Accurate segmentation of the optic disc (OD) and cup (OC)in fundus images from different datasets is critical for glaucoma disease screening. The cross-domain discrepancy (domain shift) hinders the generalization of deep neural networks to work on different domain datasets.In this work, we present an unsupervised domain adaptation framework,called Boundary and Entropy-driven Adversarial Learning (BEAL), to improve the OD and OC segmentation performance, especially on the ambiguous boundary regions. In particular, our proposed BEAL frame-work utilizes the adversarial learning to encourage the boundary prediction and mask probability entropy map (uncertainty map) of the target domain to be similar to the source ones, generating more accurate boundaries and suppressing the high uncertainty predictions of OD and OC segmentation. We evaluate the proposed BEAL framework on two public retinal fundus image datasets (Drishti-GS and RIM-ONE-r3), and the experiment results demonstrate that our method outperforms the state-of-the-art unsupervised domain adaptation methods. Codes will be available at https://github.com/EmmaW8/BEAL.
Deep learning-based segmentation methods have been widely employed for automatic glaucoma diagnosis and prognosis. In practice, fundus images obtained by different fundus cameras vary significantly in terms of illumination and intensity. Although recent unsupervised domain adaptation (UDA) methods enhance the models' generalization ability on the unlabeled target fundus datasets, they always require sufficient labeled data from the source domain, bringing auxiliary data acquisition and annotation costs. To further facilitate the data efficiency of the cross-domain segmentation methods on the f…
Adaptive Feature Fusion Neural Network for Glaucoma Segmentation on Unseen Fundus Images
International Medical College（国际医学院）；Chongqing Medical University（重庆医科大学）；The First Affiliated Hospital of Chongqing Medical University（重庆医科大学第一附属医院）；Centre for Frontier AI Research (CFAR)（前沿人工智能研究中心）；Agency for Science Technology and Research (A*STAR)（新加坡科技研究局）
Beijing Normal University（北京师范大学）；Hong Kong Baptist University（香港浸会大学）；Henan University（河南大学）
Convex Shapes (CS) are common priors for optic disc and cup segmentation in eye fundus images. It is important to design proper techniques to represent convex shapes. So far, it is still a problem to guarantee that the output objects from a Deep Neural Convolution Networks (DCNN) are convex shapes. In this work, we propose a technique which can be easily integrated into the commonly used DCNNs for image segmentation and guarantee that outputs are convex shapes. This method is flexible and it can handle multiple objects and allow some of the objects to be convex. Our method is based on the dual…
Indian Institute of Technology Kharagpur（印度理工学院卡拉格普尔分校）
Diabetic retinopathy (DR) is the most common form of diabetic eye disease. Retinopathy can affect all diabetic patients and becomes particularly dangerous, increasing the risk of blindness, if it is left untreated. The success rate of its curability solemnly depends on diagnosis at an early stage. The development of automated computer aided disease diagnosis tools could help in faster detection of symptoms with a wider reach and reasonable cost. This paper proposes a method for the automated segmentation of retinal lesions and optic disk in fundus images using a deep fully convolutional neural…
The Chinese University of Hong Kong（香港中文大学）；Stanford University（斯坦福大学）；Shenzhen University（深圳大学）；Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences（中国科学院深圳先进技术研究院）
Deep convolutional neural networks have significantly boosted the performance of fundus image segmentation when test datasets have the same distribution as the training datasets. However, in clinical practice, medical images often exhibit variations in appearance for various reasons, e.g., different scanner vendors and image quality. These distribution discrepancies could lead the deep networks to over-fit on the training datasets and lack generalization ability on the unseen test datasets. To alleviate this issue, we present a novel Domain-oriented Feature Embedding (DoFE) framework to improv…
Robust Source-Free Domain Adaptation for Fundus Image Segmentation
Institute of Automation, Chinese Academy of Sciences（中国科学院自动化研究所）；School of Artifical Intelligence, University of Chinese Academy of Sciences（中国科学院大学人工智能学院）
Existing unsupervised domain adaptation methods based on adversarial learning have achieved good performance in several medical imaging tasks. However, these methods focus only on global distribution adaptation and ignore distribution constraints at the category level, which would lead to sub-optimal adaptation performance. This paper presents an unsupervised domain adaptation framework based on category-level regularization that regularizes the category distribution from three perspectives. Specifically, for inter-domain category regularization, an adaptive prototype alignment module is propo…
