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Register a new userDcardNet: Diabetic Retinopathy Classification at Multiple Levels Based on Structural and Angiographic Optical Coherence Tomography
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Objective: Optical coherence tomography (OCT) and its angiography (OCTA) have several advantages for the early detection and diagnosis of diabetic retinopathy (DR). However, automated, complete DR classification frameworks based on both OCT and OCTA data have not been proposed. In this study, a convolutional neural network (CNN) based method is proposed to fulfill a DR classification framework using en face OCT and OCTA. Methods: A densely and continuously connected neural network with adaptive rate dropout (DcardNet) is designed for the DR classification. In addition, adaptive label smoothing was proposed and used to suppress overfitting. Three separate classification levels are generated for each case based on the International Clinical Diabetic Retinopathy scale. At the highest level the network classifies scans as referable or non-referable for DR. The second level classifies the eye as non-DR, non-proliferative DR (NPDR), or proliferative DR (PDR). The last level classifies the case as no DR, mild and moderate NPDR, severe NPDR, and PDR. Results: We used 10-fold cross-validation with 10% of the data to assess the networks performance. The overall classification accuracies of the three levels were 95.7%, 85.0%, and 71.0% respectively. Conclusion/Significance: A reliable, sensitive and specific automated classification framework for referral to an ophthalmologist can be a key technology for reducing vision loss related to DR.
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Knowledge distillation allows transferring knowledge from a pre-trained model to another. However, it suffers from limitations, and constraints related to the two models need to be architecturally similar. Knowledge distillation addresses some of the shortcomings associated with transfer learning by generalizing a complex model to a lighter model. However, some parts of the knowledge may not be distilled by knowledge distillation sufficiently. In this paper, a novel knowledge distillation approach using transfer learning is proposed. The proposed method transfers the entire knowledge of a model to a new smaller one. To accomplish this, unlabeled data are used in an unsupervised manner to transfer the maximum amount of knowledge to the new slimmer model. The proposed method can be beneficial in medical image analysis, where labeled data are typically scarce. The proposed approach is evaluated in the context of classification of images for diagnosing Diabetic Retinopathy on two publicly available datasets, including Messidor and EyePACS. Simulation results demonstrate that the approach is effective in transferring knowledge from a complex model to a lighter one. Furthermore, experimental results illustrate that the performance of different small models is improved significantly using unlabeled data and knowledge distillation.
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.
Diabetes is one of the most prevalent chronic diseases in Bangladesh, and as a result, Diabetic Retinopathy (DR) is widespread in the population. DR, an eye illness caused by diabetes, can lead to blindness if it is not identified and treated in its early stages. Unfortunately, diagnosis of DR requires medically trained professionals, but Bangladesh has limited specialists in comparison to its population. Moreover, the screening process is often expensive, prohibiting many from receiving timely and proper diagnosis. To address the problem, we introduce a deep learning algorithm which screens for different stages of DR. We use a state-of-the-art CNN architecture to diagnose patients based on retinal fundus imagery. This paper is an experimental evaluation of the algorithm we developed for DR diagnosis and screening specifically for Bangladeshi patients. We perform this validation study using separate pools of retinal image data of real patients from a hospital and field studies in Bangladesh. Our results show that the algorithm is effective at screening Bangladeshi eyes even when trained on a public dataset which is out of domain, and can accurately determine the stage of DR as well, achieving an overall accuracy of 92.27% and 93.02% on two validation sets of Bangladeshi eyes. The results confirm the ability of the algorithm to be used in real clinical settings and applications due to its high accuracy and classwise metrics. Our algorithm is implemented in the application Drishti, which is used to screen for DR in patients living in rural areas in Bangladesh, where access to professional screening is limited.
There are extensive researches focusing on automated diabetic reti-nopathy (DR) detection from fundus images. However, the accuracy drop is ob-served when applying these models in real-world DR screening, where the fun-dus camera brands are different from the ones used to capture the training im-ages. How can we train a classification model on labeled fundus images ac-quired from only one camera brand, yet still achieves good performance on im-ages taken by other brands of cameras? In this paper, we quantitatively verify the impact of fundus camera brands related domain shift on the performance of DR classification models, from an experimental perspective. Further, we pro-pose camera-oriented residual-CycleGAN to mitigate the camera brand differ-ence by domain adaptation and achieve increased classification performance on target camera images. Extensive ablation experiments on both the EyePACS da-taset and a private dataset show that the camera brand difference can signifi-cantly impact the classification performance and prove that our proposed meth-od can effectively improve the model performance on the target domain. We have inferred and labeled the camera brand for each image in the EyePACS da-taset and will publicize the camera brand labels for further research on domain adaptation.
To explore the clinical validity of elastic deformation of optical coherence tomography (OCT) images for data augmentation in the development of deep-learning model for detection of diabetic macular edema (DME).
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