Mpox lesion counting with semantic and instance segmentation methods.

Purpose: Mpox is a viral illness with symptoms similar to smallpox. A key clinical metric to monitor disease progression is the number of skin lesions. Manually counting mpox skin lesions is labor-intensive and susceptible to human error. Approach: We previously developed an mpox lesion counting method based on the UNet segmentation model using 66 photographs from 18 patients. We have compared four additional methods: the instance segmentation methods Mask R-CNN, YOLOv8, and E2EC, in addition to a UNet++ model. We designed a patient-level leave-one-out experiment, assessing their performance using Results: Mask R-CNN model achieved an Conclusions: Instance segmentation methods and UNet-based semantic segmentation methods performed equally well in lesion counting. Furthermore, the ensemble of the trained models showed no performance increase over the best-performing model UNet, likely because errors are frequently shared across models. Performance is likely limited by the availability of high-quality photographs for this complex problem, rather than the methodologies used.