Joint Optic Disc and Cup Segmentation Based on Multi-Label Deep Network and Polar Transformation

LLRHNet: Multiple Lesions Segmentation Using Local-Long Range Features

The encoder-decoder-based deep convolutional neural networks (CNNs) have made great improvements in medical image segmentation tasks. However, due to the inherent locality of convolution, CNNs generally are demonstrated to have limitations in obtaining features across layers and long-range features from the medical image. In this study, we develop a local-long range hybrid features network (LLRHNet), which inherits the merits of the iterative aggregation mechanism and the transformer technology, as a medical image segmentation model. LLRHNet adopts encoder-decoder architecture as the backbone which iteratively aggregates the projection and up-sampling to fuse local low-high resolution features across isolated layers. The transformer adopts the multi-head self-attention mechanism to extract long-range features from the tokenized image patches and fuses these features with the local-range features extracted by down-sampling operation in the backbone network. These hybrid features are used to assist the cascaded up-sampling operations to local the position of the target tissues. LLRHNet is evaluated on two multiple lesions medical image data sets, including a public liver-related segmentation data set (3DIRCADb) and an in-house stroke and white matter hyperintensity (SWMH) segmentation data set. Experimental results denote that LLRHNet achieves state-of-the-art performance on both data sets.

Detection of Small Aerial Object Using Random Projection Feature With Region Clustering

Small aerial object detection plays an important role in numerous computer vision tasks, including remote sensing, early warning systems, and visual tracking. Despite existing moving object detection techniques that can achieve reasonable results in normal size objects, they fail to distinguish the small objects from the dynamic background. To cope with this issue, a novel method is proposed for accurate small aerial object detection under different situations. Initially, the block segmentation is introduced for reducing frame information redundancy. Meanwhile, a random projection feature (RPF) is proposed for characterizing blocks into feature vectors. Subsequently, a moving direction estimation based on feature vectors is presented to measure the motions of blocks and filter out the major directions. Finally, variable search region clustering (VSRC), together with the color feature difference, is designed for extracting pixelwise targets from the remaining moving direction blocks. The comprehensive experiments demonstrate that our approach outperforms the level of state-of-the-art methods upon the integrity of small aerial objects, especially on the dynamic background and scale variation targets.

Performances of Machine Learning in Detecting Glaucoma Using Fundus and Retinal Optical Coherence Tomography Images: A Meta-Analysis

PURPOSE

To evaluate the performance of machine learning (ML) in detecting glaucoma using fundus and retinal optical coherence tomography (OCT) images.

DESIGN

Meta-analysis.

METHODS

PubMed and EMBASE were searched on August 11, 2021. A bivariate random-effects model was used to pool ML's diagnostic sensitivity, specificity, and area under the curve (AUC). Subgroup analyses were performed based on ML classifier categories and dataset types.

RESULTS

One hundred and five studies (3.3%) were retrieved. Seventy-three (69.5%), 30 (28.6%), and 2 (1.9%) studies tested ML using fundus, OCT, and both image types, respectively. Total testing data numbers were 197,174 for fundus and 16,039 for OCT. Overall, ML showed excellent performances for both fundus (pooled sensitivity = 0.92 [95% CI, 0.91-0.93]; specificity = 0.93 [95% CI, 0.91-0.94]; and AUC = 0.97 [95% CI, 0.95-0.98]) and OCT (pooled sensitivity = 0.90 [95% CI, 0.86-0.92]; specificity = 0.91 [95% CI, 0.89-0.92]; and AUC = 0.96 [95% CI, 0.93-0.97]). ML performed similarly using all data and external data for fundus and the external test result of OCT was less robust (AUC = 0.87). When comparing different classifier categories, although support vector machine showed the highest performance (pooled sensitivity, specificity, and AUC ranges, 0.92-0.96, 0.95-0.97, and 0.96-0.99, respectively), results by neural network and others were still good (pooled sensitivity, specificity, and AUC ranges, 0.88-0.93, 0.90-0.93, 0.95-0.97, respectively). When analyzed based on dataset types, ML demonstrated consistent performances on clinical datasets (fundus AUC = 0.98 [95% CI, 0.97-0.99] and OCT AUC = 0.95 [95% 0.93-0.97]).

CONCLUSIONS

Performance of ML in detecting glaucoma compares favorably to that of experts and is promising for clinical application. Future prospective studies are needed to better evaluate its real-world utility.

FastSurferVINN: Building resolution-independence into deep learning segmentation methods-A solution for HighRes brain MRI

Leading neuroimaging studies have pushed 3T MRI acquisition resolutions below 1.0 mm for improved structure definition and morphometry. Yet, only few, time-intensive automated image analysis pipelines have been validated for high-resolution (HiRes) settings. Efficient deep learning approaches, on the other hand, rarely support more than one fixed resolution (usually 1.0 mm). Furthermore, the lack of a standard submillimeter resolution as well as limited availability of diverse HiRes data with sufficient coverage of scanner, age, diseases, or genetic variance poses additional, unsolved challenges for training HiRes networks. Incorporating resolution-independence into deep learning-based segmentation, i.e., the ability to segment images at their native resolution across a range of different voxel sizes, promises to overcome these challenges, yet no such approach currently exists. We now fill this gap by introducing a Voxel-size Independent Neural Network (VINN) for resolution-independent segmentation tasks and present FastSurferVINN, which (i) establishes and implements resolution-independence for deep learning as the first method simultaneously supporting 0.7-1.0 mm whole brain segmentation, (ii) significantly outperforms state-of-the-art methods across resolutions, and (iii) mitigates the data imbalance problem present in HiRes datasets. Overall, internal resolution-independence mutually benefits both HiRes and 1.0 mm MRI segmentation. With our rigorously validated FastSurferVINN we distribute a rapid tool for morphometric neuroimage analysis. The VINN architecture, furthermore, represents an efficient resolution-independent segmentation method for wider application.

