CA-YOLO: An Efficient YOLO-Based Algorithm with Context-Awareness and Attention Mechanism for Clue Cell Detection in Fluorescence Microscopy Images.

Automatic detection of clue cells is crucial for rapid diagnosis of bacterial vaginosis (BV), but existing algorithms suffer from low sensitivity. This is because clue cells are highly similar to normal epithelial cells in terms of macroscopic size and shape. The key difference between clue cells and normal epithelial cells lies in the surface texture and edge morphology. To address this specific problem, we propose an clue cell detection algorithm named CA-YOLO. The contributions of our approach lie in two synergistic and custom-designed feature extraction modules: the context-aware module (CAM) extracts and captures bacterial distribution patterns on the surface of clue cells; and the shuffle global attention mechanism (SGAM) enhances cell edge features and suppresses irrelevant information. In addition, we integrate focal loss into the classification loss to alleviate the severe class imbalance problem inherent in clinical samples. Experimental results show that the proposed CA-YOLO achieves a sensitivity of 0.778, which is 9.2% higher than the baseline model, making the automated BV detection more reliable and feasible.