CLIP-DR: Textual Knowledge-Guided Diabetic Retinopathy Grading with Ranking-aware Prompting
University of Exeter（埃克塞特大学）；University of Liverpool（利物浦大学）；Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences（中国科学院宁波材料技术与工程研究所）；Institute of High Performance Computing, Agency for Science, Technology and Research (A*STAR)（新加坡科技研究局高性能计算研究所）
Qinkai Yu, Jianyang Xie, Anh Nguyen, He Zhao, Jiong Zhang, Huazhu Fu, Yitian Zhao, Yalin Zheng, Yanda Meng
Diabetic retinopathy (DR) is a complication of diabetes and usually takes decades to reach sight-threatening levels. Accurate and robust detection of DR severity is critical for the timely management and treatment of diabetes. However, most current DR grading methods suffer from insufficient robustness to data variability (\textit{e.g.} colour fundus images), posing a significant difficulty for accurate and robust grading. In this work, we propose a novel DR grading framework CLIP-DR based on three observations: 1) Recent pre-trained visual language models, such as CLIP, showcase a notable capacity for generalisation across various downstream tasks, serving as effective baseline models. 2) The grading of image-text pairs for DR often adheres to a discernible natural sequence, yet most existing DR grading methods have primarily overlooked this aspect. 3) A long-tailed distribution among DR severity levels complicates the grading process. This work proposes a novel ranking-aware prompting strategy to help the CLIP model exploit the ordinal information. Specifically, we sequentially design learnable prompts between neighbouring text-image pairs in two different ranking directions. Additionally, we introduce a Similarity Matrix Smooth module into the structure of CLIP to balance the class distribution. Finally, we perform extensive comparisons with several state-of-the-art methods on the GDRBench benchmark, demonstrating our CLIP-DR's robustness and superior performance. The implementation code is available \footnote{\url{https://github.com/Qinkaiyu/CLIP-DR}
Department of Computer Science & Engineering, Priyadarshini Institute of Engineering & Technology（普里达尔希尼工程技术学院计算机科学与工程系）
Diabetic Retinopathy is a critical health problem influences 100 million individuals worldwide, and these figures are expected to rise, particularly in Asia. Diabetic Retinopathy is a chronic eye disease which can lead to irreversible vision loss. Considering the visual complexity of retinal images, the early-stage diagnosis of Diabetic Retinopathy can be challenging for human experts. However, Early detection of Diabetic Retinopathy can significantly help to avoid permanent vision loss. The capability of computer-aided detection systems to accurately and efficiently detect the diabetic retino…
Manarat International University（玛纳拉特国际大学）；Bangladesh University of Engineering and Technology（孟加拉国工程技术大学）
Diabetic Retinopathy (DR) is a constantly deteriorating disease, being one of the leading causes of vision impairment and blindness. Subtle distinction among different grades and existence of many significant small features make the task of recognition very challenging. In addition, the present approach of retinopathy detection is a very laborious and time-intensive task, which heavily relies on the skill of a physician. Automated detection of diabetic retinopathy is essential to tackle these problems. Early-stage detection of diabetic retinopathy is also very important for diagnosis, which ca…
Rochester Institute of Technology（罗切斯特理工学院）；Drexel University（德雷塞尔大学）；University of Rochester（罗切斯特大学）
Widespread outreach programs using remote retinal imaging have proven to decrease the risk from diabetic retinopathy, the leading cause of blindness in the US. However, this process still requires manual verification of image quality and grading of images for level of disease by a trained human grader and will continue to be limited by the lack of such scarce resources. Computer-aided diagnosis of retinal images have recently gained increasing attention in the machine learning community. In this paper, we introduce a set of neural networks for diabetic retinopathy classification of fundus reti…
Diabetic Retinopathy (DR) has become one of the leading causes of vision impairment in working-aged people and is a severe problem worldwide. However, most of the works ignored the ordinal information of labels. In this project, we propose a novel design MTCSNN, a Multi-task Clinical Siamese Neural Network for Diabetic Retinopathy severity prediction task. The novelty of this project is to utilize the ordinal information among labels and add a new regression task, which can help the model learn more discriminative feature embedding for fine-grained classification tasks. We perform comprehensiv…
