Glaucoma is a severe eye disease that is known to deteriorate optic never fibers, causing cup size to increase, which could result in permanent loss of vision. Glaucoma is the second leading cause of blindness after cataract, but glaucoma being more dangerous as it is not curable. Early diagnoses and treatment of glaucoma can help to slow the progression of glaucoma and its damages. For the detection of glaucoma, the Cup to Disc ratio (CDR) provides significant information. The CDR depends heavily on the accurate segmentation of cup and disc regions. In this paper, we have proposed a modified M-Net with bidirectional convolution long short-term memory (LSTM), based on joint cup and disc segmentation. The proposed network combines features of encoder and decoder, with bidirectional LSTM. Our proposed model segments cup and disc regions based on which the abnormalities in cup to disc ratio can be observed. The proposed model is tested on REFUGE2 data, where our model achieves a dice score of 0.92 for optic disc and an accuracy of 98.99% in segmenting cup and disc regions
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 …
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…
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…
Inception Institute of Artificial Intelligence（人工智能起源研究所）
Retinal fundus images are widely used for the clinical screening and diagnosis of eye diseases. However, fundus images captured by operators with various levels of experience have a large variation in quality. Low-quality fundus images increase uncertainty in clinical observation and lead to the risk of misdiagnosis. However, due to the special optical beam of fundus imaging and structure of the retina, natural image enhancement methods cannot be utilized directly to address this. In this paper, we first analyze the ophthalmoscope imaging system and simulate a reliable degradation of major inf…
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 …
Automated optic disc (OD) and optic cup (OC) segmentation in fundus images is relevant to efficiently measure the vertical cup-to-disc ratio (vCDR), a biomarker commonly used in ophthalmology to determine the degree of glaucomatous optic neuropathy. In general this is solved using coarse-to-fine deep learning algorithms in which a first stage approximates the OD and a second one uses a crop of this area to predict OD/OC masks. While this approach is widely applied in the literature, there are no studies analyzing its real contribution to the results. In this paper we present a comprehensive an…
Automated Computer Aided diagnostic tools can be used for the early detection of glaucoma to prevent irreversible vision loss. In this work, we present a Multi-task Convolutional Neural Network (CNN) that jointly segments the Optic Disc (OD), Optic Cup (OC) and predicts the presence of glaucoma in color fundus images. The CNN utilizes a combination of image appearance features and structural features obtained from the OD-OC segmentation to obtain a robust prediction. The use of fewer network parameters and the sharing of the CNN features for multiple related tasks ensures the good generalizabi…
Mohamed bin Zayed University of Artificial Intelligence（穆罕默德·本·扎耶德人工智能大学）
Glaucoma is one of the most severe eye diseases, characterized by rapid progression and leading to irreversible blindness. It is often the case that diagnostics is carried out when one's sight has already significantly degraded due to the lack of noticeable symptoms at early stage of the disease. Regular glaucoma screenings of the population shall improve early-stage detection, however the desirable frequency of etymological checkups is often not feasible due to the excessive load imposed by manual diagnostics on limited number of specialists. Considering the basic methodology to detect glauco…
KU Leuven（鲁汶大学）；UZ Leuven（鲁汶大学医院）；University of Porto（波尔图大学）；Centro Hospitalar e Universitário São João（圣若昂大学医院中心）；Hasselt University（哈瑟尔特大学）；University of Antwerp（安特卫普大学）；Flemish Institute for Technological Research（弗拉芒技术研究院）
Although unprecedented sensitivity and specificity values are reported, recent glaucoma detection deep learning models lack in decision transparency. Here, we propose a methodology that advances explainable deep learning in the field of glaucoma detection and vertical cup-disc ratio (VCDR), an important risk factor. We trained and evaluated deep learning models using fundus images that underwent a certain cropping policy. We defined the crop radius as a percentage of image size, centered on the optic nerve head (ONH), with an equidistant spaced range from 10%-60% (ONH crop policy). The inverse…
