Invariant Scattering Transform for Medical Imaging

Over the years, the Invariant Scattering Transform (IST) technique has become popular for medical image analysis, including using wavelet transform computation using Convolutional Neural Networks (CNN) to capture patterns' scale and orientation in the input signal. IST aims to be invariant to transformations that are common in medical images, such as translation, rotation, scaling, and deformation, used to improve the performance in medical imaging applications such as segmentation, classification, and registration, which can be integrated into machine learning algorithms for disease detection, diagnosis, and treatment planning. Additionally, combining IST with deep learning approaches has the potential to leverage their strengths and enhance medical image analysis outcomes. This study provides an overview of IST in medical imaging by considering the types of IST, their application, limitations, and potential scopes for future researchers and practitioners

Digital ocular fundus imaging: a review

Ocular fundus imaging plays a key role in monitoring the health status of the human eye. Currently, a large number of imaging modalities allow the assessment and/or quantification of ocular changes from a healthy status. This review focuses on the main digital fundus imaging modality, color fundus photography, with a brief overview of complementary techniques, such as fluorescein angiography. While focusing on two-dimensional color fundus photography, the authors address the evolution from nondigital to digital imaging and its impact on diagnosis. They also compare several studies performed along the transitional path of this technology. Retinal image processing and analysis, automated disease detection and identification of the stage of diabetic retinopathy (DR) are addressed as well. The authors emphasize the problems of image segmentation, focusing on the major landmark structures of the ocular fundus: the vascular network, optic disk and the fovea. Several proposed approaches for the automatic detection of signs of disease onset and progression, such as microaneurysms, are surveyed. A thorough comparison is conducted among different studies with regard to the number of eyes/subjects, imaging modality, fundus camera used, field of view and image resolution to identify the large variation in characteristics from one study to another. Similarly, the main features of the proposed classifications and algorithms for the automatic detection of DR are compared, thereby addressing computer-aided diagnosis and computer-aided detection for use in screening programs.Fundação para a Ciência e TecnologiaFEDErPrograma COMPET

Blood vessel segmentation in the analysis of retinal and diaphragm images

The segmentation and characterization of structures in medical images represents an important part of the diagnostic and research procedures in medicine. This thesis focuses on the characterization methods in two application fields that make use of two imaging modalities. The first topic is the characterization of the blood vessel structure in the human retina and the second is the characterization of diaphragm movement during breathing. The imaged blood vessel structures are considered important landmarks in both applications. The framework for the retinal image processing and analysis starts with the testing of five publicly available blood vessel segmentation methods for retinal images. The parameters of the methods are optimized on five databases with the ground truth for blood vessels. An approach for predicting the method parameters is proposed based on the optimization results. The parameter prediction approach is then applied to obtain vessel segmentation on a new database and an automatic approach to the blood vessel classification and computation of the arteriovenous ratio is proposed and evaluated on the new database. The framework for the diaphragm image processing and analysis is based on the measurement of diaphragm motion. The motion is characterized by a set of features quantifying the amplitude and frequency of the breathing pattern, as well as a portion of the nonharmonic movements that occur. In addition, a set of static features like the diaphragm slope and height are proposed. Two approaches for the motion measurement are proposed and compared. A statistical evaluation of the proposed features is performed by comparing measurements from people with and without spinal findings. The results from the retinal image processing and analysis revealed the possibility of the successful prediction of the parameters of the blood vessel segmentation methods. The automatic approach for the automatic arteriovenous ratio estimation revealed a stronger association with blood pressure than the manually estimated ratio. The results from the diaphragm image processing and analysis confirmed differences in the position, shape and breathing patterns between the healthy people and people suffering from spinal findings. The blood vessel structure was shown to be a reliable marker for characterizing the diaphragm motion.Katedra kybernetik

