Due to the influence of the irregular shapes and the adjacent positions of the wrist reference bones, it is difficult for the expert to accurately estimate the mature indication of the wrist reference bones of the minor. How to precisely segment the reference bones of the minor is a challenge. For this problem, the ARU-Net for wrist reference bone segmentation is proposed. First, we extract the reference bone ROI by Faster R-CNN. Then, the pre-processed ROI is fed into ARU-Net for segmentation. On the basis of traditional U-Net, ARU-Net adds residual mapping and attention mechanism, which improves the utilization rate of features and the accuracy of reference bone segmentation. Finally, a post-processing method including the flood fill algorithm and the morphological operation is used to eliminate jagged edges and holes in the segmented result. The hamate is one of the most difficult reference bones to segment in the wrist. This paper takes it as an example to assess the performance of ARU-Net. Experiments show that compared with FCN, U-Net and ResUnet, the accuracy and F1 scores of ARU-Net are higher. The accuracy rate is 96.4%, and the F1 score is 0.953. The post-processing method can further improve the result. Finally, the accuracy rate reaches 96.5%, and the F1 score reaches 0.954. In order to verify the segmentation stability of ARU-Net, it is also applied to the segmentation of the radius and the capitate. RU-Net can precisely segment the reference bone, which facilitates the expert to assess its mature indication, so as to accurately evaluate the bone age. INDEX TERMS ARU-Net, wrist reference bone segmentation, attention module, residual mapping. The associate editor coordinating the review of this manuscript and approving it for publication was Zhen Qin.

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