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

Automated Quantitative Analysis of Blood Flow in Extracranial-Intracranial Arterial Bypass Based on Indocyanine Green Angiography

Microvascular imaging based on indocyanine green is an important tool for surgeons who carry out extracranial–intracranial arterial bypass surgery. In terms of blood perfusion, indocyanine green images contain abundant information, which cannot be effectively interpreted by humans or currently available commercial software. In this paper, an automatic processing framework for perfusion assessments based on indocyanine green videos is proposed and consists of three stages, namely, vessel segmentation based on the UNet deep neural network, preoperative and postoperative image registrations based on scale-invariant transform features, and blood flow evaluation based on the Horn–Schunck optical flow method. This automatic processing flow can reveal the blood flow direction and intensity curve of any vessel, as well as the blood perfusion changes before and after an operation. Commercial software embedded in a microscope is used as a reference to evaluate the effectiveness of the algorithm in this study. A total of 120 patients from multiple centers were sampled for the study. For blood vessel segmentation, a Dice coefficient of 0.80 and a Jaccard coefficient of 0.73 were obtained. For image registration, the success rate was 81%. In preoperative and postoperative video processing, the coincidence rates between the automatic processing method and commercial software were 89 and 87%, respectively. The proposed framework not only achieves blood perfusion analysis similar to that of commercial software but also automatically detects and matches blood vessels before and after an operation, thus quantifying the flow direction and enabling surgeons to intuitively evaluate the perfusion changes caused by bypass surgery.

Retinal image mosaicking using scale-invariant feature transformation feature descriptors and Voronoi diagram

Purpose: Peripheral retinal lesions substantially increase the risk of diabetic retinopathy and retinopathy of prematurity. The peripheral changes can be visualized in wide field imaging, which is obtained by combining multiple images with an overlapping field of view using mosaicking methods. However, a robust and accurate registration of mosaicking techniques for normal angle fundus cameras is still a challenge due to the random selection of matching points and execution time. We propose a method of retinal image mosaicking based on scale-invariant feature transformation (SIFT) feature descriptor and Voronoi diagram. Approach: In our method, the SIFT algorithm is used to describe local features in the input images. Then the input images are subdivided into regions based on the Voronoi method. Each pair of Voronoi regions is matched by the method zero mean normalized cross correlation. After matching, the retinal images are mapped into the same coordinate system to form a mosaic image. The success rate and the mean registration error (RE) of our method were compared with those of other state-of-the-art methods for the P category of the fundus image registration database. Results: Experimental results show that the proposed method accurately registered 42% of retinal image pairs with a mean RE of 3.040 pixels, while a lower success rate was observed in the other four state-of-the-art retinal image registration methods GDB-ICP (33%), Harris-PIIFD (0%), HM-2016 (0%), and HM-2017 (2%). Conclusions: The proposed method outperforms state-of-the-art methods in terms of quality and running time and reduces the computational complexity.

Automatic measurement of global retinal circulation in fluorescein angiography

Examination of the retinal circulation in patients with retinal diseases is a clinical routine for ophthalmologists. In the present work, an automatic method is proposed for measuring the global retinal circulation in fluorescein angiography (FA). First, the perfusion region in FA images is segmented using a multiscale line detector. Then, the time evolution of the perfusion area is modeled using damped least-squares regression. Based on the perfusion area profile, some circulation parameters are defined to describe quantitatively the global retinal circulation. The effectiveness of the proposed method is tested using our own and public datasets, with reasonable results and satisfactory accuracy compared with manual measurement. The proposed method has good computing efficiency and thus has potential to be used in clinical practice for evaluation of global retinal circulation.

