YOLO-SMD: A Symmetrical Multi-Scale Feature Modulation Framework for Pediatric Pneumonia Detection

Pediatric pneumonia detection faces the challenge of pathological asymmetry, where immature lung tissues present blurred boundaries and lesions exhibit extreme scale variations (e.g., small viral nodules vs. large bacterial consolidations). Conventional detectors often fail to address these imbalances. In this study, we propose YOLO-SMD, a detection framework built upon a symmetrical design philosophy to enforce balanced feature representation. We introduce three architectural innovations: (1) DySample (Content-Aware Upsampling): To address the blurred boundaries of pediatric lesions, this module replaces static interpolation with dynamic point sampling, effectively sharpening edge details that are typically smoothed out by standard upsamplers; (2) SAC2f (Cross-Dimensional Attention): To counteract background interference, this module enforces a symmetrical interaction between spatial and channel dimensions, allowing the model to suppress structural noise (e.g., rib overlaps) in low-contrast X-rays; (3) SDFM (Adaptive Gated Fusion): To resolve the extreme scale disparity, this unit employs a gated mechanism that symmetrically balances deep semantic features (crucial for large bacterial shapes) and shallow textural features (crucial for viral textures). Extensive experiments on a curated subset of 2611 images derived from the Chest X-ray Pneumonia Dataset demonstrate that YOLO-SMD achieves competitive performance with a focus on high sensitivity, attaining a Recall of 86.1% and an mAP@0.5 of 84.3%, thereby outperforming the state-of-the-art YOLOv12n by 2.4% in Recall under identical experimental conditions. The results validate that incorporating symmetry principles into feature modulation significantly enhances detection robustness in primary healthcare settings.