German Research Center for Artificial Intelligence (DFKI)（德国人工智能研究中心）；Dongguk University（东国大学）；Stanford University（斯坦福大学）；Oldenburg University（奥尔登堡大学）
This paper investigates the problem of domain adaptation for diabetic retinopathy (DR) grading. We learn invariant target-domain features by defining a novel self-supervised task based on retinal vessel image reconstructions, inspired by medical domain knowledge. Then, a benchmark of current state-of-the-art unsupervised domain adaptation methods on the DR problem is provided. It can be shown that our approach outperforms existing domain adaption strategies. Furthermore, when utilizing entire training data in the target domain, we are able to compete with several state-of-the-art approaches in…
Universidad Nacional de Colombia（哥伦比亚国立大学）；Universidad del Rosario（罗萨里奥大学）
Diabetic retinopathy (DR) is one of the leading causes of blindness in the working-age population of developed countries, caused by a side effect of diabetes that reduces the blood supply to the retina. Deep neural networks have been widely used in automated systems for DR classification on eye fundus images. However, these models need a large number of annotated images. In the medical domain, annotations from experts are costly, tedious, and time-consuming; as a result, a limited number of annotated images are available. This paper presents a semi-supervised method that leverages unlabeled im…
This paper addresses the problem of identifying two main types of lesions - Exudates and Microaneurysms - caused by Diabetic Retinopathy (DR) in the eyes of diabetic patients. We make use of Convolutional Neural Networks (CNNs) and Transfer Learning to locate and generate high-quality segmentation mask for each instance of the lesion that can be found in the patients' fundus images. We create our normalized database out of e-ophtha EX and e-ophtha MA and tweak Mask R-CNN to detect small lesions. Moreover, we employ data augmentation and the pre-trained weights of ResNet101 to compensate for ou…
The Chinese University of Hong Kong（香港中文大学）；Tsing Hua University（清华大学）；SenseTime Group Limited（商汤集团有限公司）；Sir Run Run Shaw Hospital（邵逸夫医院）
We propose a convolution neural network based algorithm for simultaneously diagnosing diabetic retinopathy and highlighting suspicious regions. Our contributions are two folds: 1) a network termed Zoom-in-Net which mimics the zoom-in process of a clinician to examine the retinal images. Trained with only image-level supervisions, Zoomin-Net can generate attention maps which highlight suspicious regions, and predicts the disease level accurately based on both the whole image and its high resolution suspicious patches. 2) Only four bounding boxes generated from the automatically learned attentio…
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…
In this manuscript, we automate the procedure of grading of diabetic retinopathy and macular edema from fundus images using an ensemble of convolutional neural networks. The availability of limited amount of labeled data to perform supervised learning was circumvented by using transfer learning approach. The models in the ensemble were pre-trained on a large dataset comprising natural images and were later fine-tuned with the limited data for the task of choice. For an image, the ensemble of classifiers generate multiple predictions, and a max-voting based approach was utilized to attain the f…
The automatic grading of diabetic retinopathy (DR) facilitates medical diagnosis for both patients and physicians. Existing researches formulate DR grading as an image classification problem. As the stages/categories of DR correlate with each other, the relationship between different classes cannot be explicitly described via a one-hot label because it is empirically estimated by different physicians with different outcomes. This class correlation limits existing networks to achieve effective classification. In this paper, we propose a Graph REsidual rE-ranking Network (GREEN) to introduce a c…
Google Research（谷歌研究院）；Palo Alto Medical Foundation（帕洛阿尔托医疗基金会）；Oregon Eye Consultants（俄勒冈眼科顾问公司）
Diabetic retinopathy (DR) and diabetic macular edema are common complications of diabetes which can lead to vision loss. The grading of DR is a fairly complex process that requires the detection of fine features such as microaneurysms, intraretinal hemorrhages, and intraretinal microvascular abnormalities. Because of this, there can be a fair amount of grader variability. There are different methods of obtaining the reference standard and resolving disagreements between graders, and while it is usually accepted that adjudication until full consensus will yield the best reference standard, the …
