Abstract
Uterine fibroids are one of the most common gynaecological tumours, but they can be hard to diagnose because their appearance varies and the images may have poor contrast. Existing computer-aided detection (CAD) methods often use features that were handcrafted or use only a single modality, which limits their reliability and interpretability. An Explainable Hybrid Deep Learning (E-HDL) framework is introduced in this study. It includes a self-improving preprocessing pipeline, adaptive multi-branch feature fusion, and attention-based interpretability for reliably detecting uterine fibroids on both ultrasound and MRI. To make sure that the input quality is the same, the process uses bias-field correction, anisotropic diffusion filtering, CLAHE contrast normalisation, and adaptive spatial alignment. Spatial deep features from a CNN are combined dynamically with contextual embeddings from Transformers and temporal representations from RNNs using an attention-based feature-scaling layer. Extensive experiments on the Mendeley Uterine Fibroid Dataset and cross-dataset evaluation on the HIFU-MRI and UFID-2023 benchmarks show that E-HDL works better than recent state-of-the-art models like Swin-Transformer, MedT, ConvNeXt, and EfficientNetV2. The suggested model is more accurate than previous combination and transformer-based systems, with a 97.1% F1-score and 0.989 AUC. Grad-CAM, SHAP, and attention heatmaps improve interpretability in clinical settings. The study shows that E-HDL is a high-performance, scalable, and easy-to-understand diagnostic aid for detecting uterine tumours.
Keywords
Uterine Fibroid Detection, Hybrid Deep Learning, Medical Image Analysis, Preprocessing Techniques, Diagnostic Accuracy, Clinical Decision Support,Downloads
References
- Z. Xia, H. Jin, Diagnostic Value of Ultrasonography Combined with Hysteroscopy in Intrauterine Space‐Occupying Abnormalities. Contrast Media & Molecular Imaging, 2022(1), (2022) 6192311. https://doi.org/10.1155/2022/6192311
- Y. Toyohara, K. Sone, K. Noda, K. Yoshida, R. Kurokawa, T. Tanishima, S. Kato, S. Inui, Y. Nakai, M. Ishida, W. Gonoi, S. Tanimoto, Y. Takahashi, F. Inoue, A. Kukita, Y. Kawata, A. Taguchi, A. Furusawa, Y. Miyamoto, T. Tsukazaki, M. Tanikawa, T. Iriyama, M. Mori-Uchino, T. Tsuruga, K. Oda, T. Yasugi, K. Takechi, O. Abe, Y. Osuga, Development of a deep learning method for improving diagnostic accuracy for uterine sarcoma cases. Scientific Reports, 12(1), (2022) 19612. https://doi.org/10.1038/s41598-022-23064-5
- A. Tinelli, O. D’Oria, E. Civino, A. Morciano, A.A. Hashmi, G.M. Baldini, R. Stefanovic, Smooth muscle tumor of uncertain malignant potential (STUMP): a comprehensive multidisciplinary update. Medicina, 59(8), (2023) 1371. https://doi.org/10.3390/medicina59081371
- T. Huo, L. Li, X. Chen, Z. Wang, X. Zhang, S. Liu, J. Huang, J. Zhang, Q. Yang, W. Wu, Y. Xie, H. Wang, Z. Ye, K. Deng, Artificial intelligence-aided method to detect uterine fibroids in ultrasound images: a retrospective study. Scientific Reports, 13(1), (2023) 3714. https://doi.org/10.1038/s41598-022-26771-1
- W. Panyarak, W. Suttapak, K. Wantanajittikul, A. Charuakkra, S. Prapayasatok, Assessment of YOLOv3 for caries detection in bitewing radiographs based on the ICCMS™ radiographic scoring system. Clinical Oral Investigations, 27(4), (2023) 1731-1742. https://doi.org/10.1007/s00784-022-04801-6
