Clustering-Based Dual Deep Learning Architecture for Detecting Red Blood Cells in Malaria Diagnostic Smears

Computer-assisted algorithms have become a mainstay of biomedical applications to improve accuracy and reproducibility of repetitive tasks like manual segmentation and annotation. We propose a novel pipeline for red blood cell detection and counting in thin blood smear microscopy images, named RBCNet, using a dual deep learning architecture. RBCNet consists of a U-Net first stage for cell-cluster or superpixel segmentation, followed by a second refinement stage Faster R-CNN for detecting small cell objects within the connected component clusters. RBCNet uses cell clustering instead of region proposals, which is robust to cell fragmentation, is highly scalable for detecting small objects or fine scale morphological structures in very large images, can be trained using non-overlapping tiles, and during inference is adaptive to the scale of cell-clusters with a low memory footprint. We tested our method on an archived collection of human malaria smears with nearly 200,000 labeled cells across 965 images from 193 patients, acquired in Bangladesh, with each patient contributing five images. Cell detection accuracy using RBCNet was higher than 97 [Formula: see text]. The novel dual cascade RBCNet architecture provides more accurate cell detections because the foreground cell-cluster masks from U-Net adaptively guide the detection stage, resulting in a notably higher true positive and lower false alarm rates, compared to traditional and other deep learning methods. The RBCNet pipeline implements a crucial step towards automated malaria diagnosis.