# Artefact-Aware Fungal Detection in Dermatophytosis: A Real-Time Transformer-Based Approach for KOH Microscopy

arXiv: https://arxiv.org/abs/2602.19156 · HTML: https://mlsanity.com/paper/2602.19156/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 8 of its 31 references that are in the map.
- First posted on arXiv 22 Feb 2026.

## Builds on (most cited first, 8 of 8)

- [A Survey on Deep Learning in Medical Image Analysis](https://mlsanity.com/paper/1702.05747/) (2017)
- [DETRs Beat YOLOs on Real-time Object Detection](https://mlsanity.com/paper/2304.08069/) (2023)
- [CheXNet: Radiologist-Level Pneumonia Detection on Chest X-Rays with Deep Learning](https://mlsanity.com/paper/1711.05225/) (2017)
- [A Survey on Explainable Artificial Intelligence (XAI): Towards Medical XAI](https://mlsanity.com/paper/1907.07374/) (2019)
- [Deep Learning for Medical Image Analysis](https://mlsanity.com/paper/1708.08987/) (2017)
- [HoVer-Net: Simultaneous Segmentation and Classification of Nuclei in Multi-Tissue Histology Images](https://mlsanity.com/paper/1812.06499/) (2018)
- [DeepCervix: A Deep Learning-based Framework for the Classification of Cervical Cells Using Hybrid Deep Feature Fusion Techniques](https://mlsanity.com/paper/2102.12191/) (2021)
- [Deep Convolutional Neural Networks for Onychomycosis Detection](https://mlsanity.com/paper/2106.16139/) (2021)

## Abstract (arXiv)

Dermatophytosis is commonly assessed using potassium hydroxide (KOH) microscopy, yet accurate recognition of fungal hyphae is hindered by artefacts, heterogeneous keratin clearance, and notable inter-observer variability. This study presents a transformer-based detection framework using the RT-DETR model architecture to achieve precise, query-driven localization of fungal structures in high-resolution KOH images. A dataset of 2,540 routinely acquired microscopy images was manually annotated using a multi-class strategy to explicitly distinguish fungal elements from confounding artefacts. The model was trained with morphology-preserving augmentations to maintain the structural integrity of thin hyphae. Evaluation on an independent test set demonstrated robust object-level performance, with a recall of 0.9737, precision of 0.8043, and an AP@0.50 of 93.56%. When aggregated for image-level diagnosis, the model achieved 100% sensitivity and 98.8% accuracy, correctly identifying all positive cases without missing a single diagnosis. Qualitative outputs confirmed the robust localization of low-contrast hyphae even in artefact-rich fields. These results highlight that an artificial intelligence (AI) system can serve as a highly reliable, automated screening tool, effectively bridging the gap between image-level analysis and clinical decision-making in dermatomycology.