Decoupling Wavelet Sub-bands for Single Source Domain Generalization in Fundus Image Segmentation
Indian Statistical Institute（印度统计研究所）；University of Oxford（牛津大学）；Radcliffe Department of Medicine, University of Oxford（牛津大学拉德克利夫医学系）；Department of Engineering Science, University of Oxford（牛津大学工程科学系）
Universidad de Sevilla（塞维利亚大学）；Universidad de Cádiz（加的斯大学）；School of Engineering, Universidad de Cádiz（加的斯大学工程学院）
Medical image segmentation can be implemented using Deep Learning methods with fast and efficient segmentation networks. Single-board computers (SBCs) are difficult to use to train deep networks due to their memory and processing limitations. Specific hardware such as Google's Edge TPU makes them suitable for real time predictions using complex pre-trained networks. In this work, we study the performance of two SBCs, with and without hardware acceleration for fundus image segmentation, though the conclusions of this study can be applied to the segmentation by deep neural networks of other type…
Domain adaptation typically requires to access source domain data to utilize their distribution information for domain alignment with the target data. However, in many real-world scenarios, the source data may not be accessible during the model adaptation in the target domain due to privacy issue. This paper studies the practical yet challenging source-free unsupervised domain adaptation problem, in which only an existing source model and the unlabeled target data are available for model adaptation. We present a novel denoised pseudo-labeling method for this problem, which effectively makes us…
Centro de Investigación CITIC（CITIC研究中心）；Universidade da Coruña（拉科鲁尼亚大学）；Instituto de Investigación Biomédica de A Coruña (INIBIC)（拉科鲁尼亚生物医学研究所（INIBIC））
The study of the retinal vasculature is a fundamental stage in the screening and diagnosis of many diseases. A complete retinal vascular analysis requires to segment and classify the blood vessels of the retina into arteries and veins (A/V). Early automatic methods approached these segmentation and classification tasks in two sequential stages. However, currently, these tasks are approached as a joint semantic segmentation task, as the classification results highly depend on the effectiveness of the vessel segmentation. In that regard, we propose a novel approach for the simultaneous segmentat…
Faculty of Informatics, Kaunas University of Technology（信息学院，卡斯图技术大学）
Age-related macular degeneration (AMD) is one of the leading causes of irreversible vision impairment in people over the age of 60. This research focuses on semantic segmentation for AMD lesion detection in RGB fundus images, a non-invasive and cost-effective imaging technique. The results of the ADAM challenge - the most comprehensive AMD detection from RGB fundus images research competition and open dataset to date - serve as a benchmark for our evaluation. Taking the U-Net connectivity as a base of our framework, we evaluate and compare several approaches to improve the segmentation model's…
ODFormer: Semantic Fundus Image Segmentation Using Transformer for Optic Nerve Head Detection
College of Electronics & Information Engineering, Tongji University（同济大学电子与信息工程学院）；Shanghai Institute of Intelligent Science and Technology, Tongji University（同济大学上海智能科学与技术研究院）；School of Life Science, Shanghai University（上海大学生命科学学院）；Tongji Hospital, School of Medicine, Tongji University（同济大学医学院附属同济医院）
MAF-Net: Multiple attention-guided fusion network for fundus vascular image segmentation
School of Electrical and Automation Engineering, East China Jiaotong University（华东交通大学电气与自动化工程学院）；School of Computer Science, Northwestern Polytechnical University（西北工业大学计算机学院）
The cup-to-disc ratio (CDR) is one of the most significant indicator for glaucoma diagnosis. Different from the use of costly fully supervised learning formulation with pixel-wise annotations in the literature, this study investigates the feasibility of accurate CDR measurement in fundus images using only tight bounding box supervision. For this purpose, we develop a two-task network named as CDRNet for accurate CDR measurement, one for weakly supervised image segmentation, and the other for bounding-box regression. The weakly supervised image segmentation task is implemented based on generali…
Facebook AI Research（Facebook 人工智能研究院）；INRIA（法国国家信息与自动化研究所）；Laboratoire Jean Kuntzmann（让·昆兹曼实验室）
Adversarial training has been shown to produce state of the art results for generative image modeling. In this paper we propose an adversarial training approach to train semantic segmentation models. We train a convolutional semantic segmentation network along with an adversarial network that discriminates segmentation maps coming either from the ground truth or from the segmentation network. The motivation for our approach is that it can detect and correct higher-order inconsistencies between ground truth segmentation maps and the ones produced by the segmentation net. Our experiments show th…