Sharda University（沙尔达大学）；Research and Technology Development Center（研究与技术开发中心）
Annotated training data insufficiency remains to be one of the challenges of applying deep learning in medical data classification problems. Transfer learning from an already trained deep convolutional network can be used to reduce the cost of training from scratch and to train with small training data for deep learning. This raises the question of whether we can use transfer learning to overcome the training data insufficiency problem in deep learning based medical data classifications. Deep convolutional networks have been achieving high performance results on the ImageNet Large Scale Visual…
Imam Abdulrahman Bin Faisal University（伊玛目阿卜杜勒-拉赫曼·本·费萨尔大学）；King Saud University（沙特国王大学）；Princess Nourah bint Abdulrahman University（努拉·宾特·阿卜杜勒-拉赫曼公主大学）；King Khalid Eye Specialist Hospital（哈立德国王眼科专科医院）
Diabetic retinopathy (DR) results in vision loss if not treated early. A computer-aided diagnosis (CAD) system based on retinal fundus images is an efficient and effective method for early DR diagnosis and assisting experts. A computer-aided diagnosis (CAD) system involves various stages like detection, segmentation and classification of lesions in fundus images. Many traditional machine-learning (ML) techniques based on hand-engineered features have been introduced. The recent emergence of deep learning (DL) and its decisive victory over traditional ML methods for various applications motivat…
Stage Aware Diagnosis of Diabetic Retinopathy via Ordinal Regression
Amrita School of Computing, Amrita Vishwa Vidyapeetham, Amaravati Campus, Andhra Pradesh - 522503, India（阿米特拉计算学校，阿米特拉世界大学，阿曼瓦蒂校区，安得拉邦，印度）；Amity Institute of Information Technology, Amity University Jharkhand, Ranchi, India（阿米特大学信息科技学院，阿米特大学贾坎德分校，拉奇，印度）
University of Oxford（牛津大学）；Big Data Institute（大数据研究所）
Diabetic retinopathy (DR) is a complication of diabetes, and one of the major causes of vision impairment in the global population. As the early-stage manifestation of DR is usually very mild and hard to detect, an accurate diagnosis via eye-screening is clinically important to prevent vision loss at later stages. In this work, we propose an ensemble method to automatically grade DR using ultra-wide optical coherence tomography angiography (UW-OCTA) images available from Diabetic Retinopathy Analysis Challenge (DRAC) 2022. First, we adopt the state-of-the-art classification networks, i.e., Res…
Research and Technology Development Center（研究与技术开发中心）；Sharda University（夏尔达大学）
Early diagnosis of diabetic retinopathy for treatment of the disease has been failing to reach diabetic people living in rural areas. Shortage of trained ophthalmologists, limited availability of healthcare centers, and expensiveness of diagnostic equipment are among the reasons. Although many deep learning-based automatic diagnosis of diabetic retinopathy techniques have been implemented in the literature, these methods still fail to provide a point-of-care diagnosis. This raises the need for an independent diagnostic of diabetic retinopathy that can be used by a non-expert. Recently the usag…
The Methodist Hospital（卫理公会医院）；The University of Texas Health Science Center Houston（德克萨斯大学休斯顿健康科学中心）
All people with diabetes have the risk of developing diabetic retinopathy (DR), a vision-threatening complication. Early detection and timely treatment can reduce the occurrence of blindness due to DR. Computer-aided diagnosis has the potential benefit of improving the accuracy and speed in DR detection. This study is concerned with automatic classification of images with microaneurysm (MA) and neovascularization (NV), two important DR clinical findings. Together with normal images, this presents a 3-class classification problem. We propose a modified color auto-correlogram feature (AutoCC) wi…
Department of Computer Science & Engineering, Priyadarshini Institute of Engineering & Technology（普里雅达希尼工程技术学院计算机科学与工程系）
Diabetic Retinopathy is a global health problem, influences 100 million individuals worldwide, and in the next few decades, these incidences are expected to reach epidemic proportions. Diabetic Retinopathy is a subtle eye disease that can cause sudden, irreversible vision loss. The early-stage Diabetic Retinopathy diagnosis can be challenging for human experts, considering the visual complexity of fundus photography retinal images. However, Early Stage detection of Diabetic Retinopathy can significantly alter the severe vision loss problem. The competence of computer-aided detection systems to…