Feature-Based Retinal Image Registration Using D-Saddle Feature

Retinal image registration is important to assist diagnosis and monitor retinal diseases, such as diabetic retinopathy and glaucoma. However, registering retinal images for various registration applications requires the detection and distribution of feature points on the low-quality region that consists of vessels of varying contrast and sizes. A recent feature detector known as Saddle detects feature points on vessels that are poorly distributed and densely positioned on strong contrast vessels. Therefore, we propose a multiresolution difference of Gaussian pyramid with Saddle detector (D-Saddle) to detect feature points on the low-quality region that consists of vessels with varying contrast and sizes. D-Saddle is tested on Fundus Image Registration (FIRE) Dataset that consists of 134 retinal image pairs. Experimental results show that D-Saddle successfully registered 43% of retinal image pairs with average registration accuracy of 2.329 pixels while a lower success rate is observed in other four state-of-the-art retinal image registration methods GDB-ICP (28%), Harris-PIIFD (4%), H-M (16%), and Saddle (16%). Furthermore, the registration accuracy of D-Saddle has the weakest correlation (Spearman) with the intensity uniformity metric among all methods. Finally, the paired t-test shows that D-Saddle significantly improved the overall registration accuracy of the original Saddle.

Accurate Joint-Alignment of Indocyanine Green and Fluorescein Angiograph Sequences for Treatment of Subretinal Lesions

In ophthalmology, aligning images in indocyanine green and fluorescein angiograph sequences is important for the treatment of subretinal lesions. This paper introduces an algorithm that is tailored to align jointly in a common reference space all the images in an angiogram sequence containing both modalities. To overcome the issues of low image contrast and low signal-to-noise ratio for late-phase images, the structural similarity between two images is enhanced using Gabor wavelet transform. Image pairs are pairwise registered and the transformations are simultaneously and globally adjusted for a mutually consistent joint alignment. The joint registration process is incremental and the success depends on the correctness of matches from the pairwise registration. To safeguard the joint process, our system performs the consistency test to exclude incorrect pairwise results automatically to ensure correct matches as more images are jointly aligned. Our dataset consists of 60 sequences of polypoidal choroidal vasculopathy collected by the EVEREST Study Group. On average, each sequence contains 20 images. Our algorithm successfully pairwise registered 95.04% of all image pairs, and joint registered 98.7% of all images, with an average alignment error of 1.58 pixels.

Registration of retinal sequences from new video-ophthalmoscopic camera

Background

Analysis of fast temporal changes on retinas has become an important part of diagnostic video-ophthalmology. It enables investigation of the hemodynamic processes in retinal tissue, e.g. blood-vessel diameter changes as a result of blood-pressure variation, spontaneous venous pulsation influenced by intracranial-intraocular pressure difference, blood-volume changes as a result of changes in light reflection from retinal tissue, and blood flow using laser speckle contrast imaging. For such applications, image registration of the recorded sequence must be performed.

Methods

Here we use a new non-mydriatic video-ophthalmoscope for simple and fast acquisition of low SNR retinal sequences. We introduce a novel, two-step approach for fast image registration. The phase correlation in the first stage removes large eye movements. Lucas-Kanade tracking in the second stage removes small eye movements. We propose robust adaptive selection of the tracking points, which is the most important part of tracking-based approaches. We also describe a method for quantitative evaluation of the registration results, based on vascular tree intensity profiles.

Results

The achieved registration error evaluated on 23 sequences (5840 frames) is 0.78 ± 0.67 pixels inside the optic disc and 1.39 ± 0.63 pixels outside the optic disc. We compared the results with the commonly used approaches based on Lucas-Kanade tracking and scale-invariant feature transform, which achieved worse results.

Conclusion

The proposed method can efficiently correct particular frames of retinal sequences for shift and rotation. The registration results for each frame (shift in X and Y direction and eye rotation) can also be used for eye-movement evaluation during single-spot fixation tasks.

Assessment of Ischemic Index in Retinal Vascular Diseases Using Ultra-Wide-Field Fluorescein Angiography: Single Versus Summarized Image

BACKGROUND AND OBJECTIVE

To compare a single image with a computer-generated summarized image from the ultra-wide-field fluorescein angiogram (UWFFA) sequence for evaluation of ischemic index (ISI).

MATERIALS AND METHODS

UWFFA sequences from patients with diabetic retinopathy (DR) (n=5), branch retinal vein occlusion (BRVO) (n=5), and central retinal vein occlusion (CRVO) (n=5) were evaluated by six graders. A single image best illustrating retinal non-perfusion was compared to a summarized image generated by computerized superimposition of angiograms. Non-perfused and ungradable retinal areas were outlined and the ISI between the single and summarized images was compared.

