Medical image segmentation is a critical task in healthcare applications, and U-Nets have demonstrated promising results in this domain. We delve into the understudied aspect of receptive field (RF) size and its impact on the U-Net and attention U-Net architectures used for medical imaging segmentation. We explore several critical elements including the relationship among RF size, characteristics of the region of interest, and model performance, as well as the balance between RF size and computational costs for U-Net and attention U-Net methods for different datasets. We also propose a mathematical notation for representing the theoretical receptive field (TRF) of a given layer in a network and propose two new metrics, namely, the effective receptive field (ERF) rate and the object rate, to quantify the fraction of significantly contributing pixels within the ERF against the TRF area and assessing the relative size of the segmentation object compared with the TRF size, respectively. The results demonstrate that there exists an optimal TRF size that successfully strikes a balance between capturing a wider global context and maintaining computational efficiency, thereby optimizing model performance. Interestingly, a distinct correlation is observed between the data complexity and the required TRF size; segmentation based solely on contrast achieved peak performance even with smaller TRF sizes, whereas more complex segmentation tasks necessitated larger TRFs. Attention U-Net models consistently outperformed their U-Net counterparts, highlighting the value of attention mechanisms regardless of TRF size. These insights present an invaluable resource for developing more efficient U-Net-based architectures for medical imaging and pave the way for future exploration of other segmentation architectures. A tool is also developed, which calculates the TRF for a U-Net (and attention U-Net) model and also suggests an appropriate TRF size for a given model and dataset.
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