Shanghai University（上海大学）；Tongji University（同济大学）；Shanghai General Hospital（上海市第一人民医院）；Shanghai Jiao Tong University School of Medicine（上海交通大学医学院）
Diabetic retinopathy (DR) is one of the leading causes of blindness. However, no specific symptoms of early DR lead to a delayed diagnosis, which results in disease progression in patients. To determine the disease severity levels, ophthalmologists need to focus on the discriminative parts of the fundus images. In recent years, deep learning has achieved great success in medical image analysis. However, most works directly employ algorithms based on convolutional neural networks (CNNs), which ignore the fact that the difference among classes is subtle and gradual. Hence, we consider automatic …
Isfahan University of Technology（伊斯法罕理工大学）；McMaster University（麦克马斯特大学）
Convolutional neural networks (CNNs) are extensively beneficial for medical image processing. Medical images are plentiful, but there is a lack of annotated data. Transfer learning is used to solve the problem of lack of labeled data and grants CNNs better training capability. Transfer learning can be used in many different medical applications; however, the model under transfer should have the same size as the original network. Knowledge distillation is recently proposed to transfer the knowledge of a model to another one and can be useful to cover the shortcomings of transfer learning. But s…
Aristotle University of Thessaloniki（塞萨洛尼基亚里士多德大学）
Diabetic Retinopathy (DR) is a leading cause of vision loss globally. Yet despite its prevalence, the majority of affected people lack access to the specialized ophthalmologists and equipment required for assessing their condition. This can lead to delays in the start of treatment, thereby lowering their chances for a successful outcome. Machine learning systems that automatically detect the disease in eye fundus images have been proposed as a means of facilitating access to DR severity estimates for patients in remote regions or even for complementing the human expert's diagnosis. In this pap…
Carnegie Mellon University（卡内基梅隆大学）；INESC TEC, Porto（波尔图INESC TEC研究所）；École de Tecnologie Superieure, Montreal（蒙特利尔高等技术学院）；Faculty of Engineering, University of Porto（波尔图大学工程学院）
Diabetic Retinopathy is the leading cause of blindness in the working-age population of the world. The main aim of this paper is to improve the accuracy of Diabetic Retinopathy detection by implementing a shadow removal and color correction step as a preprocessing stage from eye fundus images. For this, we rely on recent findings indicating that application of image dehazing on the inverted intensity domain amounts to illumination compensation. Inspired by this work, we propose a Shadow Removal Layer that allows us to learn the pre-processing function for a particular task. We show that learni…
Baidu Research, Baidu（百度研究院，百度）；Institute of Automation, Chinese Academy of Sciences（中国科学院自动化研究所）
We propose an automatic diabetic retinopathy (DR) analysis algorithm based on two-stages deep convolutional neural networks (DCNN). Compared to existing DCNN-based DR detection methods, the proposed algorithm have the following advantages: (1) Our method can point out the location and type of lesions in the fundus images, as well as giving the severity grades of DR. Moreover, since retina lesions and DR severity appear with different scales in fundus images, the integration of both local and global networks learn more complete and specific features for DR analysis. (2) By introducing imbalance…
Replication studies are essential for validation of new methods, and are crucial to maintain the high standards of scientific publications, and to use the results in practice. We have attempted to replicate the main method in 'Development and validation of a deep learning algorithm for detection of diabetic retinopathy in retinal fundus photographs' published in JAMA 2016; 316(22). We re-implemented the method since the source code is not available, and we used publicly available data sets. The original study used non-public fundus images from EyePACS and three hospitals in India for training.…
COMSATS University Islamabad（伊斯兰堡 COMSATS 大学）；Deakin University（迪肯大学）；Victoria University（维多利亚大学）