Optic nerve head three-dimensional shape analysis

We present a method for optic nerve head (ONH) 3-D shape analysis from retinal optical coherence tomography (OCT). The possibility to noninvasively acquire in vivo high-resolution 3-D volumes of the ONH using spectral domain OCT drives the need to develop tools that quantify the shape of this structure and extract information for clinical applications. The presented method automatically generates a 3-D ONH model and then allows the computation of several 3-D parameters describing the ONH. The method starts with a high-resolution OCT volume scan as input. From this scan, the model-defining inner limiting membrane (ILM) as inner surface and the retinal pigment epithelium as outer surface are segmented, and the Bruch's membrane opening (BMO) as the model origin is detected. Based on the generated ONH model by triangulated 3-D surface reconstruction, different parameters (areas, volumes, annular surface ring, minimum distances) of different ONH regions can then be computed. Additionally, the bending energy (roughness) in the BMO region on the ILM surface and 3-D BMO-MRW surface area are computed. We show that our method is reliable and robust across a large variety of ONH topologies (specific to this structure) and present a first clinical application

Detección automática de la presencia de patología ocular en retinografías empleando técnicas de procesado de imágenes

La vista es uno de los sentidos de mayor importancia para la vida humana. En los últimos años el número de enfermedades oculares ha aumentado y las predicciones de los científicos es que van a seguir aumentando en los próximos años. Existen enfermedades oculares que se han convertido en importantes causas de pérdida de visión a nivel mundial como la retinopatía diabética (RD), el glaucoma, la degeneración macular asociada a la edad (DMAE) y las cataratas. Estas enfermedades oculares suelen provocar alteraciones en el ojo humano, que pueden detectarse observando el ojo. Una de las técnicas más extendidas para observar el fondo del ojo es la retinografía, que es una imagen digital a color de la retina. Esta imagen es muy útil para el diagnóstico de enfermedades que afectan al ojo como RD y DMAE, entre otras. No obstante, la creciente incidencia de algunas enfermedades oculares y la escasez de oftalmólogos especialistas provoca que el análisis de las retinografías sea una tarea compleja y laboriosa. El objetivo de este Trabajo Fin de Grado (TFG) ha sido el diseño y desarrollo de un método automático para diferenciar entre retinografías patológicas y no patológicas. Este método permitiría ayudar en el diagnóstico y cribado de los pacientes con enfermedades oculares y reducir la carga de trabajo a los oftalmólogos. Para ello, se partió de una base de datos (BD) formada por 1044 imágenes de calidad adecuada para su procesado automático. De ellas, 326 pertenecían a sujetos sanos y a 819 pacientes con algún tipo de patología. Estas imágenes se dividieron en un conjunto de entrenamiento (559 imágenes) y un conjunto de test (585 imágenes). En todos los casos, un oftalmólogo especialista indicó si las imágenes eran normales o patológicas.Grado en Ingeniería de Tecnologías de Telecomunicació

