Detecting and refurbishing ground truth errors during training of deep learning-based echocardiography segmentation models

Deep learning models for echocardiography segmentation often struggle to generalise across institutions, scanners, and patient populations, where collecting large, consistently annotated datasets is infeasible. Data augmentation is inexpensive and widely used to improve the robustness of deep learning models; however, its role in enhancing cross-dataset generalisability in echocardiography remains insufficiently understood. This study presents a large-scale multi-dataset evaluation of 29 data augmentation techniques and their pairwise combinations for 2D left ventricular segmentation using a U-Net trained on Unity, CAMUS, and EchoNet Dynamic datasets. Each augmentation was explored under several hyperparameter settings and assessed through repeated runs using Dice and IoU in both in-domain and cross-dataset scenarios, with statistical significance quantified via independent t-tests. In-domain accuracy was near-saturated and insensitive to augmentation, whereas cross-dataset performance varied widely. Geometry-based augmentations including affine, shift-scale-rotate, flip, and perspective produced the largest and most consistent gains, while aggressive intensity- and artefact-based transforms often degraded transfer. Moreover, pairwise combinations outperformed individual augmentations mainly when the two transformations were complementary, particularly by improving some difficult domain-shift cases from poor to acceptable performance. These findings provide empirical guidance for designing augmentation policies that improve the robustness and transferability of echocardiography segmentation models.

While echocardiography is essential for cardiovascular diagnosis, inherent speckle noise and low signal-to-noise ratio often lead to ambiguous semantic features and fragmented boundaries. These limitations significantly hinder the segmentation accuracy of deep learning models in complex clinical cases. Moreover, temporal motion of the heart plays a critical role in recognizing anatomical structures. To address these challenges, we designed a STLSF module which comprises a window-matching-based semantic correction component and a semantics-guided texture enhancement component. By leveraging local transition probability correlations to correct semantics and employing semantics-guided texture enhancement, the STLSF module effectively mitigates texture instability and ambiguous semantic interpretations caused by disadvantaged echocardiography quality. Additionally, to facilitate the encoder's adaptation to the intrinsic priors of ultrasound-specific imaging patterns, we propose a frequency-aware denoising pre-training method. The entire work builds a convolution-based network with locality inductive bias and long-range dependencies. Extensive experiments confirm our SOTA performance, achieving 93.87% Dice on CAMUS and 92.62% on EchoNet-Dynamic, with respective HD95 values of 3.29mm and 2.73mm.

Deep learning is widely applied in medical image analysis, but up to 10% of manually labelled images may be incorrect, degrading model performance. This paper proposes an automated method to identify incorrectly labelled medical images by analyzing sequences of loss functions from deep learning classification networks over multiple training epochs. Identified images can be reviewed and relabelled by experts, improving dataset quality and model performance. Two experiments validate the method on a fundus image dataset for referable diabetic retinopathy screening. In the first, 6% (648) of 10,788 gold-standard labels were intentionally flipped. The method identified 75.31% (488) of the flipped samples, with only 4.85% (492) false positives among correctly labelled samples. In the second, reviewing and correcting the 980 identified samples (9.1% of the dataset) and retraining the model improved best accuracy on an independent test set from 95.93% (with 6% label noise) to 96.50% (with 1.5% noise), approaching the ideal 96.57% (with 0% noise). The results demonstrate the method's effectiveness in improving model performance through automated label quality control.