Diabetic retinopathy refers to the pathology of the retina induced by diabetes and is one of the leading causes of preventable blindness in the world. Early detection of diabetic retinopathy is critical to avoid vision problem through continuous screening and treatment. In traditional clinical practice, the involved lesions are manually detected using photographs of the fundus. However, this task is cumbersome and time-consuming and requires intense effort due to the small size of lesion and low contrast of the images. Thus, computer-assisted diagnosis of diabetic retinopathy based on the dete…
Inception Institute of Artificial Intelligence（人工智能研究院）
People with diabetes are at risk of developing an eye disease called diabetic retinopathy (DR). This disease occurs when high blood glucose levels cause damage to blood vessels in the retina. Computer-aided DR diagnosis is a promising tool for early detection of DR and severity grading, due to the great success of deep learning. However, most current DR diagnosis systems do not achieve satisfactory performance or interpretability for ophthalmologists, due to the lack of training data with consistent and fine-grained annotations. To address this problem, we construct a large fine-grained annota…
Australian e-Health Research Centre, CSIRO（澳大利亚电子健康研究中心，联邦科学与工业研究组织）；ACRV, The Australian National University（澳大利亚机器人视觉中心，澳大利亚国立大学）；University of California, Berkeley（加州大学伯克利分校）
Purpose To develop a computer based method for the automated assessment of image quality in the context of diabetic retinopathy (DR) to guide the photographer. Methods A deep learning framework was trained to grade the images automatically. A large representative set of 7000 color fundus images were used for the experiment which were obtained from the EyePACS that were made available by the California Healthcare Foundation. Three retinal image analysis experts were employed to categorize these images into Accept and Reject classes based on the precise definition of image quality in the context…
Introducing automated Diabetic Retinopathy (DR) diagnosis into Ethiopia is still a challenging task, despite recent reports that present trained Deep Learning (DL) based DR classifiers surpassing manual graders. This is mainly because of the expensive cost of conventional retinal imaging devices used in DL based classifiers. Current approaches that provide mobile based binary classification of DR, and the way towards a cheaper and offline multi-class classification of DR will be discussed in this paper.
Artificial Intelligence Group, Baidu（百度人工智能组）；Institute of Automation, Chinese Academy of Sciences（中国科学院自动化研究所）；University of Science and Technology of China（中国科学技术大学）
Diabetic retinopathy (DR) grading from fundus images has attracted increasing interest in both academic and industrial communities. Most convolutional neural network (CNN) based algorithms treat DR grading as a classification task via image-level annotations. However, these algorithms have not fully explored the valuable information in the DR-related lesions. In this paper, we present a robust framework, which collaboratively utilizes patch-level and image-level annotations, for DR severity grading. By an end-to-end optimization, this framework can bi-directionally exchange the fine-grained le…
Robert Bosch GmbH（罗伯特·博世有限公司）；TU Dortmund University（多特蒙德工业大学）；Max Planck Institute for Intelligent Systems（马克斯·普朗克智能系统研究所）
Convolutional neural networks (CNNs) show impressive performance for image classification and detection, extending heavily to the medical image domain. Nevertheless, medical experts are sceptical in these predictions as the nonlinear multilayer structure resulting in a classification outcome is not directly graspable. Recently, approaches have been shown which help the user to understand the discriminative regions within an image which are decisive for the CNN to conclude to a certain class. Although these approaches could help to build trust in the CNNs predictions, they are only slightly sho…
Kasetsart University（泰国农业大学）；National Electronics and Computer Technology Centre（泰国国家电子与计算机技术中心）；Tokyo Institute of Technology（东京工业大学）
This research aims to develop an efficient system for screening of diabetic retinopathy. Diabetic retinopathy is the major cause of blindness. Severity of diabetic retinopathy is recognized by some features, such as blood vessel area, exudates, haemorrhages and microaneurysms. To grade the disease the screening system must efficiently detect these features. In this paper we are proposing a simple and fast method for detection of diabetic retinopathy. We do pre-processing of grey-scale image and find all labelled connected components (blobs) in an image regardless of whether it is haemorrhages,…
Manipal Institute of Technology（马尼帕尔理工学院）；Manipal Academy of Higher Education（马尼帕尔高等教育学院）
