Dai Hong, Xie Wufei, Xia E
Department of Ultrasound Medicine, Hunan Provincial Peoples Hospital, Changsha, China.
School of Automation, Central South University, Changsha, China.
Med Phys. 2024 Mar;51(3):1798-1811. doi: 10.1002/mp.16672. Epub 2023 Aug 22.
The quality of segmentation of thyroid nodules in ultrasound images is a crucial factor in preventing the cancerization of thyroid nodules. However, the existing standards for the ultrasound imaging of cancerous nodules have limitations, and changes of the echo pattern of thyroid nodules pose challenges in accurately segmenting nodules, which can affect the diagnostic results of medical professionals.
The aim of this study is to address the challenges related to segmentation accuracy due to noise, low contrast, morphological scale variations, and blurred edges of thyroid nodules in ultrasound images and improve the accuracy of ultrasound-based thyroid nodule segmentation, thereby aiding the clinical diagnosis of thyroid nodules.
In this study, the dataset of thyroid ultrasound images was obtained from Hunan Provincial People's Hospital, consisting of a total of 3572 samples used for the training, validation, and testing of this model at a ratio of 8:1:1. A novel SK-Unet++ network was used to enhance the segmentation accuracy of thyroid nodules. SK-Unet++ is a novel deep learning architecture that adds the adaptive receptive fields based on the selective kernel (SK) attention mechanisms into the Unet++ network. The convolution blocks of the original UNet++ encoder part were replaced with finer SK convolution blocks in SK-Unet++. First, multiple skip connections were incorporated so that SK-Unet++ can make information from previous layers of the neural network to bypass certain layers and directly propagate to subsequent layers. The feature maps of the corresponding locations were fused on the channel, resulting in enhanced segmentation accuracy. Second, we added the adaptive receptive fields. The adaptive receptive fields were used to capture multiscale spatial features better by dynamically adjusting its receptive field. The assessment metrics contained dice similarity coefficient (Dsc), accuracy (Acc), precision (Pre), recall (Re), and Hausdorff distance, and all comparison experiments used the paired t-tests to assess whether statistically significant performance differences existed (p < 0.05). And to address the multi-comparison problem, we performed the false discovery rate (FDR) correction after the test.
The segmentation model had an Acc of 80.6%, Dsc of 84.7%, Pre of 77.5%, Re of 71.7%, and an average Hausdorff distance of 15.80 mm. Ablation experimental results demonstrated that each module in the network could contribute to the improved performance (p < 0.05) and determined the best combination of parameters. A comparison with other state-of-the-art methods showed that SK-Unet++ significantly outperformed them in terms of segmentation performance (p < 0.05), with a more accurate segmentation contour. Additionally, the adaptive weight changes of the SK module were monitored during the training process, and the resulting change curves demonstrated their convergence.
Our proposed method demonstrates favorable performance in the segmentation of ultrasound images of thyroid nodules. Results confirmed that SK-Unet++ is a feasible and effective method for the automatic segmentation of thyroid nodules in ultrasound images. The high accuracy achieved by our method can facilitate efficient screening of patients with thyroid nodules, ultimately reducing the workload of clinicians and radiologists.
超声图像中甲状腺结节的分割质量是预防甲状腺结节癌变的关键因素。然而,现有的癌性结节超声成像标准存在局限性,甲状腺结节回声模式的变化给准确分割结节带来挑战,这可能影响医学专业人员的诊断结果。
本研究旨在解决超声图像中甲状腺结节因噪声、低对比度、形态尺度变化和边缘模糊而导致的分割准确性相关挑战,提高基于超声的甲状腺结节分割准确性,从而辅助甲状腺结节的临床诊断。
在本研究中,甲状腺超声图像数据集来自湖南省人民医院,共有3572个样本,以8:1:1的比例用于该模型的训练、验证和测试。使用一种新颖的SK-Unet++网络来提高甲状腺结节的分割准确性。SK-Unet++是一种新颖的深度学习架构,它将基于选择性内核(SK)注意力机制的自适应感受野添加到Unet++网络中。在SK-Unet++中,原始Unet++编码器部分的卷积块被更精细的SK卷积块所取代。首先,纳入多个跳跃连接,使SK-Unet++能够使神经网络前层的信息绕过某些层并直接传播到后续层。在通道上融合相应位置的特征图,从而提高分割准确性。其次,添加了自适应感受野。自适应感受野用于通过动态调整其感受野更好地捕捉多尺度空间特征。评估指标包括骰子相似系数(Dsc)、准确率(Acc)、精确率(Pre)、召回率(Re)和豪斯多夫距离,所有比较实验均使用配对t检验来评估是否存在统计学上显著的性能差异(p < 0.05)。为了解决多重比较问题,我们在测试后进行了错误发现率(FDR)校正。
分割模型的Acc为80.6%,Dsc为84.7%,Pre为77.5%,Re为71.7%,平均豪斯多夫距离为15.80毫米。消融实验结果表明,网络中的每个模块都有助于性能的提升(p < 0.05),并确定了最佳参数组合。与其他现有先进方法的比较表明,SK-Unet++在分割性能方面显著优于它们(p < 0.05),分割轮廓更准确。此外,在训练过程中监测了SK模块的自适应权重变化,得到的变化曲线显示了它们的收敛情况。
我们提出的方法在甲状腺结节超声图像分割中表现出良好的性能。结果证实,SK-Unet++是一种用于超声图像中甲状腺结节自动分割的可行且有效的方法。我们的方法所实现的高精度能够促进对甲状腺结节患者的高效筛查,最终减轻临床医生和放射科医生的工作量。