Clinical Applications of Artificial Intelligence in Glaucoma

Ophthalmology is one of the major imaging-intensive fields of medicine and thus has potential for extensive applications of artificial intelligence (AI) to advance diagnosis, drug efficacy, and other treatment-related aspects of ocular disease. AI has made impressive progress in ophthalmology within the past few years and two autonomous AIenabled systems have received US regulatory approvals for autonomously screening for mid-level or advanced diabetic retinopathy and macular edema. While no autonomous AI-enabled system for glaucoma screening has yet received US regulatory approval, numerous assistive AI-enabled software tools are already employed in commercialized instruments for quantifying retinal images and visual fields to augment glaucoma research and clinical practice. In this literature review (non-systematic), we provide an overview of AI applications in glaucoma, and highlight some limitations and considerations for AI integration and adoption into clinical practice

Articulated Multi-Instrument 2D Pose Estimation Using Fully Convolutional Networks

Instrument detection, pose estimation and tracking in surgical videos is an important vision component for computer assisted interventions. While significant advances have been made in recent years, articulation detection is still a major challenge. In this paper, we propose a deep neural network for articulated multi-instrument 2D pose estimation, which is trained on a detailed annotations of endoscopic and microscopic datasets. Our model is formed by a fully convolutional detection-regression network. Joints and associations between joint pairs in our instrument model are located by the detection subnetwork and are subsequently refined through a regression subnetwork. Based on the output from the model, the poses of the instruments are inferred using maximum bipartite graph matching. Our estimation framework is powered by deep learning techniques without any direct kinematic information from a robot. Our framework is tested on single-instrument RMIT data, and also on multi-instrument EndoVis and in vivo data with promising results. In addition, the dataset annotations are publicly released along with our code and model

Diabetic Retinopathy Image Classification with Neural Networks

The world is experiencing an increased life expectancy, which results in a natural increase in the chance of getting a disease. The main concern is that some of the methods to determine an affectation are not so fast and need expert people. Therefore, it is necessary to create new low-cost mechanisms of diagnosis that can give us fast and better results. Recent studies have been implemented using known architectures getting high scores of accuracies. An experimental classification model was implemented in this work using Python libraries. This is an experimental model with custom neural network architecture. This work intends to contrast the results using a model based on the AlexNet against my experimental architecture. The 2 main reasons to compare my work versus AlexNet is that during my investigation of the state of the art I did not find researches to solve the DR categorization using this architecture and also if I had chosen other architecture, I would need more powerful computing. In the end, AlexNet was not a good solution. This solution will help the healthcare industry to have a less expensive and non-invasive way to determine if a person is being affected by diabetic retinopathy, depending on the damage shown on their retinasITESO, A. C

A Systematic Review of Artificial Intelligence in Assistive Technology for People with Visual Impairment

Recent advances in artificial intelligence (AI) have led to the development of numerous successful applications that utilize data to significantly enhance the quality of life for people with visual impairment. AI technology has the potential to further improve the lives of visually impaired individuals. However, accurately measuring the development of visual aids continues to be challenging. As an AI model is trained on larger and more diverse datasets, its performance becomes increasingly robust and applicable to a variety of scenarios. In the field of visual impairment, deep learning techniques have emerged as a solution to previous challenges associated with AI models. In this article, we provide a comprehensive and up-to-date review of recent research on the development of AI-powered visual aides tailored to the requirements of individuals with visual impairment. We adopt the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) methodology, meticulously gathering and appraising pertinent literature culled from diverse databases. A rigorous selection process was undertaken, appraising articles against precise inclusion and exclusion criteria. Our meticulous search yielded a trove of 322 articles, and after diligent scrutiny, 12 studies were deemed suitable for inclusion in the ultimate analysis. The study's primary objective is to investigate the application of AI techniques to the creation of intelligent devices that aid visually impaired individuals in their daily lives. We identified a number of potential obstacles that researchers and developers in the field of visual impairment applications might encounter. In addition, opportunities for future research and advancements in AI-driven visual aides are discussed. This review seeks to provide valuable insights into the advancements, possibilities, and challenges in the development and implementation of AI technology for people with visual impairment. By examining the current state of the field and designating areas for future research, we expect to contribute to the ongoing progress of improving the lives of visually impaired individuals through the use of AI-powered visual aids

Toward Improving Safety in Neurosurgery with an Active Handheld Instrument

Microsurgical procedures, such as petroclival meningioma resection, require careful surgical actions in order to remove tumor tissue, while avoiding brain and vessel damaging. Such procedures are currently performed under microscope magnification. Robotic tools are emerging in order to filter surgeons’ unintended movements and prevent tools from entering forbidden regions such as vascular structures. The present work investigates the use of a handheld robotic tool (Micron) to automate vessel avoidance in microsurgery. In particular, we focused on vessel segmentation, implementing a deep-learning-based segmentation strategy in microscopy images, and its integration with a feature-based passive 3D reconstruction algorithm to obtain accurate and robust vessel position. We then implemented a virtual-fixture-based strategy to control the handheld robotic tool and perform vessel avoidance. Clay vascular phantoms, lying on a background obtained from microscopy images recorded during petroclival meningioma surgery, were used for testing the segmentation and control algorithms. When testing the segmentation algorithm on 100 different phantom images, a median Dice similarity coefficient equal to 0.96 was achieved. A set of 25 Micron trials of 80 s in duration, each involving the interaction of Micron with a different vascular phantom, were recorded, with a safety distance equal to 2 mm, which was comparable to the median vessel diameter. Micron’s tip entered the forbidden region 24% of the time when the control algorithm was active. However, the median penetration depth was 16.9 μm, which was two orders of magnitude lower than median vessel diameter. Results suggest the system can assist surgeons in performing safe vessel avoidance during neurosurgical procedures

