Background Ultrasound image segmentation is challenging due to the low signal-to-noise ratio and poor quality of ultrasound images. With deep learning advancements, convolutional neural networks (CNNs) have been widely used for ultrasound image segmentation. However, due to the intrinsic locality of convolutional operations and the varying shapes of segmentation objects, segmentation methods based on CNNs still face challenges with accuracy and generalization. In addition, Transformer is a network architecture with self-attention mechanisms that performs well in the field of computer vision. Based on the characteristics of Transformer and CNNs, we propose a hybrid architecture based on Transformer and U-Net with joint loss for ultrasound image segmentation, referred to as TU-Net. Methods TU-Net is based on the encoder-decoder architecture and includes encoder, parallel attention mechanism and decoder modules. The encoder module is responsible for reducing dimensions and capturing different levels of feature information from ultrasound images; the parallel attention mechanism is responsible for capturing global and multiscale local feature information; and the decoder module is responsible for gradually recovering dimensions and delineating the boundaries of the segmentation target. Additionally, we adopt joint loss to optimize learning and improve segmentation accuracy. We use experiments on datasets of two types of ultrasound images to verify the proposed architecture. We use the Dice scores, precision, recall, Hausdorff distance (HD) and average symmetric surface distance (ASD) as evaluation metrics for segmentation performance. Results For the brachia plexus and fetal head ultrasound image datasets, TU-Net achieves mean Dice scores of 79.59% and 97.94%; precisions of 81.25% and 98.18%; recalls of 80.19% and 97.72%; HDs (mm) of 12.44 and 6.93; and ASDs (mm) of 4.29 and 2.97, respectively. Compared with those of the other six segmentation algorithms, the mean values of TU-Net increased by approximately 3.41%, 2.62%, 3.74%, 36.40% and 31.96% for the Dice score, precision, recall, HD and ASD, respectively.
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