Computational Analysis of Fundus Images: Rule-Based and Scale-Space Models

Fundus images are one of the most important imaging examinations in modern ophthalmology because they are simple, inexpensive and, above all, noninvasive. Nowadays, the acquisition and storage of highresolution fundus images is relatively easy and fast. Therefore, fundus imaging has become a fundamental investigation in retinal lesion detection, ocular health monitoring and screening programmes. Given the large volume and clinical complexity associated with these images, their analysis and interpretation by trained clinicians becomes a timeconsuming task and is prone to human error. Therefore, there is a growing interest in developing automated approaches that are affordable and have high sensitivity and specificity. These automated approaches need to be robust if they are to be used in the general population to diagnose and track retinal diseases. To be effective, the automated systems must be able to recognize normal structures and distinguish them from pathological clinical manifestations. The main objective of the research leading to this thesis was to develop automated systems capable of recognizing and segmenting retinal anatomical structures and retinal pathological clinical manifestations associated with the most common retinal diseases. In particular, these automated algorithms were developed on the premise of robustness and efficiency to deal with the difficulties and complexity inherent in these images. Four objectives were considered in the analysis of fundus images. Segmentation of exudates, localization of the optic disc, detection of the midline of blood vessels, segmentation of the vascular network and detection of microaneurysms. In addition, we also evaluated the detection of diabetic retinopathy on fundus images using the microaneurysm detection method. An overview of the state of the art is presented to compare the performance of the developed approaches with the main methods described in the literature for each of the previously described objectives. To facilitate the comparison of methods, the state of the art has been divided into rulebased methods and machine learningbased methods. In the research reported in this paper, rulebased methods based on image processing methods were preferred over machine learningbased methods. In particular, scalespace methods proved to be effective in achieving the set goals. Two different approaches to exudate segmentation were developed. The first approach is based on scalespace curvature in combination with the local maximum of a scalespace blob detector and dynamic thresholds. The second approach is based on the analysis of the distribution function of the maximum values of the noise map in combination with morphological operators and adaptive thresholds. Both approaches perform a correct segmentation of the exudates and cope well with the uneven illumination and contrast variations in the fundus images. Optic disc localization was achieved using a new technique called cumulative sum fields, which was combined with a vascular enhancement method. The algorithm proved to be reliable and efficient, especially for pathological images. The robustness of the method was tested on 8 datasets. The detection of the midline of the blood vessels was achieved using a modified corner detector in combination with binary philtres and dynamic thresholding. Segmentation of the vascular network was achieved using a new scalespace blood vessels enhancement method. The developed methods have proven effective in detecting the midline of blood vessels and segmenting vascular networks. The microaneurysm detection method relies on a scalespace microaneurysm detection and labelling system. A new approach based on the neighbourhood of the microaneurysms was used for labelling. Microaneurysm detection enabled the assessment of diabetic retinopathy detection. The microaneurysm detection method proved to be competitive with other methods, especially with highresolution images. Diabetic retinopathy detection with the developed microaneurysm detection method showed similar performance to other methods and human experts. The results of this work show that it is possible to develop reliable and robust scalespace methods that can detect various anatomical structures and pathological features of the retina. Furthermore, the results obtained in this work show that although recent research has focused on machine learning methods, scalespace methods can achieve very competitive results and typically have greater independence from image acquisition. The methods developed in this work may also be relevant for the future definition of new descriptors and features that can significantly improve the results of automated methods.As imagens do fundo do olho são hoje um dos principais exames imagiológicos da oftalmologia moderna, pela sua simplicidade, baixo custo e acima de tudo pelo seu carácter nãoinvasivo. A aquisição e armazenamento de imagens do fundo do olho com alta resolução é também relativamente simples e rápida. Desta forma, as imagens do fundo do olho são um exame fundamental na identificação de alterações retinianas, monitorização da saúde ocular, e em programas de rastreio. Considerando o elevado volume e complexidade clínica associada a estas imagens, a análise e interpretação das mesmas por clínicos treinados tornase uma tarefa morosa e propensa a erros humanos. Assim, há um interesse crescente no desenvolvimento de abordagens automatizadas, acessíveis em custo, e com uma alta sensibilidade e especificidade. Estas devem ser robustas para serem aplicadas à população em geral no diagnóstico e seguimento de doenças retinianas. Para serem eficazes, os sistemas de análise têm que conseguir detetar e distinguir estruturas normais de sinais patológicos. O objetivo principal da investigação que levou a esta tese de doutoramento é o desenvolvimento de sistemas automáticos capazes de detetar e segmentar as estruturas anatómicas da retina, e os sinais patológicos retinianos associados às doenças retinianas mais comuns. Em particular, estes algoritmos automatizados foram desenvolvidos segundo as premissas de robustez e eficácia para lidar com as dificuldades e complexidades inerentes a estas imagens. Foram considerados quatro objetivos de análise de imagens do fundo do olho. São estes, a segmentação de exsudados, a localização do disco ótico, a deteção da linha central venosa dos vasos sanguíneos e segmentação da rede vascular, e a deteção de microaneurismas. De acrescentar que usando o método de deteção de microaneurismas, avaliouse também a capacidade de deteção da retinopatia diabética em imagens do fundo do olho. Para comparar o desempenho das metodologias desenvolvidas neste trabalho, foi realizado um levantamento do estado da arte, onde foram considerados os métodos mais relevantes descritos na literatura para cada um dos objetivos descritos anteriormente. Para facilitar a comparação entre métodos, o estado da arte foi dividido em metodologias de processamento de imagem e baseadas em aprendizagem máquina. Optouse no trabalho de investigação desenvolvido pela utilização de metodologias de análise espacial de imagem em detrimento de metodologias baseadas em aprendizagem máquina. Em particular, as metodologias baseadas no espaço de escalas mostraram ser efetivas na obtenção dos objetivos estabelecidos. Para a segmentação de exsudados foram usadas duas abordagens distintas. A primeira abordagem baseiase na curvatura em espaço de escalas em conjunto com a resposta máxima local de um detetor de manchas em espaço de escalas e limiares dinâmicos. A segunda abordagem baseiase na análise do mapa de distribuição de ruído em conjunto com operadores morfológicos e limiares adaptativos. Ambas as abordagens fazem uma segmentação dos exsudados de elevada precisão, além de lidarem eficazmente com a iluminação nãouniforme e a variação de contraste presente nas imagens do fundo do olho. A localização do disco ótico foi conseguida com uma nova técnica designada por campos de soma acumulativos, combinada com métodos de melhoramento da rede vascular. O algoritmo revela ser fiável e eficiente, particularmente em imagens patológicas. A robustez do método foi verificada pela sua avaliação em oito bases de dados. A deteção da linha central dos vasos sanguíneos foi obtida através de um detetor de cantos modificado em conjunto com filtros binários e limiares dinâmicos. A segmentação da rede vascular foi conseguida com um novo método de melhoramento de vasos sanguíneos em espaço de escalas. Os métodos desenvolvidos mostraram ser eficazes na deteção da linha central dos vasos sanguíneos e na segmentação da rede vascular. Finalmente, o método para a deteção de microaneurismas assenta num formalismo de espaço de escalas na deteção e na rotulagem dos microaneurismas. Para a rotulagem foi utilizada uma nova abordagem da vizinhança dos candidatos a microaneurismas. A deteção de microaneurismas permitiu avaliar também a deteção da retinopatia diabética. O método para a deteção de microaneurismas mostrou ser competitivo quando comparado com outros métodos, em particular em imagens de alta resolução. A deteção da retinopatia diabética exibiu um desempenho semelhante a outros métodos e a especialistas humanos. Os trabalhos descritos nesta tese mostram ser possível desenvolver uma abordagem fiável e robusta em espaço de escalas capaz de detetar diferentes estruturas anatómicas e sinais patológicos da retina. Além disso, os resultados obtidos mostram que apesar de a pesquisa mais recente concentrarse em metodologias de aprendizagem máquina, as metodologias de análise espacial apresentam resultados muito competitivos e tipicamente independentes do equipamento de aquisição das imagens. As metodologias desenvolvidas nesta tese podem ser importantes na definição de novos descritores e características, que podem melhorar significativamente o resultado de métodos automatizados