Polar transform network for prostate ultrasound segmentation with uncertainty estimation

Automatic and accurate prostate ultrasound segmentation is a long-standing and challenging problem due to the severe noise and ambiguous/missing prostate boundaries. In this work, we propose a novel polar transform network (PTN) to handle this problem from a fundamentally new perspective, where the prostate is represented and segmented in the polar coordinate space rather than the original image grid space. This new representation gives a prostate volume, especially the most challenging apex and base sub-areas, much denser samples than the background and thus facilitate the learning of discriminative features for accurate prostate segmentation. Moreover, in the polar representation, the prostate surface can be efficiently parameterized using a 2D surface radius map with respect to a centroid coordinate, which allows the proposed PTN to obtain superior accuracy compared with its counterparts using convolutional neural networks while having significantly fewer (18%∼41%) trainable parameters. We also equip our PTN with a novel strategy of centroid perturbed test-time augmentation (CPTTA), which is designed to further improve the segmentation accuracy and quantitatively assess the model uncertainty at the same time. The uncertainty estimation function provides valuable feedback to clinicians when manual modifications or approvals are required for the segmentation, substantially improving the clinical significance of our work. We conduct a three-fold cross validation on a clinical dataset consisting of 315 transrectal ultrasound (TRUS) images to comprehensively evaluate the performance of the proposed method. The experimental results show that our proposed PTN with CPTTA outperforms the state-of-the-art methods with statistical significance on most of the metrics while exhibiting a much smaller model size. Source code of the proposed PTN is released at https://github.com/DIAL-RPI/PTN.

Identifying Those at Risk of Glaucoma: A Deep Learning Approach for Optic Disc and Cup Segmentation and Their Boundary Analysis

Glaucoma is a leading cause of irreversible vision loss that gradually damages the optic nerve. In ophthalmic fundus images, measurements of the cup to optic disc (CD) ratio, CD area ratio, neuroretinal rim to optic disc (RD) area ratio, and rim thickness are key measures to screen for potential glaucomatous damage. We propose an automatic method using deep learning algorithms to segment the optic disc and cup and to estimate the key measures. The proposed method comprises three steps: The Region of Interest (ROI) (location of the optic disc) detection from a fundus image using Mask R-CNN, the optic disc and cup segmentation from the ROI using the proposed Multiscale Average Pooling Net (MAPNet), and the estimation of the key measures. Our segmentation results using 1099 fundus images show 0.9381 Jaccard Index (JI) and 0.9679 Dice Coefficient (DC) for the optic disc and 0.8222 JI and 0.8996 DC for the cup. The average CD, CD area, and RD ratio errors are 0.0451, 0.0376, and 0.0376, respectively. The average disc, cup, and rim radius ratio errors are 0.0500, 0.2257, and 0.2166, respectively. Our method performs well in estimating the key measures and shows potential to work within clinical pathways once fully implemented.

Understanding the Research Landscape of Deep Learning in Biomedical Science: Scientometric Analysis

BACKGROUND

Advances in biomedical research using deep learning techniques have generated a large volume of related literature. However, there is a lack of scientometric studies that provide a bird's-eye view of them. This absence has led to a partial and fragmented understanding of the field and its progress.

OBJECTIVE

This study aimed to gain a quantitative and qualitative understanding of the scientific domain by analyzing diverse bibliographic entities that represent the research landscape from multiple perspectives and levels of granularity.

METHODS

We searched and retrieved 978 deep learning studies in biomedicine from the PubMed database. A scientometric analysis was performed by analyzing the metadata, content of influential works, and cited references.

RESULTS

In the process, we identified the current leading fields, major research topics and techniques, knowledge diffusion, and research collaboration. There was a predominant focus on applying deep learning, especially convolutional neural networks, to radiology and medical imaging, whereas a few studies focused on protein or genome analysis. Radiology and medical imaging also appeared to be the most significant knowledge sources and an important field in knowledge diffusion, followed by computer science and electrical engineering. A coauthorship analysis revealed various collaborations among engineering-oriented and biomedicine-oriented clusters of disciplines.

CONCLUSIONS

This study investigated the landscape of deep learning research in biomedicine and confirmed its interdisciplinary nature. Although it has been successful, we believe that there is a need for diverse applications in certain areas to further boost the contributions of deep learning in addressing biomedical research problems. We expect the results of this study to help researchers and communities better align their present and future work.

AFENet: Attention Fusion Enhancement Network for Optic Disc Segmentation of Premature Infants

Retinopathy of prematurity and ischemic brain injury resulting in periventricular white matter damage are the main causes of visual impairment in premature infants. Accurate optic disc (OD) segmentation has important prognostic significance for the auxiliary diagnosis of the above two diseases of premature infants. Because of the complexity and non-uniform illumination and low contrast between background and the target area of the fundus images, the segmentation of OD for infants is challenging and rarely reported in the literature. In this article, to tackle these problems, we propose a novel attention fusion enhancement network (AFENet) for the accurate segmentation of OD in the fundus images of premature infants by fusing adjacent high-level semantic information and multiscale low-level detailed information from different levels based on encoder-decoder network. Specifically, we first design a dual-scale semantic enhancement (DsSE) module between the encoder and the decoder inspired by self-attention mechanism, which can enhance the semantic contextual information for the decoder by reconstructing skip connection. Then, to reduce the semantic gaps between the high-level and low-level features, a multiscale feature fusion (MsFF) module is developed to fuse multiple features of different levels at the top of encoder by using attention mechanism. Finally, the proposed AFENet was evaluated on the fundus images of preterm infants for OD segmentation, which shows that the proposed two modules are both promising. Based on the baseline (Res34UNet), using DsSE or MsFF module alone can increase Dice similarity coefficients by 1.51 and 1.70%, respectively, whereas the integration of the two modules together can increase 2.11%. Compared with other state-of-the-art segmentation methods, the proposed AFENet achieves a high segmentation performance.

