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

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% ( 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.