Deep Ensemble Convolutional Neural Networks has become a methodology of choice for analyzing medical images with a diagnostic performance comparable to a physician, including the diagnosis of Diabetic Retinopathy. However, commonly used techniques are deterministic and are therefore unable to provide any estimate of predictive uncertainty. Quantifying model uncertainty is crucial for reducing the risk of misdiagnosis. A reliable architecture should be well-calibrated to avoid over-confident predictions. To address this, we propose a UATTA-ENS: Uncertainty-Aware Test-Time Augmented Ensemble Tec…
Aalto University School of Science（阿尔托大学理学院）；Digifundus Ltd.（Digifundus有限公司）；Central Finland Central Hospital（中芬兰中心医院）
Diabetes is a globally prevalent disease that can cause visible microvascular complications such as diabetic retinopathy and macular edema in the human eye retina, the images of which are today used for manual disease screening. This labor-intensive task could greatly benefit from automatic detection using deep learning technique. Here we present a deep learning system that identifies referable diabetic retinopathy comparably or better than presented in the previous studies, although we use only a small fraction of images (<1/4) in training but are aided with higher image resolutions. We also …
In recent years, Artificial Intelligence (AI) has proven its relevance for medical decision support. However, the "black-box" nature of successful AI algorithms still holds back their wide-spread deployment. In this paper, we describe an eXplanatory Artificial Intelligence (XAI) that reaches the same level of performance as black-box AI, for the task of classifying Diabetic Retinopathy (DR) severity using Color Fundus Photography (CFP). This algorithm, called ExplAIn, learns to segment and categorize lesions in images; the final image-level classification directly derives from these multivaria…
Although deep learning research and applications have grown rapidly over the past decade, it has shown limitation in healthcare applications and its reachability to people in remote areas. One of the challenges of incorporating deep learning in medical data classification or prediction is the shortage of annotated training data in the healthcare industry. Medical data sharing privacy issues and limited patient population size can be stated as some of the reasons for training data insufficiency in healthcare. Methods to exploit deep learning applications in healthcare have been proposed and imp…
Tsinghua-Berkeley Shenzhen Institute（清华-伯克利深圳学院）；University of California, Berkeley（加州大学伯克利分校）；Affiliated Eye Hospital of Nanchang University（南昌大学附属眼科医院）
Retinal vascular diseases affect the well-being of human body and sometimes provide vital signs of otherwise undetected bodily damage. Recently, deep learning techniques have been successfully applied for detection of diabetic retinopathy (DR). The main obstacle of applying deep learning techniques to detect most other retinal vascular diseases is the limited amount of data available. In this paper, we propose a transfer learning technique that aims to utilize the feature similarities for detecting retinal vascular diseases. We choose the well-studied DR detection as a source task and identify…
Adversarial Exposure Attack on Diabetic Retinopathy Imagery Grading
Nanyang Technological University（南洋理工大学）；Institute of High Performance Computing（高性能计算研究所）；Centre for Frontier AI Research（前沿人工智能研究中心）；Agency for Science, Technology and Research（新加坡科学技术研究局）；New York University（纽约大学）；Singapore Institute of Technology（新加坡理工学院）
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）
University of Bournemouth（伯恩茅斯大学）；École de Technolgie Superieure de Montréal（蒙特利尔高等技术学院）；Diagnos Inc.（Diagnos公司）；CRCHUM University of Montreal Hospital Centre（蒙特利尔大学医院研究中心）
Assessing the degree of disease severity in biomedical images is a task similar to standard classification but constrained by an underlying structure in the label space. Such a structure reflects the monotonic relationship between different disease grades. In this paper, we propose a straightforward approach to enforce this constraint for the task of predicting Diabetic Retinopathy (DR) severity from eye fundus images based on the well-known notion of Cost-Sensitive classification. We expand standard classification losses with an extra term that acts as a regularizer, imposing greater penaltie…
Optical Coherence Tomography Angiography-OCTA dataset for the study of Diabetic Retinopathy
Symbiosis Institute of Technology, Symbiosis International (Deemed University)（共生国际（ deemed 大学）共生技术学院）；University of Technology Sydney（悉尼科技大学）；Natasha Eye Care（娜塔莎眼科护理中心）
