Wireless capsule endoscopy is a modern non-invasive Internet of Medical Imaging Things that has been increasingly used in gastrointestinal tract examination. With about one gigabyte image data generated for a patient in each examination, automatic lesion detection is highly desirable to improve the efficiency of the diagnosis process and mitigate human errors. Despite many approaches for lesion detection have been proposed, they mainly focus on large lesions and are not directly applicable to tiny lesions due to the limitations of feature representation. As bleeding lesions are a common symptom in most serious gastrointestinal diseases, detecting tiny bleeding lesions is extremely important for early diagnosis of those diseases, which is highly relevant to the survival, treatment, and expenses of patients. In this article, a method is proposed to extract and fuse multi-scale deep features for detecting and locating both large and tiny lesions. A feature extracting network is first used as our backbone network to extract the basic features from wireless capsule endoscopy images, and then at each layer multiple regions could be identified as potential lesions. As a result, the features maps of those potential lesions are obtained at each level and fused in a top-down manner to the fully connected layer for producing final detection results. Our proposed method has been evaluated on a clinical dataset that contains 20,000 wireless capsule endoscopy images with clinical annotation. Experimental results demonstrate that our method can achieve 98.9% prediction accuracy and 93.5%
score, which has a significant performance improvement of up to 31.69% and 22.12% in terms of recall rate and
score, respectively, when compared to the state-of-the-art approaches for both large and tiny bleeding lesions. Moreover, our model also has the highest AP and the best medical diagnosis performance compared to state-of-the-art multi-scale models.