Improving vessel segmentation in ultra-wide field-of-view retinal fluorescein angiograms

ELEMENT: Multi-Modal Retinal Vessel Segmentation Based on a Coupled Region Growing and Machine Learning Approach

Vascular structures in the retina contain important information for the detection and analysis of ocular diseases, including age-related macular degeneration, diabetic retinopathy and glaucoma. Commonly used modalities in diagnosis of these diseases are fundus photography, scanning laser ophthalmoscope (SLO) and fluorescein angiography (FA). Typically, retinal vessel segmentation is carried out either manually or interactively, which makes it time consuming and prone to human errors. In this research, we propose a new multi-modal framework for vessel segmentation called ELEMENT (vEsseL sEgmentation using Machine lEarning and coNnecTivity). This framework consists of feature extraction and pixel-based classification using region growing and machine learning. The proposed features capture complementary evidence based on grey level and vessel connectivity properties. The latter information is seamlessly propagated through the pixels at the classification phase. ELEMENT reduces inconsistencies and speeds up the segmentation throughput. We analyze and compare the performance of the proposed approach against state-of-the-art vessel segmentation algorithms in three major groups of experiments, for each of the ocular modalities. Our method produced higher overall performance, with an overall accuracy of 97.40%, compared to 25 of the 26 state-of-the-art approaches, including six works based on deep learning, evaluated on the widely known DRIVE fundus image dataset. In the case of the STARE, CHASE-DB, VAMPIRE FA, IOSTAR SLO and RC-SLO datasets, the proposed framework outperformed all of the state-of-the-art methods with accuracies of 98.27%, 97.78%, 98.34%, 98.04% and 98.35%, respectively.

A Novel Deep Learning Pipeline for Retinal Vessel Detection In Fluorescein Angiography

While recent advances in deep learning have significantly advanced the state of the art for vessel detection in color fundus (CF) images, the success for detecting vessels in fluorescein angiography (FA) has been stymied due to the lack of labeled ground truth datasets. We propose a novel pipeline to detect retinal vessels in FA images using deep neural networks (DNNs) that reduces the effort required for generating labeled ground truth data by combining two key components: cross-modality transfer and human-in-the-loop learning. The cross-modality transfer exploits concurrently captured CF and fundus FA images. Binary vessels maps are first detected from CF images with a pre-trained neural network and then are geometrically registered with and transferred to FA images via robust parametric chamfer alignment to a preliminary FA vessel detection obtained with an unsupervised technique. Using the transferred vessels as initial ground truth labels for deep learning, the human-in-the-loop approach progressively improves the quality of the ground truth labeling by iterating between deep-learning and labeling. The approach significantly reduces manual labeling effort while increasing engagement. We highlight several important considerations for the proposed methodology and validate the performance on three datasets. Experimental results demonstrate that the proposed pipeline significantly reduces the annotation effort and the resulting deep learning methods outperform prior existing FA vessel detection methods by a significant margin. A new public dataset, RECOVERY-FA19, is introduced that includes high-resolution ultra-widefield images and accurately labeled ground truth binary vessel maps.

Automated Vessel Segmentation Using Infinite Perimeter Active Contour Model with Hybrid Region Information with Application to Retinal Images

Automated detection of blood vessel structures is becoming of crucial interest for better management of vascular disease. In this paper, we propose a new infinite active contour model that uses hybrid region information of the image to approach this problem. More specifically, an infinite perimeter regularizer, provided by using L(2) Lebesgue measure of the γ -neighborhood of boundaries, allows for better detection of small oscillatory (branching) structures than the traditional models based on the length of a feature's boundaries (i.e., H(1) Hausdorff measure). Moreover, for better general segmentation performance, the proposed model takes the advantage of using different types of region information, such as the combination of intensity information and local phase based enhancement map. The local phase based enhancement map is used for its superiority in preserving vessel edges while the given image intensity information will guarantee a correct feature's segmentation. We evaluate the performance of the proposed model by applying it to three public retinal image datasets (two datasets of color fundus photography and one fluorescein angiography dataset). The proposed model outperforms its competitors when compared with other widely used unsupervised and supervised methods. For example, the sensitivity (0.742), specificity (0.982) and accuracy (0.954) achieved on the DRIVE dataset are very close to those of the second observer's annotations.