Stable Deep Neural Network Architectures for Mitochondria Segmentation on Electron Microscopy Volumes

Electron microscopy (EM) allows the identification of intracellular organelles such as mitochondria, providing insights for clinical and scientific studies. In recent years, a number of novel deep learning architectures have been published reporting superior performance, or even human-level accuracy, compared to previous approaches on public mitochondria segmentation datasets. Unfortunately, many of these publications make neither the code nor the full training details public, leading to reproducibility issues and dubious model comparisons. Thus, following a recent code of best practices in the field, we present an extensive study of the state-of-the-art architectures and compare them to different variations of U-Net-like models for this task. To unveil the impact of architectural novelties, a common set of pre- and post-processing operations has been implemented and tested with each approach. Moreover, an exhaustive sweep of hyperparameters has been performed, running each configuration multiple times to measure their stability. Using this methodology, we found very stable architectures and training configurations that consistently obtain state-of-the-art results in the well-known EPFL Hippocampus mitochondria segmentation dataset and outperform all previous works on two other available datasets: Lucchi++ and Kasthuri++. The code and its documentation are publicly available at https://github.com/danifranco/EM_Image_Segmentation .

Generating future fundus images for early age-related macular degeneration based on generative adversarial networks

BACKGROUND AND OBJECTIVE

Age-related macular degeneration (AMD) is one of the most common diseases that can lead to blindness worldwide. Recently, various fundus image analyzing studies are done using deep learning methods to classify fundus images to aid diagnosis and monitor AMD disease progression. But until now, to the best of our knowledge, no attempt was made to generate future synthesized fundus images that can predict AMD progression. In this paper, we developed a deep learning model using fundus images for AMD patients with different time elapses to generate synthetic future fundus images.

METHOD

We exploit generative adversarial networks (GANs) with additional drusen masks to maintain the pathological information. The dataset included 8196 fundus images from 1263 AMD patients. A proposed GAN-based model, called Multi-Modal GAN (MuMo-GAN), was trained to generate synthetic predicted-future fundus images.

RESULTS

The proposed deep learning model indicates that the additional drusen masks can help to learn the AMD progression. Our model can generate future fundus images with appropriate pathological features. The drusen development over time is depicted well. Both qualitative and quantitative experiments show that our model is more efficient to monitor the AMD disease as compared to other studies.

CONCLUSION

This study could help individualized risk prediction for AMD patients. Compared to existing methods, the experimental results show a significant improvement in terms of tracking the AMD stage in both image-level and pixel-level.

Machine Learning and Deep Learning Techniques for Optic Disc and Cup Segmentation - A Review

Background

Globally, glaucoma is the second leading cause of blindness. Detecting glaucoma in the early stages is essential to avoid disease complications, which lead to blindness. Thus, computer-aided diagnosis systems are powerful tools to overcome the shortage of glaucoma screening programs.

Methods

A systematic search of public databases, including PubMed, Google Scholar, and other sources, was performed to identify relevant studies to overview the publicly available fundus image datasets used to train, validate, and test machine learning and deep learning methods. Additionally, existing machine learning and deep learning methods for optic cup and disc segmentation were surveyed and critically reviewed.

Results

Eight fundus images datasets were publicly available with 15,445 images labeled with glaucoma or non-glaucoma, and manually annotated optic disc and cup boundaries were found. Five metrics were identified for evaluating the developed models. Finally, three main deep learning architectural designs were commonly used for optic disc and optic cup segmentation.

Conclusion

We provided future research directions to formulate robust optic cup and disc segmentation systems. Deep learning can be utilized in clinical settings for this task. However, many challenges need to be addressed before using this strategy in clinical trials. Finally, two deep learning architectural designs have been widely adopted, such as U-net and its variants.

Graph-Based Region and Boundary Aggregation for Biomedical Image Segmentation

Segmentation is a fundamental task in biomedical image analysis. Unlike the existing region-based dense pixel classification methods or boundary-based polygon regression methods, we build a novel graph neural network (GNN) based deep learning framework with multiple graph reasoning modules to explicitly leverage both region and boundary features in an end-to-end manner. The mechanism extracts discriminative region and boundary features, referred to as initialized region and boundary node embeddings, using a proposed Attention Enhancement Module (AEM). The weighted links between cross-domain nodes (region and boundary feature domains) in each graph are defined in a data-dependent way, which retains both global and local cross-node relationships. The iterative message aggregation and node update mechanism can enhance the interaction between each graph reasoning module's global semantic information and local spatial characteristics. Our model, in particular, is capable of concurrently addressing region and boundary feature reasoning and aggregation at several different feature levels due to the proposed multi-level feature node embeddings in different parallel graph reasoning modules. Experiments on two types of challenging datasets demonstrate that our method outperforms state-of-the-art approaches for segmentation of polyps in colonoscopy images and of the optic disc and optic cup in colour fundus images. The trained models will be made available at: https://github.com/smallmax00/Graph_Region_Boudnary.

A holistic overview of deep learning approach in medical imaging

Medical images are a rich source of invaluable necessary information used by clinicians. Recent technologies have introduced many advancements for exploiting the most of this information and use it to generate better analysis. Deep learning (DL) techniques have been empowered in medical images analysis using computer-assisted imaging contexts and presenting a lot of solutions and improvements while analyzing these images by radiologists and other specialists. In this paper, we present a survey of DL techniques used for variety of tasks along with the different medical image's modalities to provide critical review of the recent developments in this direction. We have organized our paper to provide significant contribution of deep leaning traits and learn its concepts, which is in turn helpful for non-expert in medical society. Then, we present several applications of deep learning (e.g., segmentation, classification, detection, etc.) which are commonly used for clinical purposes for different anatomical site, and we also present the main key terms for DL attributes like basic architecture, data augmentation, transfer learning, and feature selection methods. Medical images as inputs to deep learning architectures will be the mainstream in the coming years, and novel DL techniques are predicted to be the core of medical images analysis. We conclude our paper by addressing some research challenges and the suggested solutions for them found in literature, and also future promises and directions for further developments.