- T. Yang, L. Yuan, P. Li, P. Liu, Real-time automatic assisted detection of uterine fibroid in ultrasound images using a deep learning detector. Ultrasound in Medicine & Biology, 49(7), (2023) 1616-1626. https://doi.org/10.1016/j.ultrasmedbio.2023.03.013
- J. Smith, J.P. Zawaideh, H. Sahin, S. Freeman, H. Bolton, H.C. Addley, Differentiating uterine sarcoma from leiomyoma: BET1T2ER Check!. The British journal of radiology, 94(1125), (2021) 20201332. https://doi.org/10.1259/bjr.20201332
- D.J. Slotman, L.W. Bartels, A. Zijlstra, I.M. Verpalen, J.A. van Osch, I.M. Nijholt, E. Heijman, M. van ‘t Veer-ten Kate, E. de Boer, R.D. van den Hoed, Diffusion-weighted MRI with deep learning for visualizing treatment results of MR-guided HIFU ablation of uterine fibroids. European Radiology, 33(6), (2023) 4178-4188. https://doi.org/10.1007/s00330-022-09294-1
- M. Yang, Y. Chen, X. Zhou, R. Yu, N. Huang, J. Chen, Machine learning models for prediction of NPVR≥ 80% with HIFU ablation for uterine fibroids. International Journal of Hyperthermia, 42(1), (2025) 2473754. https://doi.org/10.1080/02656736.2025.2473754
- B. Wen, C. Li, Q. Cai, D. Shen, X. Bu, F. Zhou, Multimodal MRI radiomics-based stacking ensemble learning model with automatic segmentation for prognostic prediction of HIFU ablation of uterine fibroids: a multicenter study. Frontiers in Physiology, 15, (2024) 1507986. https://doi.org/10.3389/fphys.2024.1507986
- T. Wang, Y. Wen, Z. Wang, nnU-Net based segmentation and 3D reconstruction of uterine fibroids with MRI images for HIFU surgery planning. BMC Medical Imaging, 24(1), (2024) 233. https://doi.org/10.1186/s12880-024-01385-3
- D.J. Slotman, L.W. Bartels, I.M. Nijholt, J.A.F. Huirne, C.T.W. Moonen, M.F. Boomsma, Development and validation of a deep learning-based method for automatic measurement of uterus, fibroid, and ablated volume in MRI after MR-HIFU treatment of uterine fibroids. European Journal of Radiology, 178, (2024) 111602. https://doi.org/10.1016/j.ejrad.2024.111602
- C. Li, Z. He, F. Lv, H. Liao, Z. Xiao, Predicting the prognosis of HIFU Ablation of Uterine Fibroids using a Deep Learning-based 3D Super-Resolution DWI Radiomics Model: a multicenter study. Academic Radiology, 31(12), (2024) 4996-5007. https://doi.org/10.1016/j.acra.2024.06.027
- Y.H. Luo, I.L. Xi, R. Wang, H.O. Abdallah, J. Wu, A.Z. Vance, K. Chang, M. Kohi, L. Jones, S. Reddy, Z.S. Zhang, H.X. Bai, R.S. Goldberg, Deep Learning based on MR Imaging for Predicting Outcome of Uterine Fibroid Embolization. Journal of Vascular and Interventional Radiology, 31(6), (2020) 1010-1017. https://doi.org/10.1016/j.jvir.2019.11.032
- R. Golcha, P. Khobragade, A. Talekar, (2024) Multimodal Deep Learning for Advanced Health Monitoring a Comprehensive Approach for Enhanced Precision and Early Disease Detection. In 2024 5th International Conference on Innovative Trends in Information Technology (ICITIIT), IEEE, India. https://doi.org/10.1109/ICITIIT61487.2024.10580622
- H. Kim, M.H. Choi, Y.J. Lee, D. Han, M. Mostapha, D. Nickel, Deep learning-accelerated T2-Weighted Imaging Versus Conventional T2-Weighted Imaging in the Female Pelvic Cavity: image Quality and Diagnostic Performance. Acta Radiologica, 65(5), (2024) 499-505. https://doi.org/10.1177/02841851241228192