Athinoula A. Martinos Center for Biomedical Imaging（阿西诺拉·A·马丁诺斯生物医学成像中心）；Casey Eye Institute, Oregon Health and Science University（俄勒冈健康与科学大学凯西眼科研究所）；Oregon Health and Science University（俄勒冈健康与科学大学）；Northeastern University（东北大学）
In this paper, we propose a new pre-training scheme for U-net based image segmentation. We first train the encoding arm as a localization network to predict the center of the target, before extending it into a U-net architecture for segmentation. We apply our proposed method to the problem of segmenting the optic disc from fundus photographs. Our work shows that the features learned by encoding arm can be transferred to the segmentation network to reduce the annotation burden. We propose that an approach could have broad utility for medical image segmentation, and alleviate the burden of delin…
The Chinese University of Hong Kong（香港中文大学）；University of Oxford（牛津大学）；The University of Hong Kong（香港大学）；SmartMore（思谋科技）
Adversarial training is promising for improving robustness of deep neural networks towards adversarial perturbations, especially on the classification task. The effect of this type of training on semantic segmentation, contrarily, just commences. We make the initial attempt to explore the defense strategy on semantic segmentation by formulating a general adversarial training procedure that can perform decently on both adversarial and clean samples. We propose a dynamic divide-and-conquer adversarial training (DDC-AT) strategy to enhance the defense effect, by setting additional branches in the…
Semantic segmentation is one of the basic topics in computer vision, it aims to assign semantic labels to every pixel of an image. Unbalanced semantic label distribution could have a negative influence on segmentation accuracy. In this paper, we investigate using data augmentation approach to balance the semantic label distribution in order to improve segmentation performance. We propose using generative adversarial networks (GANs) to generate realistic images for improving the performance of semantic segmentation networks. Experimental results show that the proposed method can not only improv…
Recently, ultra-widefield (UWF) 200\degree~fundus imaging by Optos cameras has gradually been introduced because of its broader insights for detecting more information on the fundus than regular 30 degree - 60 degree fundus cameras. Compared with UWF fundus images, regular fundus images contain a large amount of high-quality and well-annotated data. Due to the domain gap, models trained by regular fundus images to recognize UWF fundus images perform poorly. Hence, given that annotating medical data is labor intensive and time consuming, in this paper, we explore how to leverage regular fundus …
The Johns Hopkins University（约翰斯·霍普金斯大学）；UCLA（加州大学洛杉矶分校）；Baidu Research USA（百度研究院美国分部）
It has been well demonstrated that adversarial examples, i.e., natural images with visually imperceptible perturbations added, generally exist for deep networks to fail on image classification. In this paper, we extend adversarial examples to semantic segmentation and object detection which are much more difficult. Our observation is that both segmentation and detection are based on classifying multiple targets on an image (e.g., the basic target is a pixel or a receptive field in segmentation, and an object proposal in detection), which inspires us to optimize a loss function over a set of pi…
Detecting diabetic retinopathy severity through fundus images using an ensemble of classifiers
Technical University of Cluj-Napoca（克卢日-纳波卡技术大学）；“Iuliu Hatieganu” University of Medicine and Pharmacy（“尤利乌·哈采加努”医药大学）；Emergency County Hospital（急诊县医院）
In this manuscript, we present a robust method for glaucoma screening from fundus images using an ensemble of convolutional neural networks (CNNs). The pipeline comprises of first segmenting the optic disk and optic cup from the fundus image, then extracting a patch centered around the optic disk and subsequently feeding to the classification network to differentiate the image as diseased or healthy. In the segmentation network, apart from the image, we make use of spatial co-ordinate (X \& Y) space so as to learn the structure of interest better. The classification network is composed of a De…
Shantou University（汕头大学）；South China University of Technology（华南理工大学）；Nanjing University of Aeronautics and Astronautics（南京航空航天大学）；Soochow University（苏州大学）
