CRMEFNet: A coupled refinement, multiscale exploration and fusion network for medical image segmentation

Accurate segmentation of target areas in medical images, such as lesions, is essential for disease diagnosis and clinical analysis. In recent years, deep learning methods have been intensively researched and have generated significant progress in medical image segmentation tasks. However, most of the existing methods have limitations in modeling multilevel feature representations and identification of complex textured pixels at contrasting boundaries. This paper proposes a novel coupled refinement and multiscale exploration and fusion network (CRMEFNet) for medical image segmentation, which explores in the optimization and fusion of multiscale features to address the abovementioned limitations. The CRMEFNet consists of three main innovations: a coupled refinement module (CRM), a multiscale exploration and fusion module (MEFM), and a cascaded progressive decoder (CPD). The CRM decouples features into low-frequency body features and high-frequency edge features, and performs targeted optimization of both to enhance intraclass uniformity and interclass differentiation of features. The MEFM performs a two-stage exploration and fusion of multiscale features using our proposed multiscale aggregation attention mechanism, which explores the differentiated information within the cross-level features, and enhances the contextual connections between the features, to achieves adaptive feature fusion. Compared to existing complex decoders, the CPD decoder (consisting of the CRM and MEFM) can perform fine-grained pixel recognition while retaining complete semantic location information. It also has a simple design and excellent performance. The experimental results from five medical image segmentation tasks, ten datasets and twelve comparison models demonstrate the state-of-the-art performance, interpretability, flexibility and versatility of our CRMEFNet.