datasets. We carried out extensive experimental tests and algorithm comparisons on each individual dataset and across datasets, and achieved performance either notably higher than, or comparable to, that reported in the literature. The highest Dice and intersection-over-union (IoU) scores that we obtained using Mask R-CNN were 0.947 and 0.901, respectively.

Highlights

  • According to the World Health Organization (WHO), there were about 570,000 new cases of invasive cervical cancer diagnosed in 2018, representing almost 7% of all female cancers [1]

  • We investigate the effectiveness of MaskX R-convolutional neural network (CNN)

  • MaskX R-CNN may play a significant role in this case, by using both and Cbox for training the bounding box head and Amask for training the mask head

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Summary

Introduction

According to the World Health Organization (WHO), there were about 570,000 new cases of invasive cervical cancer diagnosed in 2018, representing almost 7% of all female cancers [1]. Detection and treatment of cervical cancer/pre-cancer can improve survival rate. Various screening modalities include the Pap test, Visual Inspection with Acetic acid (VIA), and Human Papillomavirus (HPV). The VIA test is conducted by applying dilute (3–5%) acetic acid to the cervix during a gynecological exam, which causes temporary whitening of HPV infected tissue, and visually inspecting the cervix [2]. The method shows promise for use in low-to-medium resource settings with high disease burden for pre-menopausal women in the age group (25–49) who tend to exhibit higher incidence of visually detectable cervical pre-cancer. The algorithm utilizes an object detection network which is trained using images from a longitudinal cervical cancer screening study in Costa Rica. The training of the network requires bounding boxes surrounding the cervix in the images. While bounding boxes are convenient for AVE, Diagnostics 2020, 10, 44; doi:10.3390/diagnostics10010044 www.mdpi.com/journal/diagnostics

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