Sun Yat-sen University（中山大学）；Baidu Inc.（百度公司）；Agency for Science, Technology and Research（新加坡科技研究局）；CONICET（阿根廷国家科学技术研究委员会）；UNICEN（阿根廷中央国立大学）；Medical University of Vienna（维也纳医科大学）；VUNO Inc.（VUNO公司）；Tencent（腾讯）
With the rapid development of artificial intelligence (AI) in medical image processing, deep learning in color fundus photography (CFP) analysis is also evolving. Although there are some open-source, labeled datasets of CFPs in the ophthalmology community, large-scale datasets for screening only have labels of disease categories, and datasets with annotations of fundus structures are usually small in size. In addition, labeling standards are not uniform across datasets, and there is no clear information on the acquisition device. Here we release a multi-annotation, multi-quality, and multi-dev…
Medical University of Vienna（维也纳医科大学）；Inception Institute of Artificial Intelligence（起源人工智能研究院）；University of Porto（波尔图大学）；KU Leuven（鲁汶大学）；Universitat Politècnica de València（瓦伦西亚理工大学）；University of Florida（佛罗里达大学）；The Chinese University of Hong Kong（香港中文大学）；Gachon University（嘉泉大学）；Samsung SDS AI Research Center（三星SDS人工智能研究中心）；Yale University（耶鲁大学）
Glaucoma is one of the leading causes of irreversible but preventable blindness in working age populations. Color fundus photography (CFP) is the most cost-effective imaging modality to screen for retinal disorders. However, its application to glaucoma has been limited to the computation of a few related biomarkers such as the vertical cup-to-disc ratio. Deep learning approaches, although widely applied for medical image analysis, have not been extensively used for glaucoma assessment due to the limited size of the available data sets. Furthermore, the lack of a standardize benchmark strategy …
JIS College of Engineering（JIS工程学院）；Kalyani Govt. Engg. College（卡利亚尼政府工程学院）
Digital Retinal Fundus Images helps to detect various ophthalmic diseases by detecting morphological changes in optical cup, optical disc and macula. Present work proposes a method for the authentication of medical images based on Discrete Wavelet Transformation (DWT) and Spread Spectrum. Proper selection of the Non Region of Interest (NROI) for watermarking is crucial, as the area under concern has to be the least required portion conveying any medical information. Proposed method discusses both the selection of least impact area and the blind watermarking technique. Watermark is embedded wit…
Technische Universität Kaiserslautern（凯泽斯劳滕工业大学）；German Research Center for Artificial Intelligence GmbH (DFKI)（德国人工智能研究中心）；Opthalmology Clinic（眼科诊所）；National University of Science and Technology (NUST)（国立科技大学）；National Center of Artificial Intelligence（国家人工智能中心）；Smart Data and Knowledge Services（智能数据与知识服务部）
Scarcity of large publicly available retinal fundus image datasets for automated glaucoma detection has been the bottleneck for successful application of artificial intelligence towards practical Computer-Aided Diagnosis (CAD). A few small datasets that are available for research community usually suffer from impractical image capturing conditions and stringent inclusion criteria. These shortcomings in already limited choice of existing datasets make it challenging to mature a CAD system so that it can perform in real-world environment. In this paper we present a large publicly available retin…
University of Sydney（悉尼大学）；Shanghai Jiao Tong University（上海交通大学）；Med-X Research Institute, Shanghai Jiao Tong University（上海交通大学Med-X研究院）；Royal Prince Alfred Hospital（皇家阿尔弗雷德王子医院）
Automated segmentation of the optic cup and disk on retinal fundus images is fundamental for the automated detection / analysis of glaucoma. Traditional segmentation approaches depend heavily upon hand-crafted features and a priori knowledge of the user. As such, these methods are difficult to be adapt to the clinical environment. Recently, deep learning methods based on fully convolutional networks (FCNs) have been successful in resolving segmentation problems. However, the reliance on large annotated training data is problematic when dealing with medical images. If a sufficient amount of ann…
