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Register a new userMulti-modal, multi-task, multi-attention (M3) deep learning detection of reticular pseudodrusen: towards automated and accessible classification of age-related macular degeneration
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Qingyu Chen
Publication date
2020
fields
Informatics Engineering
and research's language is
English
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Objective Reticular pseudodrusen (RPD), a key feature of age-related macular degeneration (AMD), are poorly detected by human experts on standard color fundus photography (CFP) and typically require advanced imaging modalities such as fundus autofluorescence (FAF). The objective was to develop and evaluate the performance of a novel M3 deep learning framework on RPD detection. Materials and Methods A deep learning framework M3 was developed to detect RPD presence accurately using CFP alone, FAF alone, or both, employing >8000 CFP-FAF image pairs obtained prospectively (Age-Related Eye Disease Study 2). The M3 framework includes multi-modal (detection from single or multiple image modalities), multi-task (training different tasks simultaneously to improve generalizability), and multi-attention (improving ensembled feature representation) operation. Performance on RPD detection was compared with state-of-the-art deep learning models and 13 ophthalmologists; performance on detection of two other AMD features (geographic atrophy and pigmentary abnormalities) was also evaluated. Results For RPD detection, M3 achieved area under receiver operating characteristic (AUROC) 0.832, 0.931, and 0.933 for CFP alone, FAF alone, and both, respectively. M3 performance on CFP was very substantially superior to human retinal specialists (median F1-score 0.644 versus 0.350). External validation (on Rotterdam Study, Netherlands) demonstrated high accuracy on CFP alone (AUROC 0.965). The M3 framework also accurately detected geographic atrophy and pigmentary abnormalities (AUROC 0.909 and 0.912, respectively), demonstrating its generalizability. Conclusion This study demonstrates the successful development, robust evaluation, and external validation of a novel deep learning framework that enables accessible, accurate, and automated AMD diagnosis and prognosis.
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Age-related Macular Degeneration (AMD) is a leading cause of blindness. Although the Age-Related Eye Disease Study group previously developed a 9-step AMD severity scale for manual classification of AMD severity from color fundus images, manual grading of images is time-consuming and expensive. Built on our previous work DeepSeeNet, we developed a novel deep learning model for automated classification of images into the 9-step scale. Instead of predicting the 9-step score directly, our approach simulates the reading center grading process. It first detects four AMD characteristics (drusen area, geographic atrophy, increased pigment, and depigmentation), then combines these to derive the overall 9-step score. Importantly, we applied multi-task learning techniques, which allowed us to train classification of the four characteristics in parallel, share representation, and prevent overfitting. Evaluation on two image datasets showed that the accuracy of the model exceeded the current state-of-the-art model by > 10%.
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.
Background: Patients with neovascular age-related macular degeneration (AMD) can avoid vision loss via certain therapy. However, methods to predict the progression to neovascular age-related macular degeneration (nvAMD) are lacking. Purpose: To develop and validate a deep learning (DL) algorithm to predict 1-year progression of eyes with no, early, or intermediate AMD to nvAMD, using color fundus photographs (CFP). Design: Development and validation of a DL algorithm. Methods: We trained a DL algorithm to predict 1-year progression to nvAMD, and used 10-fold cross-validation to evaluate this approach on two groups of eyes in the Age-Related Eye Disease Study (AREDS): none/early/intermediate AMD, and intermediate AMD (iAMD) only. We compared the DL algorithm to the manually graded 4-category and 9-step scales in the AREDS dataset. Main outcome measures: Performance of the DL algorithm was evaluated using the sensitivity at 80% specificity for progression to nvAMD. Results: The DL algorithms sensitivity for predicting progression to nvAMD from none/early/iAMD (78+/-6%) was higher than manual grades from the 9-step scale (67+/-8%) or the 4-category scale (48+/-3%). For predicting progression specifically from iAMD, the DL algorithms sensitivity (57+/-6%) was also higher compared to the 9-step grades (36+/-8%) and the 4-category grades (20+/-0%). Conclusions: Our DL algorithm performed better in predicting progression to nvAMD than manual grades. Future investigations are required to test the application of this DL algorithm in a real-world clinical setting.
The features used in many image analysis-based applications are frequently of very high dimension. Feature extraction offers several advantages in high-dimensional cases, and many recent studies have used multi-task feature extraction approaches, which often outperform single-task feature extraction approaches. However, most of these methods are limited in that they only consider data represented by a single type of feature, even though features usually represent images from multiple modalities. We therefore propose a novel large margin multi-modal multi-task feature extraction (LM3FE) framework for handling multi-modal features for image classification. In particular, LM3FE simultaneously learns the feature extraction matrix for each modality and the modality combination coefficients. In this way, LM3FE not only handles correlated and noisy features, but also utilizes the complementarity of different modalities to further help reduce feature redundancy in each modality. The large margin principle employed also helps to extract strongly predictive features so that they are more suitable for prediction (e.g., classification). An alternating algorithm is developed for problem optimization and each sub-problem can be efficiently solved. Experiments on two challenging real-world image datasets demonstrate the effectiveness and superiority of the proposed method.
In this paper, we propose an end-to-end multi-task neural network called FetalNet with an attention mechanism and stacked module for spatio-temporal fetal ultrasound scan video analysis. Fetal biometric measurement is a standard examination during pregnancy used for the fetus growth monitoring and estimation of gestational age and fetal weight. The main goal in fetal ultrasound scan video analysis is to find proper standard planes to measure the fetal head, abdomen and femur. Due to natural high speckle noise and shadows in ultrasound data, medical expertise and sonographic experience are required to find the appropriate acquisition plane and perform accurate measurements of the fetus. In addition, existing computer-aided methods for fetal US biometric measurement address only one single image frame without considering temporal features. To address these shortcomings, we propose an end-to-end multi-task neural network for spatio-temporal ultrasound scan video analysis to simultaneously localize, classify and measure the fetal body parts. We propose a new encoder-decoder segmentation architecture that incorporates a classification branch. Additionally, we employ an attention mechanism with a stacked module to learn salient maps to suppress irrelevant US regions and efficient scan plane localization. We trained on the fetal ultrasound video comes from routine examinations of 700 different patients. Our method called FetalNet outperforms existing state-of-the-art methods in both classification and segmentation in fetal ultrasound video recordings.
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