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Register a new userTransfer Learning for Automated OCTA Detection of Diabetic Retinopathy
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Purpose: To test the feasibility of using deep learning for optical coherence tomography angiography (OCTA) detection of diabetic retinopathy (DR). Methods: A deep learning convolutional neural network (CNN) architecture VGG16 was employed for this study. A transfer learning process was implemented to re-train the CNN for robust OCTA classification. In order to demonstrate the feasibility of using this method for artificial intelligence (AI) screening of DR in clinical environments, the re-trained CNN was incorporated into a custom developed GUI platform which can be readily operated by ophthalmic personnel. Results: With last nine layers re-trained, CNN architecture achieved the best performance for automated OCTA classification. The overall accuracy of the re-trained classifier for differentiating healthy, NoDR, and NPDR was 87.27%, with 83.76% sensitivity and 90.82% specificity. The AUC metrics for binary classification of healthy, NoDR and DR were 0.97, 0.98 and 0.97, respectively. The GUI platform enabled easy validation of the method for AI screening of DR in a clinical environment. Conclusion: With a transfer leaning process to adopt the early layers for simple feature analysis and to re-train the upper layers for fine feature analysis, the CNN architecture VGG16 can be used for robust OCTA classification of healthy, NoDR, and NPDR eyes. Translational Relevance: OCTA can capture microvascular changes in early DR. A transfer learning process enables robust implementation of convolutional neural network (CNN) for automated OCTA classification of DR.
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Manually annotating medical images is extremely expensive, especially for large-scale datasets. Self-supervised contrastive learning has been explored to learn feature representations from unlabeled images. However, unlike natural images, the application of contrastive learning to medical images is relatively limited. In this work, we propose a self-supervised framework, namely lesion-based contrastive learning for automated diabetic retinopathy (DR) grading. Instead of taking entire images as the input in the common contrastive learning scheme, lesion patches are employed to encourage the feature extractor to learn representations that are highly discriminative for DR grading. We also investigate different data augmentation operations in defining our contrastive prediction task. Extensive experiments are conducted on the publicly-accessible dataset EyePACS, demonstrating that our proposed framework performs outstandingly on DR grading in terms of both linear evaluation and transfer capacity evaluation.
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 retinal images. We evaluate the efficiency of the proposed classifiers in combination with preprocessing and augmentation steps on a sample dataset. Our experimental results show that neural networks in combination with preprocessing on the images can boost the classification accuracy on this dataset. Moreover the proposed models are scalable and can be used in large scale datasets for diabetic retinopathy detection. The models introduced in this paper can be used to facilitate the diagnosis and speed up the detection process.
This paper presents a multitask deep learning model to detect all the five stages of diabetic retinopathy (DR) consisting of no DR, mild DR, moderate DR, severe DR, and proliferate DR. This multitask model consists of one classification model and one regression model, each with its own loss function. Noting that a higher severity level normally occurs after a lower severity level, this dependency is taken into consideration by concatenating the classification and regression models. The regression model learns the inter-dependency between the stages and outputs a score corresponding to the severity level of DR generating a higher score for a higher severity level. After training the regression model and the classification model separately, the features extracted by these two models are concatenated and inputted to a multilayer perceptron network to classify the five stages of DR. A modified Squeeze Excitation Densely Connected deep neural network is developed to implement this multitasking approach. The developed multitask model is then used to detect the five stages of DR by examining the two large Kaggle datasets of APTOS and EyePACS. A multitasking transfer learning model based on Xception network is also developed to evaluate the proposed approach by classifying DR into five stages. It is found that the developed model achieves a weighted Kappa score of 0.90 and 0.88 for the APTOS and EyePACS datasets, respectively, higher than any existing methods for detection of the five stages of DR
Purpose: To validate the performance of a commercially-available, CE-certified deep learning (DL) system, RetCAD v.1.3.0 (Thirona, Nijmegen, The Netherlands), for the joint automatic detection of diabetic retinopathy (DR) and age-related macular degeneration (AMD) in color fundus (CF) images on a dataset with mixed presence of eye diseases. Methods: Evaluation of joint detection of referable DR and AMD was performed on a DR-AMD dataset with 600 images acquired during routine clinical practice, containing referable and non-referable cases of both diseases. Each image was graded for DR and AMD by an experienced ophthalmologist to establish the reference standard (RS), and by four independent observers for comparison with human performance. Validation was furtherly assessed on Messidor (1200 images) for individual identification of referable DR, and the Age-Related Eye Disease Study (AREDS) dataset (133821 images) for referable AMD, against the corresponding RS. Results: Regarding joint validation on the DR-AMD dataset, the system achieved an area under the ROC curve (AUC) of 95.1% for detection of referable DR (SE=90.1%, SP=90.6%). For referable AMD, the AUC was 94.9% (SE=91.8%, SP=87.5%). Average human performance for DR was SE=61.5% and SP=97.8%; for AMD, SE=76.5% and SP=96.1%. Regarding detection of referable DR in Messidor, AUC was 97.5% (SE=92.0%, SP=92.1%); for referable AMD in AREDS, AUC was 92.7% (SE=85.8%, SP=86.0%). Conclusions: The validated system performs comparably to human experts at simultaneous detection of DR and AMD. This shows that DL systems can facilitate access to joint screening of eye diseases and become a quick and reliable support for ophthalmological experts.
Though deep learning has shown successful performance in classifying the label and severity stage of certain diseases, most of them give few explanations on how to make predictions. Inspired by Kochs Postulates, the foundation in evidence-based medicine (EBM) to identify the pathogen, we propose to exploit the interpretability of deep learning application in medical diagnosis. By determining and isolating the neuron activation patterns on which diabetic retinopathy (DR) detector relies to make decisions, we demonstrate the direct relation between the isolated neuron activation and lesions for a pathological explanation. To be specific, we first define novel pathological descriptors using activated neurons of the DR detector to encode both spatial and appearance information of lesions. Then, to visualize the symptom encoded in the descriptor, we propose Patho-GAN, a new network to synthesize medically plausible retinal images. By manipulating these descriptors, we could even arbitrarily control the position, quantity, and categories of generated lesions. We also show that our synthesized images carry the symptoms directly related to diabetic retinopathy diagnosis. Our generated images are both qualitatively and quantitatively superior to the ones by previous methods. Besides, compared to existing methods that take hours to generate an image, our second level speed endows the potential to be an effective solution for data augmentation.
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