State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Vision Science, Guangdong Provincial Clinical Research Center for Ocular Diseases（眼科学国家重点实验室、中山眼科中心、中山大学、广东省眼科学重点实验室和视觉科学、广东省眼科临床研究中心）；Faculty of Data Science, City University of Macau（澳门城市大学数据科学学院）；Hainan International College, Minzu University of China（海南国际学院，中国民族大学）；School of Information Technology, Faculty of Business and Hospitality, Torrens University Australia（澳大利亚托伦斯大学信息科技学院，商业与酒店管理学院）；AIM for Health Lab, Faculty of IT, Monash University, Australia（健康AIM实验室，墨尔本大学IT学院，澳大利亚）；Department of Ophthalmology, Guangzhou First People’s Hospital, the Second Affiliated Hospital of South China University of Technology（广州第一人民医院，华南理工大学第二附属医院）；The Third Xiangya Hospital of Central South University（中南大学湘雅医学院第三医院）
Opening the black box of deep learning: Validating the statistical association between explainable artificial intelligence (XAI) and clinical domain knowledge in fundus image-based glaucoma diagnosis
Duke-NUS Medical School（杜克-新加坡国立大学医学院）；Singapore National Eye Centre（新加坡国家眼科中心）
Glaucoma is a serious ocular disorder for which the screening and diagnosis are carried out by the examination of the optic nerve head (ONH). The color fundus image (CFI) is the most common modality used for ocular screening. In CFI, the central r
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)…
Observing retinal fundus images by an ophthalmologist is a major diagnosis approach for glaucoma. However, it is still difficult to distinguish the features of the lesion solely through manual observations, especially, in glaucoma early phase. In this paper, we present two deep learning-based automated algorithms for glaucoma detection and optic disc and cup segmentation. We utilize the attention mechanism to learn pixel-wise features for accurate prediction. In particular, we present two convolutional neural networks that can focus on learning various pixel-wise level features. In addition, w…
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…
Computer Vision Institute, Shenzhen University（深圳大学计算机视觉研究所）；Tencent Jarvis Lab（腾讯贾维斯实验室）
Domain shift between medical images from multicentres is still an open question for the community, which degrades the generalization performance of deep learning models. Generative adversarial network (GAN), which synthesize plausible images, is one of the potential solutions to address the problem. However, the existing GAN-based approaches are prone to fail at preserving image-objects in image-to-image (I2I) translation, which reduces their practicality on domain adaptation tasks. In this paper, we propose a novel GAN (namely MI$^2$GAN) to maintain image-contents during cross-domain I2I tran…
Cixi Institute of Biomedical Engineering, Chinese Academy of Sciences（中国科学院慈溪生物医学工程研究所）；Institute for Infocomm Research, Agency for Science, Technology and Research（新加坡科技研究局资讯通信研究院）；Shanghai University（上海大学）
Retinal fundus photographs have been used in the diagnosis of many ocular diseases such as glaucoma, pathological myopia, age-related macular degeneration and diabetic retinopathy. With the development of computer science, computer aided diagnosis has been developed to process and analyse the retinal images automatically. One of the challenges in the analysis is that the quality of the retinal image is often degraded. For example, a cataract in human lens will attenuate the retinal image, just as a cloudy camera lens which reduces the quality of a photograph. It often obscures the details in t…
Institute of High Performance Computing, A*STAR（新加坡科技研究局高性能计算研究所）；University of Electronic Science and Technology of China（电子科技大学）
Medical image segmentation is important for computer-aided diagnosis. Good segmentation demands the model to see the big picture and fine details simultaneously, i.e., to learn image features that incorporate large context while keep high spatial resolutions. To approach this goal, the most widely used methods -- U-Net and variants, extract and fuse multi-scale features. However, the fused features still have small "effective receptive fields" with a focus on local image cues, limiting their performance. In this work, we propose Segtran, an alternative segmentation framework based on transform…
Technical University of Munich（慕尼黑工业大学）；Heritage Institute of Technology（印度传统理工学院）
Automatic evaluation of the retinal fundus image is emerging as one of the most important tools for early detection and treatment of progressive eye diseases like Glaucoma. Glaucoma results to a progressive degeneration of vision and is characterized by the deformation of the shape of optic cup and the degeneration of the blood vessels resulting in the formation of a notch along the neuroretinal rim. In this paper, we propose a deep learning-based pipeline for automatic segmentation of optic disc (OD) and optic cup (OC) regions from Digital Fundus Images (DFIs), thereby extracting distinct fea…
