Accurate computer-aided polyp detection and segmentation during colonoscopy examinations can help endoscopists resect abnormal tissue and thereby decrease chances of polyps growing into cancer. Towards developing a fully automated model for pixel-wise polyp segmentation, we propose ResUNet++, which is an improved ResUNet architecture for colonoscopic image segmentation. Our experimental evaluations show that the suggested architecture produces good segmentation results on publicly available datasets. Furthermore, ResUNet++ significantly outperforms U-Net and ResUNet, two key state-ofthe-art deep learning architectures, by achieving high evaluation scores with a dice coefficient of 81.33%, and a mean Intersection over Union (mIoU) of 79.27% for the Kvasir-SEG dataset and a dice coefficient of 79.55%, and a mIoU of 79.62% with CVC-612 dataset.

Semantic image segmentation is the process of labeling each pixel of an image with its corresponding class. An encoder-decoder based approach, like U-Net and its variants, is a popular strategy for solving medical image segmentation tasks. To improve the performance of U-Net on various segmentation tasks, we propose a novel architecture called DoubleU-Net, which is a combination of two U-Net architectures stacked on top of each other. The first U-Net uses a pre-trained VGG-19 as the encoder, which has already learned features from ImageNet and can be transferred to another task easily. To capture more semantic information efficiently, we added another U-Net at the bottom. We also adopt Atrous Spatial Pyramid Pooling (ASPP) to capture contextual information within the network. We have evaluated DoubleU-Net using four medical segmentation datasets, covering various imaging modalities such as colonoscopy, dermoscopy, and microscopy. Experiments on the 2015 MICCAI sub-challenge on automatic polyp detection dataset, the CVC-ClinicDB, the 2018 Data Science Bowl challenge, and the Lesion boundary segmentation datasets demonstrate that the DoubleU-Net outperforms U-Net and the baseline models. Moreover, DoubleU-Net produces more accurate segmentation masks, especially in the case of the CVC-ClinicDB and 2015 MICCAI sub-challenge on automatic polyp detection dataset, which have challenging images such as smaller and flat polyps. These results show the improvement over the existing U-Net model. The encouraging results, produced on various medical image segmentation datasets, show that DoubleU-Net can be used as a strong baseline for both medical image segmentation and cross-dataset evaluation testing to measure the generalizability of Deep Learning (DL) models.

Computer-aided detection, localisation, and segmentation methods can help improve colonoscopy procedures. Even though many methods have been built to tackle automatic detection and segmentation of polyps, benchmarking of state-of-the-art methods still remains an open problem. This is due to the increasing number of researched computer-vision methods that can be applied to polyp datasets. Benchmarking of novel methods can provide a direction to the development of automated polyp detection and segmentation tasks. Furthermore, it ensures that the produced results in the community are reproducible and provide a fair comparison of developed methods. In this paper, we benchmark several recent state-of-the-art methods using Kvasir-SEG, an open-access dataset of colonoscopy images, for polyp detection, localisation, and segmentation evaluating both method accuracy and speed. Whilst, most methods in literature have competitive performance over accuracy, we show that YOLOv4 with a Darknet53 backbone and crossstage-partial connections achieved a better trade-off between an average precision of 0.8513 and mean IoU of 0.8025, and the fastest speed of 48 frames per second for the detection and localisation task. Likewise, the proposed ColonSegNet achieved a competitive dice coefficient of 0.8206 and the best average speed of 182.38 frames per second for the segmentation task. Our comprehensive comparison with various state-ofthe-art methods reveal the importance of benchmarking the deep learning methods for automated real-time polyp identification and delineations that can potentially transform current clinical practices and minimise miss-detection rates.

Methods based on convolutional neural networks have improved the performance of biomedical image segmentation. However, most of these methods cannot efficiently segment objects of variable sizes and train on small and biased datasets, which are common for biomedical use cases. While methods exist that incorporate multi-scale fusion approaches to address the challenges arising with variable sizes, they usually use complex models that are more suitable for general semantic segmentation problems. In this paper, we propose a novel architecture called Multi-Scale Residual Fusion Network (MSRF-Net), which is specially designed for medical image segmentation. The proposed MSRF-Net is able to exchange multi-scale features of varying receptive fields using a Dual-Scale Dense Fusion (DSDF) block. Our DSDF block can exchange information rigorously across two different resolution scales, and our MSRF sub-network uses multiple DSDF blocks in sequence to perform multi-scale fusion. This allows the preservation of resolution, improved information flow and propagation of both high-and low-level features to obtain accurate segmentation maps. The proposed MSRF-Net allows to capture object variabilities and provides improved results on different biomedical datasets. Extensive experiments on MSRF-Net demonstrate that the proposed method outperforms the cutting-edge medical image segmentation methods on four publicly available datasets. We achieve the Dice Coefficient (DSC) of 0.9217, 0.9420, and 0.9224, 0.8824 on Kvasir-SEG, CVC-ClinicDB, 2018 Data Science Bowl dataset, and ISIC-2018 skin lesion segmentation challenge dataset respectively. We further conducted generalizability tests and achieved DSC of 0.7921 and 0.7575 on CVC-ClinicDB and Kvasir-SEG, respectively.

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Precise and efficient automated identification of gastrointestinal (GI) tract diseases can help doctors treat more patients and improve the rate of disease detection and identification. Currently, automatic analysis of diseases in the GI tract is a hot topic in both computer science and medical-related journals. Nevertheless, the evaluation of such an automatic analysis is often incomplete or simply wrong. Algorithms are often only tested on small and biased datasets, and cross-dataset evaluations are rarely performed. A clear understanding of evaluation metrics and machine learning models with cross datasets is crucial to bring research in the field to a new quality level. Toward this goal, we present comprehensive evaluations of five distinct machine learning models using global features and deep neural networks that can classify 16 different key types of GI tract conditions, including pathological findings, anatomical landmarks, polyp removal conditions, and normal findings from images captured by common GI tract examination instruments. In our evaluation, we introduce performance hexagons using six performance metrics, such as recall, precision, specificity, accuracy, F1-score, and the Matthews correlation coefficient to demonstrate how to determine the real capabilities of models rather than evaluating them shallowly. Furthermore, we perform cross-dataset evaluations using different datasets for training and testing. With these cross-dataset evaluations, we demonstrate the challenge of actually building a generalizable model that could be used across different hospitals. Our experiments clearly show that more sophisticated performance metrics and evaluation methods need to be applied to get reliable models rather than depending on evaluations of the splits of the same dataset—that is, the performance metrics should always be interpreted together rather than relying on a single metric.

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The increase of available large clinical and experimental datasets has contributed to a substantial amount of important contributions in the area of biomedical image analysis. Image segmentation, which is crucial for any quantitative analysis, has especially attracted attention. Recent hardware advancement has led to the success of deep learning approaches. However, although deep learning models are being trained on large datasets, existing methods do not use the information from different learning epochs effectively. In this work, we leverage the information of each training epoch to prune the prediction maps of the subsequent epochs. We propose a novel architecture called feedback attention network (FANet) that unifies the previous epoch mask with the feature map of the current training epoch. The previous epoch mask is then used to provide hard attention to the learned feature maps at different convolutional layers. The network also allows rectifying the predictions in an iterative fashion during the test time. We show that our proposed feedback attention model provides a substantial improvement on most segmentation metrics tested on seven publicly available biomedical imaging datasets demonstrating the effectiveness of FANet. The source code is available at https://github.com/nikhilroxtomar/FANet.