- K. Drukker, M. Medved, C.B. Harmath, M.L. Giger, O.S. Madueke-Laveaux, Radiomics and Quantitative Multi-Parametric MRI for Predicting Uterine Fibroid Growth. Journal of Medical Imaging, 11(5), (2024) 054501-054501. https://doi.org/10.1117/1.JMI.11.5.054501
- C. Li, J. Tan, H. Li, Y. Lei, G. Yang, C. Zhang, Y. Song, Y. Wu, G. Bi, Q. Bi, The value of multiparametric MRI-based habitat imaging for differentiating uterine sarcomas from atypical leiomyomas: a multicentre study. Abdominal Radiology, 50(2), (2025) 995-1008. https://doi.org/10.1007/s00261-024-04539-7
- H. Xi, W. Wang, Deep learning based uterine fibroid detection in ultrasound images. BMC Medical Imaging, 24(1), (2024) 218. https://doi.org/10.1186/s12880-024-01389-z
- R. Sinha, R. Raina, M. Bag, B. Rupa, Empowering gynaecologists with Artificial Intelligence: Tailoring surgical solutions for fibroids. European Journal of Obstetrics & Gynecology and Reproductive Biology, 299, (2024) 72-77. https://doi.org/10.1016/j.ejogrb.2024.06.001
- D.K. Girija, M. Varshney, Proposed Model to Detect Uterine Fibroid By using Data Mining Techniques. Journal of Positive School Psychology, 6(2), (2022) 2062–2065. https://journalppw.com/index.php/jpsp/article/view/1780/997
- J. Zhang, C. Yang, C. Gong, Y. Zhou, C. Li, F. Li. Magnetic Resonance Imaging Parameter-based Machine Learning for Prognosis Prediction of High- Intensity focused Ultrasound Ablation of uterine fibroids. International Journal of Hyperthermia, 39(1), (2022) 835–846. https://doi.org/10.1080/02656736.2022.2090622
- T. Yang, (2023). Uterine Fibroid Ultrasound Images. Mendeley Data. https://doi.org/10.17632/n2zcmcypgb.2
- İ. Öz, E.E. Yegin, A.U. Öz, E. Ulukaya, An AI-Driven Clinical Decision Support Model Based on Anemia and Fibroid Parameters to Guide Surgical Decision-Making. Medicina, 62(3), (2026) 555. https://doi.org/10.3390/medicina62030555
- J.L. Tao, Y.T. Wei, J.M. Chen, C.C. Liang, H.F. Zhang, X.N. Wang, Y. Ning, L. Cao, B. Bi, Machine Learning Models for the Prediction of Uterine Fibroids. Medicine, 104 (52), (2025) e46828. https://doi.org/10.1097/md.0000000000046828
- A. Sunder, M. Menon, H. Al Fadhel, B. Darwish, (2025). Artificial Intelligence-Powered MRI Segmentation for Uterine Fibroid Mapping: A Proof-of- Concept Study. Research Square. https://doi.org/10.21203/rs.3.rs-7605030/v1
- M. Lekshmanan Chinna, J.P. Pathrose Mary, Efficient Feature Extraction and Hybrid Deep Learning for Early Identification of Uterine Fibroids in Ultrasound Images. International Journal of Imaging Systems and Technology, 34(3), (2024) e23073. https://doi.org/10.1002/ima.23073
- M.K. Gupta, S. Pattnaik, C. Sudandiradoss. Artificial Intelligence Driven based Diagnostics with Combined Surgical and Non-Surgical management of uterine fibroids: a narrative review. Middle East Fertility Society Journal, 30(1), (2025) 64. https://doi.org/10.1186/s43043-025-00270-5
- S. Janghorbani, A. Caprio, L. Sam, B.C. Lee, M.R. Sabuncu, N.A. Lamparello, M. Schiffman, B. Mosadegh, Predicting Clinical Outcomes and Symptom Relief in Uterine Fibroid Embolization Using Machine Learning on MRI Features. AI, 6(9), (2025) 200. https://doi.org/10.3390/ai6090200
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