University of Electronic Science and Technology of China（电子科技大学）；Shanghai AI Lab（上海人工智能实验室）；ShanghaiTech University（上海科技大学）；Shanghai Jiao Tong University（上海交通大学）
Efficiently utilizing discriminative features is crucial for convolutional neural networks to achieve remarkable performance in medical image segmentation and is also important for model generalization across multiple domains, where letting model recognize domain-specific and domain-invariant information among multi-site datasets is a reasonable strategy for domain generalization. Unfortunately, most of the recent disentangle networks are not directly adaptable to unseen-domain datasets because of the limitations of offered data distribution. To tackle this deficiency, we propose Contrastive D…
Southern University of Science and Technology（南方科技大学）；The University of Hong Kong（香港大学）
Fundus photography has been routinely used to document the presence and severity of various retinal degenerative diseases such as age-related macula degeneration, glaucoma, and diabetic retinopathy, for which the fovea, optic disc (OD), and optic cup (OC) are important anatomical landmarks. Identification of those anatomical landmarks is of great clinical importance. However, the presence of lesions, drusen, and other abnormalities during retinal degeneration severely complicates automatic landmark detection and segmentation. Most existing works treat the identification of each landmark as a s…
Screening for the diagnosis of glaucoma through a fundus image can be determined by the optic cup to disc diameter ratio (CDR), which requires the segmentation of the cup and disc regions. In this paper, we propose two novel approaches, namely Parameter-Shared Branched Network (PSBN) andWeak Region of Interest Model-based segmentation (WRoIM) to identify disc and cup boundaries. Unlike the previous approaches, the proposed methods are trained end-to-end through a single neural network architecture and use dynamic cropping instead of manual or traditional computer vision-based cropping. We are …
Baidu Research（百度研究院）；Mind Vogue Lab（Mind Vogue实验室）；Institute for Infocomm Research, A*STAR（新加坡科技研究局资讯通信研究院）
Diffusion probabilistic model (DPM) recently becomes one of the hottest topic in computer vision. Its image generation application such as Imagen, Latent Diffusion Models and Stable Diffusion have shown impressive generation capabilities, which aroused extensive discussion in the community. Many recent studies also found it is useful in many other vision tasks, like image deblurring, super-resolution and anomaly detection. Inspired by the success of DPM, we propose the first DPM based model toward general medical image segmentation tasks, which we named MedSegDiff. In order to enhance the step…
HCDG: A Hierarchical Consistency Framework for Domain Generalization on Medical Image Segmentation
The Hong Kong University of Science and Technology (Guangzhou)（香港科技大学（广州））；University of Cambridge（剑桥大学）；The Hong Kong University of Science and Technology（香港科技大学）；The University of Hong Kong（香港大学）
University of Florida（佛罗里达大学）；UNC Charlotte（北卡罗来纳大学夏洛特分校）；Xi’an Jiaotong University（西安交通大学）；Sensetime Research（商汤科技研究院）
Recently, deep neural networks have demonstrated comparable and even better performance with board-certified ophthalmologists in well-annotated datasets. However, the diversity of retinal imaging devices poses a significant challenge: domain shift, which leads to performance degradation when applying the deep learning models to new testing domains. In this paper, we propose a novel unsupervised domain adaptation framework, called Collaborative Feature Ensembling Adaptation (CFEA), to effectively overcome this challenge. Our proposed CFEA is an interactive paradigm which presents an exquisite o…
Indian Institute of Technology Madras（印度理工学院马德拉斯分校）；Healthcare Technology Innovation Centre（医疗技术创新中心）；Indian Institute of Information Technology Design & Manufacturing Kancheepuram（金奈设计与制造印度理工学院）；Zasti（Zasti公司）
Recently, state-of-the-art results have been achieved in semantic segmentation using fully convolutional networks (FCNs). Most of these networks employ encoder-decoder style architecture similar to U-Net and are trained with images and the corresponding segmentation maps as a pixel-wise classification task. Such frameworks only exploit class information by using the ground truth segmentation maps. In this paper, we propose a multi-task learning framework with the main aim of exploiting structural and spatial information along with the class information. We modify the decoder part of the FCN to…
