DPC-MSGATNet: dual-path chain multi-scale gated axial-transformer network for four-chamber view segmentation in fetal echocardiography

Echocardiography is essential in evaluating fetal cardiac anatomical structures and functions when clinicians conduct early treatment and screening for congenital heart defects, a common and intricate fetal malformation. Nevertheless, the prenatal detection rate of fetal CHD remains low since the peculiarities of fetal cardiac structures and the variousness of fetal CHD. Precisely segmenting four cardiac chambers can assist clinicians in analyzing cardiac morphology and further facilitate CHD diagnosis. Hence, we design a dual-path chain multi-scale gated axial-transformer network (DPC-MSGATNet) that simultaneously models global dependencies and local visual cues for fetal ultrasound (US) four-chamber (FC) views and further accurately segments four chambers. Our DPC-MSGATNet includes a global and a local branch that simultaneously operates on an entire FC view and image patches to learn multi-scale representations. We design a plug-and-play module, Interactive dual-path chain gated axial-transformer (IDPCGAT), to enhance the interactions between global and local branches. In IDPCGAT, the multi-scale representations from the two branches can complement each other, capturing the same region's salient features and suppressing feature responses to maintain only the activations associated with specific targets. Extensive experiments demonstrate that the DPC-MSGATNet exceeds seven state-of-the-art convolution-and transformer-based methods by a large margin in terms of F1 and IoU scores on our fetal FC view dataset, achieving a F1 score of 96.87% and an IoU score of 93.99%.