Domain-Guided YOLO26 with Composite BCE-Dice-Lovász Loss for Multi-Class Fetal Head Ultrasound Segmentation

Head circumference (HC) measured from 2D ultrasound is a routine marker of fetal growth, and automating it needs segmentations whose boundaries hold up on individual scans, not only on average. We present FETALFusion, a dual-path CNN-Mamba encoder-decoder for fetal head segmentation across acquisition types. It applies four-directional state-space scans only at the two highest-resolution stages, routes bottleneck features through domain-specific channel gates that are averaged at test time, and adds a weak landmark shape prior. We train jointly on transabdominal (HC-18) and transperineal (PSFHS) images and compare ten methods on a held-out test set of 471 images, each trained under one schedule and scored by surface distances at native resolution. FETALFusion reaches a Dice score of 0.963 and an HD95 of 2.10 mm without test-time augmentation or a domain label. It improves on U-Mamba on all five reported metrics (HD95 reduced by 0.31 mm; Holm-corrected ($p < 10^{-4}$), a lead that holds under test-time augmentation and across two independent training runs, and in the mean on U-Net, Attention U-Net and TransUNet. Residual encoders close the gap: a ResNet-34 UNet++ exceeds FETALFusion, and an ImageNet initialised ResNet-34 U-Net is best overall (HD95 1.75 mm). The ablation agrees. Calibrated against run-to-run variation, it attributes FETALFusion's measurable gains to the landmark shape prior and, on transperineal images, to the domain gates, while removing the state-space branch does not measurably change accuracy. HC from the predicted masks agrees with the clinical reference at an intraclass correlation of 0.9986.

Maternal-fetal US is the primary imaging modality for monitoring fetal development, yet accurate automated segmentation remains challenging due to the scarcity of pixel-level annotations. To address this issue, we propose DACL, a semi-supervised framework for robust fetal US image segmentation. DACL jointly trains a deployment-oriented lightweight convolutional network (1.47\thinsp\mathrm{M} parameters) and a Transformer-based network, leveraging labeled data for supervised learning and unlabeled data via CPS. To enhance prediction stability, we introduce a dual-agreement consistency loss that couples pixel-wise probabilistic divergence with entropy-guided confidence alignment. Unlike conventional CPS methods that enforce agreement only at the prediction level, DACL explicitly regularizes both distributional alignment and uncertainty, thereby suppressing unreliable pseudo-labels and enabling stable cross-architecture pseudo-label learning under extreme annotation scarcity. Furthermore, an interpolation-based consistency strategy using mixup is applied to unlabeled samples to enhance robustness. Under 5% labeled data, DACL improves Dice by up to 2.77% and reduces HD95 by up to 14.69 mm compared with the strongest recent semi-supervised methods, demonstrating significant improvements in boundary accuracy on both fetal head and abdomen datasets. These results demonstrate the effectiveness of agreement-based consistency learning for annotation-efficient fetal US segmentation. Our code is on GitHub.

Automated fetal head segmentation in ultrasound images is critical for accurate biometric measurements in prenatal care. While existing deep learning approaches have achieved a reasonable performance, they struggle with issues like low contrast, noise, and complex anatomical boundaries which are inherent to ultrasound imaging. This paper presents Attention-ResUNet. It is a novel architecture that synergistically combines residual learning with multi-scale attention mechanisms in order to achieve enhanced fetal head segmentation. Our approach integrates attention gates at four decoder levels to focus selectively on anatomically relevant regions while suppressing the background noise, and complemented by residual connections which facilitates gradient flow and feature reuse. Extensive evaluation on the HC18 Challenge dataset where n = 200 demonstrates that Attention ResUNet achieves a superior performance with a mean Dice score of 99.30 +/- 0.14% against similar architectures. It significantly outperforms five baseline architectures including ResUNet (99.26%), Attention U-Net (98.79%), Swin U-Net (98.60%), Standard U-Net (98.58%), and U-Net++ (97.46%). Through statistical analysis we confirm highly significant improvements (p < 0.001) with effect sizes that range from 0.230 to 13.159 (Cohen's d). Using Saliency map analysis, we reveal that our architecture produces highly concentrated, anatomically consistent activation patterns, which demonstrate an enhanced interpretability which is crucial for clinical deployment. The proposed method establishes a new state of the art performance for automated fetal head segmentation whilst maintaining computational efficiency with 14.7M parameters and a 45 GFLOPs inference cost. Code repository: https://github.com/Ammar-ss