The segmentation of optic disc(OD) and optic cup(OC) from fundus images is an important fundamental task for glaucoma diagnosis. In the clinical practice, it is often necessary to collect opinions from multiple experts to obtain the final OD/OC annotation. This clinical routine helps to mitigate the individual bias. But when data is multiply annotated, standard deep learning models will be inapplicable. In this paper, we propose a novel neural network framework to learn OD/OC segmentation from multi-rater annotations. The segmentation results are self-calibrated through the iterative optimizat…
University of Florida（佛罗里达大学）；UNC Charlotte（北卡罗来纳大学夏洛特分校）
The diversity of retinal imaging devices poses a significant challenge: domain shift, which leads to performance degradation when applying the deep learning models trained on one domain to new testing domains. In this paper, we propose a multi-scale input along with multiple domain adaptors applied hierarchically in both feature and output spaces. The proposed training strategy and novel unsupervised domain adaptation framework, called Collaborative Adversarial Domain Adaptation (CADA), can effectively overcome the challenge. Multi-scale inputs can reduce the information loss due to the poolin…
University of Electronic Science and Technology of China（电子科技大学）；Shanghai AI Lab（上海人工智能实验室）；Shanghai Jiao Tong University（上海交通大学）；ShanghaiTech University（上海科技大学）；Sensetime Research（商汤科技研究院）；Sichuan University（四川大学）；Sichuan Cancer Hospital and Institute（四川省肿瘤医院（四川省肿瘤研究所））
Generalization to previously unseen images with potential domain shifts and different styles is essential for clinically applicable medical image segmentation, and the ability to disentangle domain-specific and domain-invariant features is key for achieving Domain Generalization (DG). However, existing DG methods can hardly achieve effective disentanglement to get high generalizability. To deal with this problem, we propose an efficient Contrastive Domain Disentanglement and Style Augmentation (CDDSA) framework for generalizable medical image segmentation. First, a disentangle network is propo…
Glaucoma is a chronic visual disease that may cause permanent irreversible blindness. Measurement of the cup-to-disc ratio (CDR) plays a pivotal role in the detection of glaucoma in its early stage, preventing visual disparities. Therefore, accurate and automatic segmentation of optic disc (OD) and optic cup (OC) from retinal fundus images is a fundamental requirement. Existing CNN-based segmentation frameworks resort to building deep encoders with aggressive downsampling layers, which suffer from a general limitation on modeling explicit long-range dependency. To this end, in this paper, we p…
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…
With the advancement of deep learning techniques, an increasing number of methods have been proposed for optic disc and cup (OD/OC) segmentation from the fundus images. Clinically, OD/OC segmentation is often annotated by multiple clinical experts to mitigate the personal bias. However, it is hard to train the automated deep learning models on multiple labels. A common practice to tackle the issue is majority vote, e.g., taking the average of multiple labels. However such a strategy ignores the different expertness of medical experts. Motivated by the observation that OD/OC segmentation is oft…
Convolutional neural networks have been widely applied to medical image segmentation and have achieved considerable performance. However, the performance may be significantly affected by the domain gap between training data (source domain) and testing data (target domain). To address this issue, we propose a data manipulation based domain generalization method, called Automated Augmentation for Domain Generalization (AADG). Our AADG framework can effectively sample data augmentation policies that generate novel domains and diversify the training set from an appropriate search space. Specifical…
The performance of a computer-aided automated diagnosis system of lung cancer from Computed Tomography (CT) volumetric images greatly depends on the accurate detection and segmentation of tumor regions. In this paper, we present Recurrent 3D-DenseUNet, a novel deep learning based architecture for volumetric lung tumor segmentation from CT scans. The proposed architecture consists of a 3D encoder block that learns to extract fine-grained spatial and coarse-grained temporal features, a recurrent block of multiple Convolutional Long Short-Term Memory (ConvLSTM) layers to extract fine-grained spat…
