Abstract

Peripheral nerve blocking (PNB) is a standard procedure to support regional anesthesia. Still, correct localization of the nerve’s structure is needed to avoid adverse effects; thereby, ultrasound images are used as an aid approach. In addition, image-based automatic nerve segmentation from deep learning methods has been proposed to mitigate attenuation and speckle noise ultrasonography issues. Notwithstanding, complex architectures highlight the region of interest lacking suitable data interpretability concerning the learned features from raw instances. Here, a kernel-based deep learning enhancement is introduced for nerve structure segmentation. In a nutshell, a random Fourier features-based approach was utilized to complement three well-known semantic segmentation architectures, e.g., fully convolutional network, U-net, and ResUnet. Moreover, two ultrasound image datasets for PNB were tested. Obtained results show that our kernel-based approach provides a better generalization capability from image segmentation-based assessments on different nerve structures. Further, for data interpretability, a semantic segmentation extension of the GradCam++ for class-activation mapping was used to reveal relevant learned features separating between nerve and background. Thus, our proposal favors both straightforward (shallow) and complex architectures (deeper neural networks).

Highlights

  • Regional procedures have been arisen as an attractive alternative for general anesthesia in the context of medical surgeries to enhance post-operative mobility and reduce mortality and morbidity [1]

  • To compare the performance of our random Fourier features (RFF)-based framework for nerve structure segmentation that includes RFF-fully convolutional network (FCN), RFF-U-net, and RFF-residual neural network and U-net (ResUnet), where RFF stands for approximating kernel mapping, we considered the following relevant stateof-the-art approaches: (i) FCN [12], (ii) U-net [14,41], and (iii) ResUnet [16]

  • It is worth mentioning that both ResUnet and RFF-ResUnet provide false-positive segmentation, which can be explained by the overfitting issue of deeper architectures [33]

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Summary

Introduction

Regional procedures have been arisen as an attractive alternative for general anesthesia in the context of medical surgeries to enhance post-operative mobility and reduce mortality and morbidity [1] In this sense, peripheral nerve blocking (PNB) is a widely used method that involves the administration of an anesthetic substance in the area surrounding a nerve structure to block the transmission of nociceptive information [2]. Ultrasonography has been used to support PNB This technique aims to improve targeting accuracy enabling realtime visualization of the nerve at low cost, while being non-invasive and using no radiation [4]. The Win-based measure results prove that our RFF-based variants (RFF-FCN, RFF-Unet, and RFF-ResUnet) improve the model score from their explanation maps, pushing relevant and discriminant input image patterns

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