Muhammad S. Hussain ^1* Umer Asgher ² Arslan Shaukat ³ Jinhui Wang ⁴ Vladimír Socha ⁵ Tian Feng ⁶ Sajid Nisar ⁷ Rehan Z. Paracha ³ Muhammad Ali Khan ³

• ¹ Sir Syed CASE Institute of Technology, Islamabad, Pakistan
• ² National University of Sciences and Technology (NUST), Islamabad, Islamabad, Pakistan
• ³ NUST Business School, National University of Sciences and Technology, Islamabad, Islamabad, Pakistan
• ⁴ South China Normal University, Guangzhou, Guangdong, China
• ⁵ Czech Technical University in Prague, Prague 6, Prague, Czechia
• ⁶ Zhengzhou University, Zhengzhou, Henan Province, China
• ⁷ Faculty of Science, Kyoto University, Kyoto, Kyōto, Japan

Colonoscopy is a reliable diagnostic method to detect colorectal polyps early on and prevent colorectal cancer. The current examination techniques face a significant challenge of high missed rates, resulting in numerous undetected polyps and irregularities. Automated and realtime segmentation methods can help endoscopists to segment the shape and location of polyps from colonoscopy images in order to facilitate clinician's timely diagnosis and interventions.Different parameters like shapes, small sizes of polyps, and their close resemblance to surrounding tissues make this task challenging. Furthermore, high-definition image quality and reliance on the operator make real-time and accurate endoscopic image segmentation more challenging. Deep learning models utilized for segmenting polyps, designed to capture diverse patterns, are becoming progressively complex. This complexity poses challenges for real-time medical operations. In clinical settings, utilizing automated methods requires the development of accurate, lightweight models with minimal latency, ensuring seamless integration with endoscopic hardware devices. To address these challenges, in this study a novel lightweight and more generalized Enhanced Nanonet model, an improved version of Nanonet using NanonetB for real-time and precise colonoscopy image segmentation, is proposed. The proposed model enhances the performance of Nanonet using Nanonet B on the overall prediction scheme by applying data augmentation, Conditional Random Field (CRF), and Test Time Augmentation (TTA). Six publicly available datasets are utilized to perform thorough evaluations, assess generalizability, and validate the improvements: Kvasir-SEG, Endotect Challenge 2020, Kvasir-instrument, CVC-ClinicDB, CVC-ColonDB, and CVC-300. Through extensive experimentation, using the Kvasir-SEG dataset, our model achieves a mIoU score of 0.8188 and a Dice coefficient of 0.8060 with only 132,049 parameters and employing minimal computational resources. A thorough cross-dataset evaluation was performed to assess the generalization capability of the proposed Enhanced Nanonet model across various publicly available polyp datasets for potential real-world applications. The result of this study shows that using CRF (Conditional Random Fields) and TTA (Test Time Augmentation) enhances performance within the same dataset and also across diverse datasets with a model size of just 1,32,049 parameters. Also, the proposed method indicates improved results in detecting smaller and sessile polyps (flats) that are significant contributors to the high miss rates.