Multiscale U-Net with Spatial Positional Attention for Retinal Vessel Segmentation

Retinal vessel segmentation is essential for the detection and diagnosis of eye diseases. However, it is difficult to accurately identify the vessel boundary due to the large variations of scale in the retinal vessels and the low contrast between the vessel and the background. Deep learning has a good effect on retinal vessel segmentation since it can capture representative and distinguishing features for retinal vessels. An improved U-Net algorithm for retinal vessel segmentation is proposed in this paper. To better identify vessel boundaries, the traditional convolutional operation CNN is replaced by a global convolutional network and boundary refinement in the coding part. To better divide the blood vessel and background, the improved position attention module and channel attention module are introduced in the jumping connection part. Multiscale input and multiscale dense feature pyramid cascade modules are used to better obtain feature information. In the decoding part, convolutional long and short memory networks and deep dilated convolution are used to extract features. In public datasets, DRIVE and CHASE_DB1, the accuracy reached 96.99% and 97.51%. The average performance of the proposed algorithm is better than that of existing algorithms.

ECSD-Net: A joint optic disc and cup segmentation and glaucoma classification network based on unsupervised domain adaptation

BACKGROUND AND OBJECTIVES

Glaucoma can cause irreversible vision loss and even blindness, and early diagnosis can help prevent vision loss. Analyzing the optic disc and optic cup helps diagnose glaucoma, which motivates many computer-aided diagnosis methods based on deep learning networks. However, the performance of the trained model on new datasets is seriously hindered due to the distribution gap between different datasets. Therefore, we aim to develop an unsupervised learning method to solve this problem and improve the prediction performance of the model on new datasets.

METHODS

In this paper, we propose a novel unsupervised model based on adversarial learning to perform the optic disc and cup segmentation and glaucoma screening tasks in a more generalized and efficient manner. We adopt an efficient segmentation and classification network and employ unsupervised domain adaptation technology on the output space of the segmentation network to solve the domain shift problem. We conduct glaucoma screening task by combining classification and segmentation networks to obtain more stable and efficient glaucoma screening prediction.

RESULTS

We verify the effectiveness and efficiency of our proposed method on three public datasets, the REFUGE, DRISHTI-GS and RIM-ONE-r3 datasets. The experimental results demonstrate that the proposed method can effectively alleviate the deterioration of segmentation performance caused by domain shift and improve the accuracy of glaucoma screening. Furthermore, the proposed method outperforms state-of-the-art unsupervised optic disc and cup segmentation domain adaptation methods.

CONCLUSIONS

The proposed method can assist clinicians in screening and diagnosis of glaucoma and is suitable for real-world applications.

A Novel Hybrid Approach Based on Deep CNN to Detect Glaucoma Using Fundus Imaging

Glaucoma is one of the eye diseases stimulated by the fluid pressure that increases in the eyes, damaging the optic nerves and causing partial or complete vision loss. As Glaucoma appears in later stages and it is a slow disease, detailed screening and detection of the retinal images is required to avoid vision forfeiture. This study aims to detect glaucoma at early stages with the help of deep learning-based feature extraction. Retinal fundus images are utilized for the training and testing of our proposed model. In the first step, images are pre-processed, before the region of interest (ROI) is extracted employing segmentation. Then, features of the optic disc (OD) are extracted from the images containing optic cup (OC) utilizing the hybrid features descriptors, i.e., convolutional neural network (CNN), local binary patterns (LBP), histogram of oriented gradients (HOG), and speeded up robust features (SURF). Moreover, low-level features are extracted using HOG, whereas texture features are extracted using the LBP and SURF descriptors. Furthermore, high-level features are computed using CNN. Additionally, we have employed a feature selection and ranking technique, i.e., the MR-MR method, to select the most representative features. In the end, multi-class classifiers, i.e., support vector machine (SVM), random forest (RF), and K-nearest neighbor (KNN), are employed for the classification of fundus images as healthy or diseased. To assess the performance of the proposed system, various experiments have been performed using combinations of the aforementioned algorithms that show the proposed model based on the RF algorithm with HOG, CNN, LBP, and SURF feature descriptors, providing ≤99% accuracy on benchmark datasets and 98.8% on k-fold cross-validation for the early detection of glaucoma.

Co-optimization Learning Network for MRI Segmentation of Ischemic Penumbra Tissues

Convolutional neural networks (CNNs) have brought hope for the medical image auxiliary diagnosis. However, the shortfall of labeled medical image data is the bottleneck that limits the performance improvement of supervised CNN methods. In addition, annotating a large number of labeled medical image data is often expensive and time-consuming. In this study, we propose a co-optimization learning network (COL-Net) for Magnetic Resonance Imaging (MRI) segmentation of ischemic penumbra tissues. COL-Net base on the limited labeled samples and consists of an unsupervised reconstruction network (R), a supervised segmentation network (S), and a transfer block (T). The reconstruction network extracts the robust features from reconstructing pseudo unlabeled samples, which is the auxiliary branch of the segmentation network. The segmentation network is used to segment the target lesions under the limited labeled samples and the auxiliary of the reconstruction network. The transfer block is used to co-optimization the feature maps between the bottlenecks of the reconstruction network and segmentation network. We propose a mix loss function to optimize COL-Net. COL-Net is verified on the public ischemic penumbra segmentation challenge (SPES) with two dozen labeled samples. Results demonstrate that COL-Net has high predictive accuracy and generalization with the Dice coefficient of 0.79. The extended experiment also shows COL-Net outperforms most supervised segmentation methods. COL-Net is a meaningful attempt to alleviate the limited labeled sample problem in medical image segmentation.

AAU-Net: Attention-Based Asymmetric U-Net for Subject-Sensitive Hashing of Remote Sensing Images

The prerequisite for the use of remote sensing images is that their security must be guaranteed. As a special subset of perceptual hashing, subject-sensitive hashing overcomes the shortcomings of the existing perceptual hashing that cannot distinguish between “subject-related tampering” and “subject-unrelated tampering” of remote sensing images. However, the existing subject-sensitive hashing still has a large deficiency in robustness. In this paper, we propose a novel attention-based asymmetric U-Net (AAU-Net) for the subject-sensitive hashing of remote sensing (RS) images. Our AAU-Net demonstrates obvious asymmetric structure characteristics, which is important to improve the robustness of features by combining the attention mechanism and the characteristics of subject-sensitive hashing. On the basis of AAU-Net, a subject-sensitive hashing algorithm is developed to integrate the features of various bands of RS images. Our experimental results show that our AAU-Net-based subject-sensitive hashing algorithm is more robust than the existing deep learning models such as Attention U-Net and MUM-Net, and its tampering sensitivity remains at the same level as that of Attention U-Net and MUM-Net.