Multi-modal classifier fusion with feature cooperation for glaucoma diagnosis

Background: Glaucoma is a major public health problem that can lead to an optic nerve lesion, requiring systematic screening in the population over 45 years of age. The diagnosis and classification of this disease have had a marked and excellent development in recent years, particularly in the machine learning domain. Multimodal data have been shown to be a significant aid to the machine learning domain, especially by its contribution to improving data driven decision-making. Method: Solving classification problems by combinations of classifiers has made it possible to increase the robustness as well as the classification reliability by using the complementarity that may exist between the classifiers. Complementarity is considered a key property of multimodality. A Convolutional Neural Network (CNN) works very well in pattern recognition and has been shown to exhibit superior performance, especially for image classification which can learn by themselves useful features from raw data. This article proposes a multimodal classification approach based on deep Convolutional Neural Network and Support Vector Machine (SVM) classifiers using multimodal data and multimodal feature for glaucoma diagnosis from retinal fundus images from RIM-ONE dataset. We make use of handcrafted feature descriptors such as the Gray Level Co-Occurrence Matrix, Central Moments and Hu Moments to co-operate with features automatically generated by the CNN in order to properly detect the optic nerve and consequently obtain a better classification rate, allowing a more reliable diagnosis of glaucoma. Results: The experimental results confirm that the combination of classifiers using the BWWV technique is better than learning classifiers separately. The proposed method provides a computerized diagnosis system for glaucoma disease with impressive results comparing them to the main related studies that allow us to continue in this research path