In this paper, a hierarchical image matting model is proposed to extract blood vessels from fundus images. More specifically, a hierarchical strategy utilizing the continuity and extendibility of retinal blood vessels is integrated into the image matting model for blood vessel segmentation. Normally the matting models require the user specified trimap, which separates the input image into three regions manually: the foreground, background and unknown regions. However, since creating a user specified trimap is a tedious and time-consuming task, region features of blood vessels are used to gener…
This work explores a hybrid approach to segmentation as an alternative to a purely data-driven approach. We introduce an end-to-end U-Net based network called DU-Net, which uses additional frequency preserving features, namely the Scattering Coefficients (SC), for medical image segmentation. SC are translation invariant and Lipschitz continuous to deformations which help DU-Net outperform other conventional CNN counterparts on four datasets and two segmentation tasks: Optic Disc and Optic Cup in color fundus images and fetal Head in ultrasound images. The proposed method shows remarkable impro…
The visual analysis of retina and of its vascular characteristics is important in the diagnosis and monitoring of diseases of visual perception. In the related medical diagnoses, the digital processing of the fundus images is used to obtain the segmentation of retinal vessels. However, an image segmentation is often requiring methods based on peculiar or complex algorithms: in this paper we will show some alternative approaches obtained by applying freely available tools to enhance, without a specific segmentation, the images of the fundus of the eye. We will see in particular, that combining …
Shell Global Solutions International B.V.（壳牌全球解决方案国际有限公司）
Semantic segmentation is one of the most fundamental problems in computer vision with significant impact on a wide variety of applications. Adversarial learning is shown to be an effective approach for improving semantic segmentation quality by enforcing higher-level pixel correlations and structural information. However, state-of-the-art semantic segmentation models cannot be easily plugged into an adversarial setting because they are not designed to accommodate convergence and stability issues in adversarial networks. We bridge this gap by building a conditional adversarial network with a st…
University of Munich（慕尼黑大学）；University of Oxford（牛津大学）
Deep neural network-based image classification can be misled by adversarial examples with small and quasi-imperceptible perturbations. Furthermore, the adversarial examples created on one classification model can also fool another different model. The transferability of the adversarial examples has recently attracted a growing interest since it makes black-box attacks on classification models feasible. As an extension of classification, semantic segmentation has also received much attention towards its adversarial robustness. However, the transferability of adversarial examples on segmentation…
Renmin University of China（中国人民大学）；Visionary Intelligence Ltd.（远景智能有限公司）
Glaucoma is a severe blinding disease, for which automatic detection methods are urgently needed to alleviate the scarcity of ophthalmologists. Many works have proposed to employ deep learning methods that involve the segmentation of optic disc and cup for glaucoma detection, in which the segmentation process is often considered merely as an upstream sub-task. The relationship between fundus images and segmentation masks in terms of joint decision-making in glaucoma assessment is rarely explored. We propose a novel segmentation-based information extraction and amalgamation method for the task …
Airdoc LLC（爱丁堡医疗科技有限公司）；Monash University（莫纳什大学）；Nanjing University of Posts and Telecommunications（南京邮电大学）
For decades, advances in retinal imaging technology have enabled effective diagnosis and management of retinal disease using fundus cameras. Recently, ultra-wide-field (UWF) fundus imaging by Optos camera is gradually put into use because of its broader insights on fundus for some lesions that are not typically seen in traditional fundus images. Research on traditional fundus images is an active topic but studies on UWF fundus images are few. One of the most important reasons is that UWF fundus images are hard to obtain. In this paper, for the first time, we explore domain adaptation from the …
Indian Institute of Technology Kharagpur（印度理工学院卡拉格普尔分校）
Automated segmentation of retinal blood vessels in label-free fundus images entails a pivotal role in computed aided diagnosis of ophthalmic pathologies, viz., diabetic retinopathy, hypertensive disorders and cardiovascular diseases. The challenge remains active in medical image analysis research due to varied distribution of blood vessels, which manifest variations in their dimensions of physical appearance against a noisy background. In this paper we formulate the segmentation challenge as a classification task. Specifically, we employ unsupervised hierarchical feature learning using ensembl…