ALA-Net: Adaptive Lesion-Aware Attention Network for 3D Colorectal Tumor Segmentation

Accurate and reliable segmentation of colorectal tumors and surrounding colorectal tissues on 3D magnetic resonance images has critical importance in preoperative prediction, staging, and radiotherapy. Previous works simply combine multilevel features without aggregating representative semantic information and without compensating for the loss of spatial information caused by down-sampling. Therefore, they are vulnerable to noise from complex backgrounds and suffer from misclassification and target incompleteness-related failures. In this paper, we address these limitations with a novel adaptive lesion-aware attention network (ALA-Net) which explicitly integrates useful contextual information with spatial details and captures richer feature dependencies based on 3D attention mechanisms. The model comprises two parallel encoding paths. One of these is designed to explore global contextual features and enlarge the receptive field using a recurrent strategy. The other captures sharper object boundaries and the details of small objects that are lost in repeated down-sampling layers. Our lesion-aware attention module adaptively captures long-range semantic dependencies and highlights the most discriminative features, improving semantic consistency and completeness. Furthermore, we introduce a prediction aggregation module to combine multiscale feature maps and to further filter out irrelevant information for precise voxel-wise prediction. Experimental results show that ALA-Net outperforms state-of-the-art methods and inherently generalizes well to other 3D medical images segmentation tasks, providing multiple benefits in terms of target completeness, reduction of false positives, and accurate detection of ambiguous lesion regions.

Automated delineation of corneal layers on OCT images using a boundary-guided CNN

Accurate segmentation of corneal layers depicted on optical coherence tomography (OCT) images is very helpful for quantitatively assessing and diagnosing corneal diseases (e.g., keratoconus and dry eye). In this study, we presented a novel boundary-guided convolutional neural network (CNN) architecture (BG-CNN) to simultaneously extract different corneal layers and delineate their boundaries. The developed BG-CNN architecture used three convolutional blocks to construct two network modules on the basis of the classical U-Net network. We trained and validated the network on a dataset consisting of 1,712 OCT images acquired on 121 subjects using a 10-fold cross-validation method. Our experiments showed an average dice similarity coefficient (DSC) of 0.9691, an intersection over union (IOU) of 0.9411, and a Hausdorff distance (HD) of 7.4423 pixels. Compared with several other classical networks, namely U-Net, Attention U-Net, Asymmetric U-Net, BiO-Net, CE-Net, CPFnte, M-Net, and Deeplabv3, on the same dataset, the developed network demonstrated a promising performance, suggesting its unique strength in segmenting corneal layers depicted on OCT images.

Diagnosing glaucoma on imbalanced data with self-ensemble dual-curriculum learning

Glaucoma diagnosis often suffers from two types of data imbalances: 1) class imbalance, i.e., the non-glaucoma majority cases occupy most of the data; 2) rare cases, i.e., few cases present the uncommon retinopathy e.g., bayoneting or physiologic cupping. This dual-imbalances make glaucoma diagnosis model easy to be dominated by the majority cases but cannot correctly classify the minority and/or rare ones. In this paper, we propose an adaptive re-balancing strategy in the feature space, Self-Ensemble Dual-Curriculum learning (SEDC), to improve the glaucoma diagnosis on imbalanced data by augmenting feature distribution with feature distilling and feature re-weighting. Firstly, the self-ensembling (SEL) is developed to reinforce the discriminative ability of feature representations for the minority class and rare cases by distilling the features learned from the abundant majority cases. Secondly, the dual-curriculum (DCL) is designed to adaptively re-weight the imbalanced data in the feature space to learn a balanced decision function for accurate glaucoma diagnosis. Benefiting from feature distilling and re-weighting, the proposed SEDC fairly represents fundus images, regardless of the majority or rare cases, by augmenting the feature distribution to obtains the optimal decision boundary for accurate glaucoma diagnosis on the imbalanced dataset. Experimental results on three challenging glaucoma datasets show that our SEDC successfully delivers accurate glaucoma diagnosis by the adaptive re-balancing strategy, with the average mean value of Accuracy 0.9712, Sensitivity 0.9520, Specificity 0.9816, AUC 0.9928, F2-score 0.9547. Ablation and comparison studies demonstrate that our method outperforms state-of-the-art methods and traditional re-balancing strategies. The experiment also shows that the adaptive re-balancing strategy proposed in our method provides a more effective training approach with optimal convergence performance. It endows our SEDC a great advantage to handle the disease diagnosis on imbalanced data distribution.

A Novel Context Aware Joint Segmentation and Classification Framework for Glaucoma Detection

Glaucoma is a chronic ocular disease characterized by damage to the optic nerve resulting in progressive and irreversible visual loss. Early detection and timely clinical interventions are critical in improving glaucoma-related outcomes. As a typical and complicated ocular disease, glaucoma detection presents a unique challenge due to its insidious onset and high intra- and interpatient variabilities. Recent studies have demonstrated that robust glaucoma detection systems can be realized with deep learning approaches. The optic disc (OD) is the most commonly studied retinal structure for screening and diagnosing glaucoma. This paper proposes a novel context aware deep learning framework called GD-YNet, for OD segmentation and glaucoma detection. It leverages the potential of aggregated transformations and the simplicity of the YNet architecture in context aware OD segmentation and binary classification for glaucoma detection. Trained with the RIGA and RIMOne-V2 datasets, this model achieves glaucoma detection accuracies of 99.72%, 98.02%, 99.50%, and 99.41% with the ACRIMA, Drishti-gs, REFUGE, and RIMOne-V1 datasets. Further, the proposed model can be extended to a multiclass segmentation and classification model for glaucoma staging and severity assessment.