Automated Detection of Vessel Abnormalities on Fluorescein Angiogram in Malarial Retinopathy

The detection and assessment of intravascular filling defects is important, because they may represent a process central to cerebral malaria pathogenesis: neurovascular sequestration. We have developed and validated a framework that can automatically detect intravascular filling defects in fluorescein angiogram images. It first employs a state-of-the-art segmentation approach to extract the vessels from images and then divide them into individual segments by geometrical analysis. A feature vector based on the intensity and shape of saliency maps is generated to represent the level of abnormality of each vessel segment. An AdaBoost classifier with weighted cost coefficient is trained to classify the vessel segments into normal and abnormal categories. To demonstrate its effectiveness, we apply this framework to 6,358 vessel segments in images from 10 patients with malarial retinopathy. The test sensitivity, specificity, accuracy, and area under curve (AUC) are 74.7%, 73.5%, 74.1% and 74.2% respectively when compared to the reference standard of human expert manual annotations. This performance is comparable to the agreement that we find between human observers of intravascular filling defects. Our method will be a powerful new tool for studying malarial retinopathy.

Retinal vessel segmentation: an efficient graph cut approach with retinex and local phase

Our application concerns the automated detection of vessels in retinal images to improve understanding of the disease mechanism, diagnosis and treatment of retinal and a number of systemic diseases. We propose a new framework for segmenting retinal vasculatures with much improved accuracy and efficiency. The proposed framework consists of three technical components: Retinex-based image inhomogeneity correction, local phase-based vessel enhancement and graph cut-based active contour segmentation. These procedures are applied in the following order. Underpinned by the Retinex theory, the inhomogeneity correction step aims to address challenges presented by the image intensity inhomogeneities, and the relatively low contrast of thin vessels compared to the background. The local phase enhancement technique is employed to enhance vessels for its superiority in preserving the vessel edges. The graph cut-based active contour method is used for its efficiency and effectiveness in segmenting the vessels from the enhanced images using the local phase filter. We have demonstrated its performance by applying it to four public retinal image datasets (3 datasets of color fundus photography and 1 of fluorescein angiography). Statistical analysis demonstrates that each component of the framework can provide the level of performance expected. The proposed framework is compared with widely used unsupervised and supervised methods, showing that the overall framework outperforms its competitors. For example, the achieved sensitivity (0:744), specificity (0:978) and accuracy (0:953) for the DRIVE dataset are very close to those of the manual annotations obtained by the second observer.

RERBEE: robust efficient registration via bifurcations and elongated elements applied to retinal fluorescein angiogram sequences

We present RERBEE (robust efficient registration via bifurcations and elongated elements), a novel feature-based registration algorithm able to correct local deformations in high-resolution ultra-wide field-of-view (UWFV) fluorescein angiogram (FA) sequences of the retina. The algorithm is able to cope with peripheral blurring, severe occlusions, presence of retinal pathologies and the change of image content due to the perfusion of the fluorescein dye in time. We have used the computational power of a graphics processor to increase the performance of the most computationally expensive parts of the algorithm by a factor of over × 1300, enabling the algorithm to register a pair of 3900 × 3072 UWFV FA images in 5-10 min instead of the 5-7 h required using only the CPU. We demonstrate accurate results on real data with 267 image pairs from a total of 277 (96.4%) graded as correctly registered by a clinician and 10 (3.6%) graded as correctly registered with minor errors but usable for clinical purposes. Quantitative comparison with state-of-the-art intensity-based and feature-based registration methods using synthetic data is also reported. We also show some potential usage of a correctly aligned sequence for vein/artery discrimination and automatic lesion detection.