Abstract
PURPOSE: Segmenting ultrasound images is important for precise area and/or volume calculations, ensuring reliable diagnosis and effective treatment evaluation for diseases. Recently, many segmentation methods have been proposed and shown impressive performance. However, currently, there is no deeper understanding of how networks segment target regions or how they define the boundaries. In this paper, we present a new approach that analyzes ultrasound segmentation networks in terms of learned borders because border delimitation is challenging in ultrasound. METHODS: We propose a way to split the boundaries for ultrasound images into distinct and completed. By exploiting the Grad-CAM of the split borders, we analyze the areas each network pays attention to. Further, we calculate the ratio of correct predictions for distinct and completed borders. We conducted experiments on an in-house leg ultrasound dataset (LEG-3D-US) as well as on two additional public datasets of thyroid, nerves, and one private for prostate. RESULTS: Quantitatively, the networks exhibit around 10% improvement in handling completed borders compared to distinct borders. Similar to doctors, the network struggles to define the borders in less visible areas. Additionally, the Seg-Grad-CAM analysis underscores how completion uses distinct borders and landmarks, while distinct focuses mainly on the shiny structures. We also observe variations depending on the attention mechanism of each architecture. CONCLUSION: In this work, we highlight the importance of studying ultrasound borders differently than other modalities such as MRI or CT. We split the borders into distinct and completed, similar to clinicians, and show the quality of the network-learned information for these two types of borders. Additionally, we open-source a 3D leg ultrasound dataset to the community https://github.com/Al3xand1a/segmentation-border-analysis .