Surgical instrument segmentation based on multi-scale and multi-level feature network

Surgical instrument segmentation is critical for the field of computer-aided surgery system. Most of deep-learning based algorithms only use either multi-scale information or multi-level information, which may lead to ambiguity of semantic information. In this paper, we propose a new neural network, which extracts both multi-scale and multilevel features based on the backbone of U-net. Specifically, the cascaded and double convolutional feature pyramid is input into the U-net. Then we propose a DFP (short for Dilation Feature-Pyramid) module for decoder which extracts multi-scale and multi-level information. The proposed algorithm is evaluated on two publicly available datasets, and extensive experiments prove that the five evaluation metrics by our algorithm are superior than other comparing methods.

Deep level set method for optic disc and cup segmentation on fundus images

Glaucoma is a leading cause of blindness. The measurement of vertical cup-to-disc ratio combined with other clinical features is one of the methods used to screen glaucoma. In this paper, we propose a deep level set method to implement the segmentation of optic cup (OC) and optic disc (OD). We present a multi-scale convolutional neural network as the prediction network to generate level set initial contour and evolution parameters. The initial contour will be further refined based on the evolution parameters. The network is integrated with augmented prior knowledge and supervised by active contour loss, which makes the level set evolution yield more accurate shape and boundary details. The experimental results on the REFUGE dataset show that the IoU of the OC and OD are 93.61% and 96.69%, respectively. To evaluate the robustness of the proposed method, we further test the model on the Drishthi-GS1 dataset. The segmentation results show that the proposed method outperforms the state-of-the-art methods.

Fundus image segmentation via hierarchical feature learning

Fundus Image Segmentation (FIS) is an essential procedure for the automated diagnosis of ophthalmic diseases. Recently, deep fully convolutional networks have been widely used for FIS with state-of-the-art performance. The representative deep model is the U-Net, which follows an encoder-decoder architecture. I believe it is suboptimal for FIS because consecutive pooling operations in the encoder lead to low-resolution representation and loss of detailed spatial information, which is particularly important for the segmentation of tiny vessels and lesions. Motivated by this, a high-resolution hierarchical network (HHNet) is proposed to learn semantic-rich high-resolution representations and preserve spatial details simultaneously. Specifically, a High-resolution Feature Learning (HFL) module with increasing dilation rates was first designed to learn the high-level high-resolution representations. Then, the HHNet was constructed by incorporating three HFL modules and two feature aggregation modules. The HHNet runs in a coarse-to-fine manner, and fine segmentation maps are output at the last level. Extensive experiments were conducted on fundus lesion segmentation, vessel segmentation, and optic cup segmentation. The experimental results reveal that the proposed method shows highly competitive or even superior performance in terms of segmentation performance and computation cost, indicating its potential advantages in clinical application.

NENet: Nested EfficientNet and adversarial learning for joint optic disc and cup segmentation

Glaucoma is an ocular disease threatening irreversible vision loss. Primary screening of Glaucoma involves computation of optic cup (OC) to optic disc (OD) ratio that is widely accepted metric. Recent deep learning frameworks for OD and OC segmentation have shown promising results and ways to attain remarkable performance. In this paper, we present a novel segmentation network, Nested EfficientNet (NENet) that consists of EfficientNetB4 as an encoder along with a nested network of pre-activated residual blocks, atrous spatial pyramid pooling (ASPP) block and attention gates (AGs). The combination of cross-entropy and dice coefficient (DC) loss is utilized to guide the network for accurate segmentation. Further, a modified patch-based discriminator is designed for use with the NENet to improve the local segmentation details. Three publicly available datasets, REFUGE, Drishti-GS, and RIM-ONE-r3 were utilized to evaluate the performances of the proposed network. In our experiments, NENet outperformed state-of-the-art methods for segmentation of OD and OC. Additionally, we show that NENet has excellent generalizability across camera types and image resolution. The obtained results suggest that the proposed technique has potential to be an important component for an automated Glaucoma screening system.

GDCSeg-Net: general optic disc and cup segmentation network for multi-device fundus images

Accurate segmentation of optic disc (OD) and optic cup (OC) in fundus images is crucial for the analysis of many retinal diseases, such as the screening and diagnosis of glaucoma and atrophy segmentation. Due to domain shift between different datasets caused by different acquisition devices and modes and inadequate training caused by small sample dataset, the existing deep-learning-based OD and OC segmentation networks have poor generalization ability for different fundus image datasets. In this paper, adopting the mixed training strategy based on different datasets for the first time, we propose an encoder-decoder based general OD and OC segmentation network (named as GDCSeg-Net) with the newly designed multi-scale weight-shared attention (MSA) module and densely connected depthwise separable convolution (DSC) module, to effectively overcome these two problems. Experimental results show that our proposed GDCSeg-Net is competitive with other state-of-the-art methods on five different public fundus image datasets, including REFUGE, MESSIDOR, RIM-ONE-R3, Drishti-GS and IDRiD.

Leveraging Regular Fundus Images for Training UWF Fundus Diagnosis Models via Adversarial Learning and Pseudo-Labeling

Recently, ultra-widefield (UWF) 200° fundus imaging by Optos cameras has gradually been introduced because of its broader insights for detecting more information on the fundus than regular 30° - 60° 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 images to improve the limited UWF fundus data and annotations for more efficient training. We propose the use of a modified cycle generative adversarial network (CycleGAN) model to bridge the gap between regular and UWF fundus and generate additional UWF fundus images for training. A consistency regularization term is proposed in the loss of the GAN to improve and regulate the quality of the generated data. Our method does not require that images from the two domains be paired or even that the semantic labels be the same, which provides great convenience for data collection. Furthermore, we show that our method is robust to noise and errors introduced by the generated unlabeled data with the pseudo-labeling technique. We evaluated the effectiveness of our methods on several common fundus diseases and tasks, such as diabetic retinopathy (DR) classification, lesion detection and tessellated fundus segmentation. The experimental results demonstrate that our proposed method simultaneously achieves superior generalizability of the learned representations and performance improvements in multiple tasks.