RESULTS

The mean ISI in the single versus (vs) summarized images was 17% vs 15% in BRVO (p=0.12), 48% vs 48% in CRVO (p=0.67), and 25% vs 23% in DR (p=0.005). Inter-grader agreement of ISI in single versus summarized images was 0.43 vs 0.40 in BRVO, 0.69 vs 0.71 in CRVO, and 0.53 vs 0.34 in DR.

CONCLUSION

Computer-generated summarized images were similar to single images for grading ISI in BRVO and CRVO, but underestimated it in DR.

Fully automatic segmentation of fluorescein leakage in subjects with diabetic macular edema

PURPOSE

To create and validate software to automatically segment leakage area in real-world clinical fluorescein angiography (FA) images of subjects with diabetic macular edema (DME).

METHODS

Fluorescein angiography images obtained from 24 eyes of 24 subjects with DME were retrospectively analyzed. Both video and still-frame images were obtained using a Heidelberg Spectralis 6-mode HRA/OCT unit. We aligned early and late FA frames in the video by a two-step nonrigid registration method. To remove background artifacts, we subtracted early and late FA frames. Finally, after postprocessing steps, including detection and inpainting of the vessels, a robust active contour method was utilized to obtain leakage area in a 1500-μm-radius circular region centered at the fovea. Images were captured at different fields of view (FOVs) and were often contaminated with outliers, as is the case in real-world clinical imaging. Our algorithm was applied to these images with no manual input. Separately, all images were manually segmented by two retina specialists. The sensitivity, specificity, and accuracy of manual interobserver, manual intraobserver, and automatic methods were calculated.

RESULTS

The mean accuracy was 0.86 ± 0.08 for automatic versus manual, 0.83 ± 0.16 for manual interobserver, and 0.90 ± 0.08 for manual intraobserver segmentation methods.

CONCLUSIONS

Our fully automated algorithm can reproducibly and accurately quantify the area of leakage of clinical-grade FA video and is congruent with expert manual segmentation. The performance was reliable for different DME subtypes. This approach has the potential to reduce time and labor costs and may yield objective and reproducible quantitative measurements of DME imaging biomarkers.

Retinal imaging as a source of biomarkers for diagnosis, characterization and prognosis of chronic illness or long-term conditions

The black void behind the pupil was optically impenetrable before the invention of the ophthalmoscope by von Helmholtz over 150 years ago. Advances in retinal imaging and image processing, especially over the past decade, have opened a route to another unexplored landscape, the retinal neurovascular architecture and the retinal ganglion pathways linking to the central nervous system beyond. Exploiting these research opportunities requires multidisciplinary teams to explore the interface sitting at the border between ophthalmology, neurology and computing science. It is from the detail and depth of retinal phenotyping that novel metrics and candidate biomarkers are likely to emerge. Confirmation that in vivo retinal neurovascular measures are predictive of microvascular change in the brain and other organs is likely to be a major area of research activity over the next decade. Unlocking this hidden potential within the retina requires integration of structural and functional data sets, that is, multimodal mapping and longitudinal studies spanning the natural history of the disease process. And with further advances in imaging, it is likely that this area of retinal research will remain active and clinically relevant for many years to come. Accordingly, this review looks at state-of-the-art retinal imaging and its application to diagnosis, characterization and prognosis of chronic illness or long-term conditions.

Towards automatic detection of abnormal retinal capillaries in ultra-widefield-of-view retinal angiographic exams

Retinal capillary abnormalities include small, leaky, severely tortuous blood vessels that are associated with a variety of retinal pathologies. We present a prototype image-processing system for detecting abnormal retinal capillary regions in ultra-widefield-of-view (UWFOV) fluorescein angiography exams of the human retina. The algorithm takes as input an UWFOV FA frame and returns the candidate regions identified. An SVM classifier is trained on regions traced by expert ophthalmologists. Tests with a variety of feature sets indicate that edge features and allied properties differentiate best between normal and abnormal retinal capillary regions. Experiments with an initial set of images from patients showing branch retinal vein occlusion (BRVO) indicate promising area under the ROC curve of 0.950 and a weighted Cohen's Kappa value of 0.822.