Towards PACE-CAD Systems

Despite phenomenal advancements in the availability of medical image datasets and the development of modern classification algorithms, Computer-Aided Diagnosis (CAD) has had limited practical exposure in the real-world clinical workflow. This is primarily because of the inherently demanding and sensitive nature of medical diagnosis that can have far-reaching and serious repercussions in case of misdiagnosis. In this work, a paradigm called PACE (Pragmatic, Accurate, Confident, & Explainable) is presented as a set of some of must-have features for any CAD. Diagnosis of glaucoma using Retinal Fundus Images (RFIs) is taken as the primary use case for development of various methods that may enrich an ordinary CAD system with PACE. However, depending on specific requirements for different methods, other application areas in ophthalmology and dermatology have also been explored. Pragmatic CAD systems refer to a solution that can perform reliably in day-to-day clinical setup. In this research two, of possibly many, aspects of a pragmatic CAD are addressed. Firstly, observing that the existing medical image datasets are small and not representative of images taken in the real-world, a large RFI dataset for glaucoma detection is curated and published. Secondly, realising that a salient attribute of a reliable and pragmatic CAD is its ability to perform in a range of clinically relevant scenarios, classification of 622 unique cutaneous diseases in one of the largest publicly available datasets of skin lesions is successfully performed. Accuracy is one of the most essential metrics of any CAD system's performance. Domain knowledge relevant to three types of diseases, namely glaucoma, Diabetic Retinopathy (DR), and skin lesions, is industriously utilised in an attempt to improve the accuracy. For glaucoma, a two-stage framework for automatic Optic Disc (OD) localisation and glaucoma detection is developed, which marked new state-of-the-art for glaucoma detection and OD localisation. To identify DR, a model is proposed that combines coarse-grained classifiers with fine-grained classifiers and grades the disease in four stages with respect to severity. Lastly, different methods of modelling and incorporating metadata are also examined and their effect on a model's classification performance is studied. Confidence in diagnosing a disease is equally important as the diagnosis itself. One of the biggest reasons hampering the successful deployment of CAD in the real-world is that medical diagnosis cannot be readily decided based on an algorithm's output. Therefore, a hybrid CNN architecture is proposed with the convolutional feature extractor trained using point estimates and a dense classifier trained using Bayesian estimates. Evaluation on 13 publicly available datasets shows the superiority of this method in terms of classification accuracy and also provides an estimate of uncertainty for every prediction. Explainability of AI-driven algorithms has become a legal requirement after Europe’s General Data Protection Regulations came into effect. This research presents a framework for easy-to-understand textual explanations of skin lesion diagnosis. The framework is called ExAID (Explainable AI for Dermatology) and relies upon two fundamental modules. The first module uses any deep skin lesion classifier and performs detailed analysis on its latent space to map human-understandable disease-related concepts to the latent representation learnt by the deep model. The second module proposes Concept Localisation Maps, which extend Concept Activation Vectors by locating significant regions corresponding to a learned concept in the latent space of a trained image classifier. This thesis probes many viable solutions to equip a CAD system with PACE. However, it is noted that some of these methods require specific attributes in datasets and, therefore, not all methods may be applied on a single dataset. Regardless, this work anticipates that consolidating PACE into a CAD system can not only increase the confidence of medical practitioners in such tools but also serve as a stepping stone for the further development of AI-driven technologies in healthcare

Feature Learning from Spectrograms for Assessment of Personality Traits

Several methods have recently been proposed to analyze speech and automatically infer the personality of the speaker. These methods often rely on prosodic and other hand crafted speech processing features extracted with off-the-shelf toolboxes. To achieve high accuracy, numerous features are typically extracted using complex and highly parameterized algorithms. In this paper, a new method based on feature learning and spectrogram analysis is proposed to simplify the feature extraction process while maintaining a high level of accuracy. The proposed method learns a dictionary of discriminant features from patches extracted in the spectrogram representations of training speech segments. Each speech segment is then encoded using the dictionary, and the resulting feature set is used to perform classification of personality traits. Experiments indicate that the proposed method achieves state-of-the-art results with a significant reduction in complexity when compared to the most recent reference methods. The number of features, and difficulties linked to the feature extraction process are greatly reduced as only one type of descriptors is used, for which the 6 parameters can be tuned automatically. In contrast, the simplest reference method uses 4 types of descriptors to which 6 functionals are applied, resulting in over 20 parameters to be tuned.Comment: 12 pages, 3 figure