Joint optic disc and cup segmentation based on multi-scale feature analysis and attention pyramid architecture for glaucoma screening

Automatic segmentation of optic disc (OD) and optic cup (OC) is an essential task for analysing colour fundus images. In clinical practice, accurate OD and OC segmentation assist ophthalmologists in diagnosing glaucoma. In this paper, we propose a unified convolutional neural network, named ResFPN-Net, which learns the boundary feature and the inner relation between OD and OC for automatic segmentation. The proposed ResFPN-Net is mainly composed of multi-scale feature extractor, multi-scale segmentation transition and attention pyramid architecture. The multi-scale feature extractor achieved the feature encoding of fundus images and captured the boundary representations. The multi-scale segmentation transition is employed to retain the features of different scales. Moreover, an attention pyramid architecture is proposed to learn rich representations and the mutual connection in the OD and OC. To verify the effectiveness of the proposed method, we conducted extensive experiments on two public datasets. On the Drishti-GS database, we achieved a Dice coefficient of 97.59%, 89.87%, the accuracy of 99.21%, 98.77%, and the Averaged Hausdorff distance of 0.099, 0.882 on the OD and OC segmentation, respectively. We achieved a Dice coefficient of 96.41%, 83.91%, the accuracy of 99.30%, 99.24%, and the Averaged Hausdorff distance of 0.166, 1.210 on the RIM-ONE database for OD and OC segmentation, respectively. Comprehensive results show that the proposed method outperforms other competitive OD and OC segmentation methods and appears more adaptable in cross-dataset scenarios. The introduced multi-scale loss function achieved significantly lower training loss and higher accuracy compared with other loss functions. Furthermore, the proposed method is further validated in OC to OD ratio calculation task and achieved the best MAE of 0.0499 and 0.0630 on the Drishti-GS and RIM-ONE datasets, respectively. Finally, we evaluated the effectiveness of the glaucoma screening on Drishti-GS and RIM-ONE datasets, achieving the AUC of 0.8947 and 0.7964. These results proved that the proposed ResFPN-Net is effective in analysing fundus images for glaucoma screening and can be applied in other relative biomedical image segmentation applications.

Deep Relation Transformer for Diagnosing Glaucoma With Optical Coherence Tomography and Visual Field Function

Glaucoma is the leading reason for irreversible blindness. Early detection and timely treatment of glaucoma are essential for preventing visual field loss or even blindness. In clinical practice, Optical Coherence Tomography (OCT) and Visual Field (VF) exams are two widely-used and complementary techniques for diagnosing glaucoma. OCT provides quantitative measurements of the optic nerve head (ONH) structure, while VF test is the functional assessment of peripheral vision. In this paper, we propose a Deep Relation Transformer (DRT) to perform glaucoma diagnosis with OCT and VF information combined. A novel deep reasoning mechanism is proposed to explore implicit pairwise relations between OCT and VF information in global and regional manners. With the pairwise relations, a carefully-designed deep transformer mechanism is developed to enhance the representation with complementary information for each modal. Based on reasoning and transformer mechanisms, three successive modules are designed to extract and collect valuable information for glaucoma diagnosis, the global relation module, the guided regional relation module, and the interaction transformer module, namely. Moreover, we build a large dataset, namely ZOC-OCT&VF dataset, which includes 1395 OCT-VF pairs for developing and evaluating our DRT. We conduct extensive experiments to validate the effectiveness of the proposed method. Experimental results show that our method achieves 88.3% accuracy and outperforms the existing single-modal approaches with a large margin. The codes and dataset will be publicly available in the future.

Fully Convolutional Network and Visual Saliency-Based Automatic Optic Disc Detection in Retinal Fundus Images

We present in this paper a novel optic disc detection method based on a fully convolutional network and visual saliency in retinal fundus images. Firstly, we employ the morphological reconstruction-based object detection method to locate the optic disc region roughly. According to the location result, a 400 × 400 image patch that covers the whole optic disc is obtained by cropping the original retinal fundus image. Secondly, the Simple Linear Iterative Cluster approach is utilized to segment such an image patch into many smaller superpixels. Thirdly, each superpixel is assigned a uniform initial saliency value according to the background prior information based on the assumption that the superpixels located on the boundary of the image belong to the background. Meanwhile, we use a pretrained fully convolutional network to extract the deep features from different layers of the network and design the strategy to represent each superpixel by the deep features. Finally, both the background prior information and the deep features are integrated into the single-layer cellular automata framework to gain the accurate optic disc detection result. We utilize the DRISHTI-GS dataset and RIM-ONE r3 dataset to evaluate the performance of our method. The experimental results demonstrate that the proposed method can overcome the influence of intensity inhomogeneity, weak contrast, and the complex surroundings of the optic disc effectively and has superior performance in terms of accuracy and robustness.

Simultaneous segmentation and classification of the retinal arteries and veins from color fundus images

BACKGROUND AND OBJECTIVES

The study of the retinal vasculature represents a fundamental stage in the screening and diagnosis of many high-incidence diseases, both systemic and ophthalmic. A complete retinal vascular analysis requires the segmentation of the vascular tree along with the classification of the blood vessels into arteries and veins. Early automatic methods approach these complementary segmentation and classification tasks in two sequential stages. However, currently, these two tasks are approached as a joint semantic segmentation, because the classification results highly depend on the effectiveness of the vessel segmentation. In that regard, we propose a novel approach for the simultaneous segmentation and classification of the retinal arteries and veins from eye fundus images.

METHODS

We propose a novel method that, unlike previous approaches, and thanks to the proposal of a novel loss, decomposes the joint task into three segmentation problems targeting arteries, veins and the whole vascular tree. This configuration allows to handle vessel crossings intuitively and directly provides accurate segmentation masks of the different target vascular trees.

RESULTS

The provided ablation study on the public Retinal Images vessel Tree Extraction (RITE) dataset demonstrates that the proposed method provides a satisfactory performance, particularly in the segmentation of the different structures. Furthermore, the comparison with the state of the art shows that our method achieves highly competitive results in the artery/vein classification, while significantly improving the vascular segmentation.

