Radiological segmentation of knee meniscus ultrasound images based on boundary constraints and multi-scale fusion network

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Knee osteoarthritis (KOA) is one of the most popular joint diseases endangering human health because of its high incidence, disability, and younger onset. However, there is no suitable method for early diagnosis, evaluation, and treatment of KOA. In recent years, some clinical studies have found that ultrasound can detect early changes in KOA in advance, and the automatic segmentation of ultrasound images can achieve rapid and effective quantitative research on KOA. However, in ultrasound images, the soft tissue boundaries of the lesion are blurred, making lesion segmentation difficult. Although the U-Net family is one of the best networks for image segmentation, they still have defects such as blurred segmentation boundaries, distorted morphology, and insufficient accuracy when segmenting ultrasound images. To address this issue, we added attention, atrous spatial pyramid pooling (ASSP), and edge loss function terms into the Unet3+ network, which improved the contour clarity and accuracy of output images (the improved Unet3+ Dice acc = 78.74%. Then, we extract the key features of the improved Unet3+ for outputting meniscus images: calculating meniscus area and distance, where the average accuracy of the area is: area_ avg_ acc = 91.12%, with an average distance accuracy of distance_ avg_ acc = 91.14%. This thesis creates a new dataset collection from West China Hospital, Sichuan University, and automated measurement of knee meniscus protrusion area has been achieved for the first time. This article is the first to apply deep learning to ultrasound image segmentation of the knee meniscus, helping doctors conduct qualitative and quantitative analysis of the diagnosis and treatment of early KOA. The results indicate that the improved Unet3+ can assist doctors in automatically diagnosing and evaluating KOA based on meniscus ultrasound images, which is beneficial for guiding early clinical intervention.