FETALFusion: Resolution-Aware State-Space Modeling for Multi-Domain Fetal Head Segmentation

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

Segmenting fetal head structures from prenatal ultrasound remains a practical bottleneck in obstetric imaging. The current state-of-the-art baseline, proposed alongside the published dataset, adapts the Segment Anything Model with per-class Dice and Lovász losses but still depends on bounding-box prompts at test time. We build a prompt-free pipeline on top of YOLO26-Seg that jointly detects and segments three structures, Brain, Cavum Septi Pellucidi (CSP), and Lateral Ventricles (LV), in a single forward pass. Three modifications are central to our approach: (i) a composite BCE-Dice-Lovász segmentation loss with inverse-frequency class weighting, injected into the YOLO26 training loop via runtime monkey-patching; (ii) domain-guided copy-paste augmentation that transplants minority-class structures while respecting their anatomical location relative to the brain boundary; and (iii) inter-patient stratified splitting to prevent data leakage. On 575 held-out test images, the composite loss variant reaches a mean Dice coefficient of 0.9253, exceeding the baseline (0.9012) by 2.68 percentage points, despite reporting over three foreground classes only, whereas the baseline's reported mean includes the easy background class. We further ablate each component and discuss annotation-quality and class-imbalance effects on CSP and LV performance.

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.