University of Science and Technology of China（中国科学技术大学）；Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences（中国科学院苏州生物医学工程技术研究所）；Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences（中国科学院脑科学与智能技术卓越创新中心）；the Third People’s Hospital of Changzhou（常州市第三人民医院）
Fluorescein angiography can provide a map of retinal vascular structure and function, which is commonly used in ophthalmology diagnosis, however, this imaging modality may pose risks of harm to the patients. To help physicians reduce the potential risks of diagnosis, an image translation method is adopted. In this work, we proposed a conditional generative adversarial network(GAN) - based method to directly learn the mapping relationship between structure fundus images and fundus fluorescence angiography images. Moreover, local saliency maps, which define each pixel's importance, are used to d…
The Chinese University of Hong Kong (Shenzhen)（香港中文大学（深圳））；Shenzhen Research Institute of Big Data（深圳大数据研究院）；University of Science and Technology of China（中国科学技术大学）
Diabetic retinopathy is the most important complication of diabetes. Early diagnosis of retinal lesions helps to avoid visual loss or blindness. Due to high-resolution and small-size lesion regions, applying existing methods, such as U-Nets, to perform segmentation on fundus photography is very challenging. Although downsampling the input images could simplify the problem, it loses detailed information. Conducting patch-level analysis helps reaching fine-scale segmentation yet usually leads to misunderstanding as the lack of context information. In this paper, we propose an efficient network t…
Objective Automatic artery/vein (A/V) segmentation from fundus images is required to track blood vessel changes occurring with many pathologies including retinopathy and cardiovascular pathologies. One of the clinical measures that quantifies vessel changes is the arterio-venous ratio (AVR) which represents the ratio between artery and vein diameters. This measure significantly depends on the accuracy of vessel segmentation and classification into arteries and veins. This paper proposes a fast, novel method for semantic A/V segmentation combining deep learning and graph propagation. Methods A …
Even though deep neural networks succeed on many different tasks including semantic segmentation, they lack on robustness against adversarial examples. To counteract this exploit, often adversarial training is used. However, it is known that adversarial training with weak adversarial attacks (e.g. using the Fast Gradient Method) does not improve the robustness against stronger attacks. Recent research shows that it is possible to increase the robustness of such single-step methods by choosing an appropriate step size during the training. Finding such a step size, without increasing the computa…
Image normalization is a critical step in medical imaging. This step is often done on a per-dataset basis, preventing current segmentation algorithms from the full potential of exploiting jointly normalized information across multiple datasets. To solve this problem, we propose an adversarial normalization approach for image segmentation which learns common normalizing functions across multiple datasets while retaining image realism. The adversarial training provides an optimal normalizer that improves both the segmentation accuracy and the discrimination of unrealistic normalizing functions. …
University of Nevada, Reno（内华达大学雷诺分校）；Deakin University（迪肯大学）；Houston Eye Associates（休斯顿眼科协会）
Fluorescein Angiography (FA) is a technique that employs the designated camera for Fundus photography incorporating excitation and barrier filters. FA also requires fluorescein dye that is injected intravenously, which might cause adverse effects ranging from nausea, vomiting to even fatal anaphylaxis. Currently, no other fast and non-invasive technique exists that can generate FA without coupling with Fundus photography. To eradicate the need for an invasive FA extraction procedure, we introduce an Attention-based Generative network that can synthesize Fluorescein Angiography from Fundus imag…
Shenzhen International Graduate School, Tsinghua University（清华大学深圳国际研究生院）；Shenzhen Eye Hospital affiliated to Jinan University（暨南大学附属深圳眼科医院）
Ophthalmologists have used fundus images to screen and diagnose eye diseases. However, different equipments and ophthalmologists pose large variations to the quality of fundus images. Low-quality (LQ) degraded fundus images easily lead to uncertainty in clinical screening and generally increase the risk of misdiagnosis. Thus, real fundus image restoration is worth studying. Unfortunately, real clinical benchmark has not been explored for this task so far. In this paper, we investigate the real clinical fundus image restoration problem. Firstly, We establish a clinical dataset, Real Fundus (RF)…