Diabetic retinopathy diagnosis through multi-agent approaches

Programa Doutoral em Engenharia BiomédicaDiabetic retinopathy has been revealed as a serious public health problem in occidental world, since it is the most common cause of vision impairment among people of working age. The early diagnosis and an adequate treatment can prevent loss of vision. Thus, a regular screening program to detect diabetic retinopathy in the early stages could be efficient for the prevention of blindness. Due to its characteristics, digital color fundus photographs have been the preferred eye examination method adopted in these programs. Nevertheless, due to the growing incidence of diabetes in population, ophthalmologists have to observe a huge number of images. Therefore, the development of computational tools that can assist the diagnosis is of major importance. Several works have been published in the recent past years for this purpose; but an automatic system for clinical practice has yet to come. In general, these algorithms are used to normalize, segment and extract information from images to be utilized by classifiers which aim to classify the regions of the fundus image. These methods are mostly based on global approaches that cannot be locally adapted to the image properties and therefore, none of them perform as needed because of fundus images complexity. This thesis focuses on the development of new tools based on multi-agent approaches, to assist the diabetic retinopathy early diagnosis. The fundus image automatic segmentation concerning the diabetic retinopathy diagnosis should comprise both pathological (dark and bright lesions) and anatomical features (optic disc, blood vessels and fovea). In that way, systems for the optic disc detection, bright lesions segmentation, blood vessels segmentation and dark lesions segmentation were implemented and, when possible, compared to those approaches already described in literature. Two kinds of agent based systems were investigated and applied to digital color fundus photographs: ant colony system and multi-agent system composed of reactive agents with interaction mechanisms between them. The ant colony system was used to the optic disc detection and for bright lesion segmentation. Multi-agent system models were developed for the blood vessel segmentation and for small dark lesion segmentation. The multi-agent system models created in this study are not image processing techniques on their own, but they are used as tools to improve the traditional algorithms results at the micro level. The results of all the proposed approaches are very promising and reveal that the systems created perform better than other recent methods described in the literature. Therefore, the main scientific contribution of this thesis is to prove that multi-agent systems based approaches can be efficient in segmenting structures in retinal images. Such an approach overcomes the classic image processing algorithms that are limited to macro results and do not consider the local characteristics of images. Hence, multi-agent systems based approaches could be a fundamental tool, responsible for a very efficient system development to be used in screening programs concerning diabetic retinopathy early diagnosis.A retinopatia diabética tem-se revelado como um problema sério de saúde pública no mundo ocidental, uma vez que é a principal causa de cegueira entre as pessoas em idade ativa. Contudo, a perda de visão pode ser prevenida através da deteção precoce da doença e de um tratamento adequado. Por isso, um programa regular de rastreio e monitorização da retinopatia diabética pode ser eficiente na prevenção da deterioração da visão. Devido às suas características, a fotografia digital colorida do fundo do olho tem sido o exame adotado neste tipo de programas. No entanto, devido ao aumento da incidência da diabetes na população, o número de imagens a serem analisadas pelos oftalmologistas é elevado. Assim sendo, é muito importante o desenvolvimento de ferramentas computacionais para auxiliar no diagnóstico desta patologia. Nos últimos anos, têm sido vários os trabalhos publicados com este propósito; porém, não existe ainda um sistema automático (ou recomendável) para ser usado nas práticas clínicas. No geral, estes algoritmos são usados para normalizar, segmentar e extrair informação das imagens que vai ser utilizada por classificadores, cujo objetivo é identificar as regiões da imagem que se procuram. Estes métodos são maioritariamente baseados em abordagens globais que não podem ser localmente adaptadas às propriedades das imagens e, portanto, nenhum apresenta a performance necessária devido à complexidade das imagens do fundo do olho. Esta tese foca-se no desenvolvimento de novas ferramentas computacionais baseadas em sistemas multi-agente, para auxiliar na deteção precoce da retinopatia diabética. A segmentação automática das imagens do fundo do olho com o objetivo de diagnosticar a retinopatia diabética, deve englobar características patológicas (lesões claras e escuras) e anatómicas (disco ótico, vasos sanguíneos e fóvea). Deste modo, foram criados sistemas para a deteção do disco ótico e para a segmentação das lesões claras, dos vasos sanguíneos e das lesões escuras e, quando possível, estes foram comparados com abordagens já descritas na literatura. Dois tipos de sistemas baseados em agentes foram investigados e aplicados nas imagens digitais coloridas do fundo do olho: sistema de colónia de formigas e sistema multi-agente constituído por agentes reativos e com mecanismos de interação entre eles. O sistema de colónia de formigas foi usado para a deteção do disco ótico e para a segmentação das lesões claras. Modelos de sistemas multi-agente foram desenvolvidos para a segmentação dos vasos sanguíneos e das lesões escuras. Os modelos multi-agentes criados ao longo deste estudo não são por si só técnicas de processamento de imagem, mas são sim usados como ferramentas para melhorar os resultados dos algoritmos tradicionais no baixo nível. Os resultados de todas as abordagens propostas são muito promissores e revelam que os sistemas criados apresentam melhor performance que outras abordagens recentes descritas na literatura. Posto isto, a maior contribuição científica desta tese é provar que abordagens baseadas em sistemas multi-agente podem ser eficientes na segmentação de estruturas em imagens da retina. Uma abordagem deste tipo ultrapassa os algoritmos clássicos de processamento de imagem, que se limitam aos resultados de alto nível e não têm em consideração as propriedades locais das imagens. Portanto, as abordagens baseadas em sistemas multi-agente podem ser uma ferramenta fundamental, responsável pelo desenvolvimento de um sistema eficiente para ser usado nos programas de rastreio e monitorização da retinopatia diabética.Work supported by FEDER funds through the "Programa Operacional Factores de Competitividade – COMPETE" and by national funds by FCT- Fundação para a Ciência e a Tecnologia. C. Pereira thanks the FCT for the SFRH / BD / 61829 / 2009 grant