CONCLUSIONS

The proposed multi-segmentation method allows to detect more vessels and better segment the different structures, while achieving a competitive classification performance. Also, in these terms, our approach outperforms the approaches of various reference works. Moreover, in contrast with previous approaches, the proposed method allows to directly detect the vessel crossings, as well as preserving the continuity of both arteries and veins at these complex locations.

S-CCCapsule: Pneumonia detection in chest X-ray images using skip-connected convolutions and capsule neural network

The squash function in capsule networks (CapsNets) dynamic routing is less capable of performing discrimination of non-informative capsules which leads to abnormal activation value distribution of capsules. In this paper, we propose vertical squash (VSquash) to improve the original squash by preventing the activation values of capsules in the primary capsule layer to shrink non-informative capsules, promote discriminative capsules and avoid high information sensitivity. Furthermore, a new neural network, (i) skip-connected convolutional capsule (S-CCCapsule), (ii) Integrated skip-connected convolutional capsules (ISCC) and (iii) Ensemble skip-connected convolutional capsules (ESCC) based on CapsNets are presented where the VSquash is applied in the dynamic routing. In order to achieve uniform distribution of coupling coefficient of probabilities between capsules, we use the Sigmoid function rather than Softmax function. Experiments on Guangzhou Women and Children’s Medical Center (GWCMC), Radiological Society of North America (RSNA) and Mendeley CXR Pneumonia datasets were performed to validate the effectiveness of our proposed methods. We found that our proposed methods produce better accuracy compared to other methods based on model evaluation metrics such as confusion matrix, sensitivity, specificity and Area under the curve (AUC). Our method for pneumonia detection performs better than practicing radiologists. It minimizes human error and reduces diagnosis time.

CLCU-Net: Cross-level connected U-shaped network with selective feature aggregation attention module for brain tumor segmentation

BACKGROUND AND OBJECTIVE

Brain tumors are among the most deadly cancers worldwide. Due to the development of deep convolutional neural networks, many brain tumor segmentation methods help clinicians diagnose and operate. However, most of these methods insufficiently use multi-scale features, reducing their ability to extract brain tumors' features and details. To assist clinicians in the accurate automatic segmentation of brain tumors, we built a new deep learning network to make full use of multi-scale features for improving the performance of brain tumor segmentation.

METHODS

We propose a novel cross-level connected U-shaped network (CLCU-Net) to connect different scales' features for fully utilizing multi-scale features. Besides, we propose a generic attention module (Segmented Attention Module, SAM) on the connections of different scale features for selectively aggregating features, which provides a more efficient connection of different scale features. Moreover, we employ deep supervision and spatial pyramid pooling (SSP) to improve the method's performance further.

RESULTS

We evaluated our method on the BRATS 2018 dataset by five indexes and achieved excellent performance with a Dice Score of 88.5%, a Precision of 91.98%, a Recall of 85.62%, a Params of 36.34M and Inference Time of 8.89ms for the whole tumor, which outperformed six state-of-the-art methods. Moreover, the performed analysis of different attention modules' heatmaps proved that the attention module proposed in this study was more suitable for segmentation tasks than the other existing popular attention modules.

CONCLUSION

Both the qualitative and quantitative experimental results indicate that our cross-level connected U-shaped network with selective feature aggregation attention module can achieve accurate brain tumor segmentation and is considered quite instrumental in clinical practice implementation.

Fully automated segmentation of brain tumor from multiparametric MRI using 3D context deep supervised U-Net

PURPOSE

Owing to histologic complexities of brain tumors, its diagnosis requires the use of multimodalities to obtain valuable structural information so that brain tumor subregions can be properly delineated. In current clinical workflow, physicians typically perform slice-by-slice delineation of brain tumor subregions, which is a time-consuming process and also more susceptible to intra- and inter-rater variabilities possibly leading to misclassification. To deal with this issue, this study aims to develop an automatic segmentation of brain tumor in MR images using deep learning.

METHOD

In this study, we develop a context deep-supervised U-Net to segment brain tumor subregions. A context block which aggregates multiscale contextual information for dense segmentation was proposed. This approach enlarges the effective receptive field of convolutional neural networks, which, in turn, improves the segmentation accuracy of brain tumor subregions. We performed the fivefold cross-validation on the Brain Tumor Segmentation Challenge (BraTS) 2020 training dataset. The BraTS 2020 testing datasets were obtained via BraTS online website as a hold-out test. For BraTS, the evaluation system divides the tumor into three regions: whole tumor (WT), tumor core (TC), and enhancing tumor (ET). The performance of our proposed method was compared against two state-of-the-arts CNN networks in terms of segmentation accuracy via Dice similarity coefficient (DSC) and Hausdorff distance (HD). The tumor volumes generated by our proposed method were compared with manually contoured volumes via Bland-Altman plots and Pearson analysis.

RESULTS

The proposed method achieved the segmentation results with a DSC of 0.923 ± 0.047, 0.893 ± 0.176, and 0.846 ± 0.165 and a 95% HD95 of 3.946 ± 7.041, 3.981 ± 6.670, and 10.128 ± 51.136 mm on WT, TC, and ET, respectively. Experimental results demonstrate that our method achieved comparable to significantly (p < 0.05) better segmentation accuracies than other two state-of-the-arts CNN networks. Pearson correlation analysis showed a high positive correlation between the tumor volumes generated by proposed method and manual contour.

CONCLUSION

Overall qualitative and quantitative results of this work demonstrate the potential of translating proposed technique into clinical practice for segmenting brain tumor subregions, and further facilitate brain tumor radiotherapy workflow.

Artificial intelligence in tumor subregion analysis based on medical imaging: A review

Medical imaging is widely used in the diagnosis and treatment of cancer, and artificial intelligence (AI) has achieved tremendous success in medical image analysis. This paper reviews AI-based tumor subregion analysis in medical imaging. We summarize the latest AI-based methods for tumor subregion analysis and their applications. Specifically, we categorize the AI-based methods by training strategy: supervised and unsupervised. A detailed review of each category is presented, highlighting important contributions and achievements. Specific challenges and potential applications of AI in tumor subregion analysis are discussed.