Automatic Meniscus Segmentation Using YOLO-Based Deep Learning Models with Ensemble Methods in Knee MRI Images

The meniscus is a C-shaped connective tissue with a cartilage-like structure in the knee joint. This study proposes an innovative method based on You Only Look Once (YOLO) series models and ensemble methods for meniscus segmentation from knee magnetic resonance imaging (MRI) images to improve segmentation performance and evaluate generalization capability. In this study, five different segmentation models were trained, and masks were created from the YOLO series. These masks are combined with pixel-based voting, weighted multiple voting, and dynamic weighted multiple voting optimized by grid search. Tests were conducted on internal and external sets and various metrics. The dynamic weighted multiple voting method optimized with grid search performed the best on both the test set (DSC: 0.8976 ± 0.0071, PPV: 0.8561 ± 0.0121, Sensitivity: 0.9467 ± 0.0077) and the external set (DSC: 0.9004 ± 0.0064, PPV: 0.8876 ± 0.0134, Sensitivity: 0.9200 ± 0.0119). The proposed ensemble methods offer high accuracy, reliability, and generalization capability for meniscus segmentation.