Multi‐scale dual attention embedded U‐shaped network for accurate segmentation of coronary vessels in digital subtraction angiography

Abstract Background Most attention‐based networks fall short in effectively integrating spatial and channel‐wise information across different scales, which results in suboptimal performance for segmenting coronary vessels in x‐ray digital subtraction angiography (DSA) images. This limitation becomes particularly evident when attempting to identify tiny sub‐branches. Purpose To address this limitation, a multi‐scale dual attention embedded network (named MDA‐Net) is proposed to consolidate contextual spatial and channel information across contiguous levels and scales. Methods MDA‐Net employs five cascaded double‐convolution blocks within its encoder to adeptly extract multi‐scale features. It incorporates skip connections that facilitate the retention of low‐level feature details throughout the decoding phase, thereby enhancing the reconstruction of detailed image information. Furthermore, MDA modules, which take in features from neighboring scales and hierarchical levels, are tasked with discerning subtle distinctions between foreground elements, such as coronary vessels of diverse morphologies and dimensions, and the complex background, which includes structures like catheters or other tissues with analogous intensities. To sharpen the segmentation accuracy, the network utilizes a composite loss function that integrates intersection over union (IoU) loss with binary cross‐entropy loss, ensuring the precision of the segmentation outcomes and maintaining an equilibrium between positive and negative classifications. Results Experimental results demonstrate that MDA‐Net not only performs more robustly and effectively on DSA images under various image conditions, but also achieves significant advantages over state‐of‐the‐art methods, achieving the optimal scores in terms of IoU, Dice, accuracy, and Hausdorff distance 95%. Conclusions MDA‐Net has high robustness for coronary vessels segmentation, providing an active strategy for early diagnosis of cardiovascular diseases. The code is publicly available at https://github.com/30410B/MDA‐Net.git .