An improved YOLOv10-based framework for knee MRI lesion detection with enhanced small object recognition and low contrast feature extraction

Abstract

Rationale and objectives To address the challenges in detecting anterior cruciate ligament (ACL) lesions in knee MRI examinations, including difficulties in identifying tiny lesions, insufficient extraction of low-contrast features, and poor modeling of irregular lesion morphologies, and to provide a precise and efficient auxiliary diagnostic tool for clinical practice. Materials and methods An enhanced framework based on YOLOv10 is constructed. The backbone network is optimized using the C2f-SimAM module to enhance multi-scale feature extraction and spatial attention; an Adaptive Spatial Fusion (ASF) module is introduced in the neck to better fuse multi-scale spatial features; and a novel hybrid loss function combining Focal-EIoU and KPT Loss is employed. To ensure rigorous statistical evaluation, we utilized a five-fold cross-validation strategy on a dataset of 917 cases. Results Evaluation on the KneeMRI dataset demonstrates that the proposed model achieves statistically significant improvements over standard YOLOv10, Faster R-CNN, and Transformer-based detectors (RT-DETR). Specifically, mAP@0.5 is increased by 1.3% ( p < 0.05) compared to the standard YOLOv10, and mAP@0.5:0.95 is improved by 2.5%. Qualitative analysis further confirms the model's ability to reduce false negatives in small, low-contrast tears. Conclusion This framework effectively connects general object detection models with the specific requirements of medical imaging, providing a precise and efficient solution for diagnosing ACL injuries in routine clinical workflows.

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