Deep learning for accurate B-line detection and localization in lung ultrasound imaging.

Introduction: Lung ultrasound (LUS) has become an essential imaging modality for assessing various pulmonary conditions, including the presence of B-line artifacts. These artifacts are commonly associated with conditions such as increased extravascular lung water, decompensated heart failure, dialysis-related chronic kidney disease, interstitial lung disease, and COVID-19 pneumonia. Accurate detection of the B-line in LUS images is crucial for effective diagnosis and treatment. However, interpreting LUS is often subject to observer variability, requiring significant expertise and posing challenges in resource-limited settings with few trained professionals. Methods: To address these limitations, deep learning models have been developed for automated B-line detection and localization. This study introduces YOLOv5-PBB and YOLOv8-PBB, two modified models based on YOLOv5 and YOLOv8, respectively, designed for precise and interpretable B-line localization using polygonal bounding boxes (PBBs). YOLOv5-PBB was enhanced by modifying the detection head, loss function, non-maximum suppression, and data loader to enable PBB localization. YOLOv8-PBB was customized to convert segmentation masks into polygonal representations, displaying only boundaries while removing the masks. Additionally, an image preprocessing technique was incorporated into the models to enhance LUS image quality. The models were trained on a diverse dataset from a publicly available repository and Ugandan health facilities. Results: Experimental results showed that YOLOv8-PBB achieved the highest precision (0.947), recall (0.926), and mean average precision (0.957). YOLOv5-PBB, while slightly lower in performance (precision: 0.931, recall: 0.918, mAP: 0.936), had advantages in model size (14 MB vs. 21 MB) and average inference time (33.1 ms vs. 47.7 ms), making it more suitable for real-time applications in low-resource settings. Discussion: The integration of these models into a mobile LUS screening tool provides a promising solution for B-line localization in resource-limited settings, where accessibility to trained professionals may be scarce. The YOLOv5-PBB and YOLOv8-PBB models offer high performance while addressing challenges related to inference speed and model size, making them ideal candidates for mobile deployment in such environments.