Computer-Assisted Algorithms for Ultrasound Imaging Systems

Ultrasound imaging works on the principle of transmitting ultrasound waves into the body and reconstructs the images of internal organs based on the strength of the echoes. Ultrasound imaging is considered to be safer, economical and can image the organs in real-time, which makes it widely used diagnostic imaging modality in health-care. Ultrasound imaging covers the broad spectrum of medical diagnostics; these include diagnosis of kidney, liver, pancreas, fetal monitoring, etc. Currently, the diagnosis through ultrasound scanning is clinic-centered, and the patients who are in need of ultrasound scanning has to visit the hospitals for getting the diagnosis. The services of an ultrasound system are constrained to hospitals and did not translate to its potential in remote health-care and point-of-care diagnostics due to its high form factor, shortage of sonographers, low signal to noise ratio, high diagnostic subjectivity, etc. In this thesis, we address these issues with an objective of making ultrasound imaging more reliable to use in point-of-care and remote health-care applications. To achieve the goal, we propose (i) computer-assisted algorithms to improve diagnostic accuracy and assist semi-skilled persons in scanning, (ii) speckle suppression algorithms to improve the diagnostic quality of ultrasound image, (iii) a reliable telesonography framework to address the shortage of sonographers, and (iv) a programmable portable ultrasound scanner to operate in point-of-care and remote health-care applications