Indian Institute of Science（印度科学学院）；University of Southern California（南加州大学）
Optic disc (OD) and optic cup (OC) are regions of prominent clinical interest in a retinal fundus image. They are the primary indicators of a glaucomatous condition. With the advent and success of deep learning for healthcare research, several approaches have been proposed for the segmentation of important features in retinal fundus images. We propose a novel approach for the simultaneous segmentation of the OD and OC using a residual encoder-decoder network (REDNet) based regional convolutional neural network (RCNN). The RED-RCNN is motivated by the Mask RCNN (MRCNN). Performance comparisons …
University of Central Florida（中佛罗里达大学）；Mayo Clinic Cancer Center（妙佑医疗国际癌症中心）
Adversarial learning has been proven to be effective for capturing long-range and high-level label consistencies in semantic segmentation. Unique to medical imaging, capturing 3D semantics in an effective yet computationally efficient way remains an open problem. In this study, we address this computational burden by proposing a novel projective adversarial network, called PAN, which incorporates high-level 3D information through 2D projections. Furthermore, we introduce an attention module into our framework that helps for a selective integration of global information directly from our segmen…
University of Michigan（密歇根大学）；Simon Fraser University（西蒙弗雷泽大学）；UIUC（伊利诺伊大学厄巴纳-香槟分校）；UC Berkeley（加州大学伯克利分校）
Deep Neural Networks (DNNs) have been widely applied in various recognition tasks. However, recently DNNs have been shown to be vulnerable against adversarial examples, which can mislead DNNs to make arbitrary incorrect predictions. While adversarial examples are well studied in classification tasks, other learning problems may have different properties. For instance, semantic segmentation requires additional components such as dilated convolutions and multiscale processing. In this paper, we aim to characterize adversarial examples based on spatial context information in semantic segmentation…
Universitat Rovira i Virgili（罗维拉-威尔吉利大学）；Bioinformatics Institute（生物信息学研究所）
In this paper, an optic disc and cup segmentation method is proposed using U-Net followed by a multi-scale feature matching network. The proposed method targets task 2 of the REFUGE challenge 2018. In order to solve the segmentation problem of task 2, we firstly crop the input image using single shot multibox detector (SSD). The cropped image is then passed to an encoder-decoder network with skip connections also known as generator. Afterwards, both the ground truth and generated images are fed to a convolution neural network (CNN) to extract their multi-level features. A dice loss function is…
The Chinese University of Hong Kong（香港中文大学）；Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences（中国科学院深圳先进技术研究院）
Glaucoma is a leading cause of irreversible blindness. Accurate segmentation of the optic disc (OD) and cup (OC) from fundus images is beneficial to glaucoma screening and diagnosis. Recently, convolutional neural networks demonstrate promising progress in joint OD and OC segmentation. However, affected by the domain shift among different datasets, deep networks are severely hindered in generalizing across different scanners and institutions. In this paper, we present a novel patchbased Output Space Adversarial Learning framework (pOSAL) to jointly and robustly segment the OD and OC from diffe…
We develop and approach to unsupervised semantic medical image segmentation that extends previous work with generative adversarial networks. We use existing edge detection methods to construct simple edge diagrams, train a generative model to convert them into synthetic medical images, and construct a dataset of synthetic images with known segmentations using variations on extracted edge diagrams. This synthetic dataset is then used to train a supervised image segmentation model. We test our approach on a clinical dataset of kidney ultrasound images and the benchmark ISIC 2018 skin lesion data…
Ghent University（根特大学）；Ghent University Global Campus（根特大学全球校区）
Deep learning models, which are increasingly being used in the field of medical image analysis, come with a major security risk, namely, their vulnerability to adversarial examples. Adversarial examples are carefully crafted samples that force machine learning models to make mistakes during testing time. These malicious samples have been shown to be highly effective in misguiding classification tasks. However, research on the influence of adversarial examples on segmentation is significantly lacking. Given that a large portion of medical imaging problems are effectively segmentation problems, …
