Wrist joint synovial hypertrophy and effusion detection in musculoskeletal ultrasound images using self-attention U-Net

Skeletal muscle ultrasound has emerged as a pivotal imaging modality in rheumatology clinics, offering unparalleled advantages such as radiation-free imaging, safety, and dynamic examination capabilities. However, its reliance on operator expertise often leads to inconsistent interpretations and diagnostic variability. In this study, we present a novel diagnostic system aimed at detecting rheumatoid arthritis (RA) in the wrist joint, with a focus on identifying synovial hypertrophy and effusion using musculoskeletal ultrasound images. Leveraging deep learning techniques, specifically semantic segmentation models, we introduce SEAT-UNet, which combines the U-Net architecture with a self-attention mechanism to enhance the accuracy of lesion classification and localization. SEAT-UNet addresses the challenge of discontinuous dispersion encountered in conventional segmentation models, particularly when delineating lesion areas. Our experimental results demonstrate exceptional performance, achieving a sensitivity and Dice coefficient of 100% and 84%, respectively, in synovial hypertrophy detection, and 86% sensitivity with an 84% Dice coefficient in effusion detection. These findings underscore the potential of SEAT-UNet as a valuable tool for early RA diagnosis, offering improved patient outcomes and facilitating more effective disease management strategies.