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Register a new userDetecting Anemia from Retinal Fundus Images
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Added by
Akinori Mitani
Publication date
2019
fields
Informatics Engineering
and research's language is
English
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Despite its high prevalence, anemia is often undetected due to the invasiveness and cost of screening and diagnostic tests. Though some non-invasive approaches have been developed, they are less accurate than invasive methods, resulting in an unmet need for more accurate non-invasive methods. Here, we show that deep learning-based algorithms can detect anemia and quantify several related blood measurements using retinal fundus images both in isolation and in combination with basic metadata such as patient demographics. On a validation dataset of 11,388 patients from the UK Biobank, our algorithms achieved a mean absolute error of 0.63 g/dL (95% confidence interval (CI) 0.62-0.64) in quantifying hemoglobin concentration and an area under receiver operating characteristic curve (AUC) of 0.88 (95% CI 0.86-0.89) in detecting anemia. This work shows the potential of automated non-invasive anemia screening based on fundus images, particularly in diabetic patients, who may have regular retinal imaging and are at increased risk of further morbidity and mortality from anemia.
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Refractive error, one of the leading cause of visual impairment, can be corrected by simple interventions like prescribing eyeglasses. We trained a deep learning algorithm to predict refractive error from the fundus photographs from participants in the UK Biobank cohort, which were 45 degree field of view images and the AREDS clinical trial, which contained 30 degree field of view images. Our model use the attention method to identify features that are correlated with refractive error. Mean absolute error (MAE) of the algorithms prediction compared to the refractive error obtained in the AREDS and UK Biobank. The resulting algorithm had a MAE of 0.56 diopters (95% CI: 0.55-0.56) for estimating spherical equivalent on the UK Biobank dataset and 0.91 diopters (95% CI: 0.89-0.92) for the AREDS dataset. The baseline expected MAE (obtained by simply predicting the mean of this population) was 1.81 diopters (95% CI: 1.79-1.84) for UK Biobank and 1.63 (95% CI: 1.60-1.67) for AREDS. Attention maps suggested that the foveal region was one of the most important areas used by the algorithm to make this prediction, though other regions also contribute to the prediction. The ability to estimate refractive error with high accuracy from retinal fundus photos has not been previously known and demonstrates that deep learning can be applied to make novel predictions from medical images. Given that several groups have recently shown that it is feasible to obtain retinal fundus photos using mobile phones and inexpensive attachments, this work may be particularly relevant in regions of the world where autorefractors may not be readily available.
Retinal fundus images are widely used for the clinical screening and diagnosis of eye diseases. However, fundus images captured by operators with various levels of experience have a large variation in quality. Low-quality fundus images increase uncertainty in clinical observation and lead to the risk of misdiagnosis. However, due to the special optical beam of fundus imaging and structure of the retina, natural image enhancement methods cannot be utilized directly to address this. In this paper, we first analyze the ophthalmoscope imaging system and simulate a reliable degradation of major inferior-quality factors, including uneven illumination, image blurring, and artifacts. Then, based on the degradation model, a clinically oriented fundus enhancement network (cofe-Net) is proposed to suppress global degradation factors, while simultaneously preserving anatomical retinal structures and pathological characteristics for clinical observation and analysis. Experiments on both synthetic and real images demonstrate that our algorithm effectively corrects low-quality fundus images without losing retinal details. Moreover, we also show that the fundus correction method can benefit medical image analysis applications, e.g., retinal vessel segmentation and optic disc/cup detection.
Traditionally, medical discoveries are made by observing associations and then designing experiments to test these hypotheses. However, observing and quantifying associations in images can be difficult because of the wide variety of features, patterns, colors, values, shapes in real data. In this paper, we use deep learning, a machine learning technique that learns its own features, to discover new knowledge from retinal fundus images. Using models trained on data from 284,335 patients, and validated on two independent datasets of 12,026 and 999 patients, we predict cardiovascular risk factors not previously thought to be present or quantifiable in retinal images, such as such as age (within 3.26 years), gender (0.97 AUC), smoking status (0.71 AUC), HbA1c (within 1.39%), systolic blood pressure (within 11.23mmHg) as well as major adverse cardiac events (0.70 AUC). We further show that our models used distinct aspects of the anatomy to generate each prediction, such as the optic disc or blood vessels, opening avenues of further research.
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.
Assessing the degree of disease severity in biomedical images is a task similar to standard classification but constrained by an underlying structure in the label space. Such a structure reflects the monotonic relationship between different disease grades. In this paper, we propose a straightforward approach to enforce this constraint for the task of predicting Diabetic Retinopathy (DR) severity from eye fundus images based on the well-known notion of Cost-Sensitive classification. We expand standard classification losses with an extra term that acts as a regularizer, imposing greater penalties on predicted grades when they are farther away from the true grade associated to a particular image. Furthermore, we show how to adapt our method to the modelling of label noise in each of the sub-problems associated to DR grading, an approach we refer to as Atomic Sub-Task modeling. This yields models that can implicitly take into account the inherent noise present in DR grade annotations. Our experimental analysis on several public datasets reveals that, when a standard Convolutional Neural Network is trained using this simple strategy, improvements of 3-5% of quadratic-weighted kappa scores can be achieved at a negligible computational cost. Code to reproduce our results is released at https://github.com/agaldran/cost_sensitive_loss_classification.
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