Automated segmentation of retinal layers from optical coherence tomography images using geodesic distance

Optical coherence tomography (OCT) is a noninvasive imaging technique that can produce images of the eye at the microscopic level. OCT image segmentation to detect retinal layer boundaries is a fundamental procedure for diagnosing and monitoring the progression of retinal and optical nerve diseases. In this paper, we introduce a novel and accurate segmentation method based on geodesic distance for both two and three dimensional OCT images. The geodesic distance is weighted by an exponential function, which takes into account both horizontal and vertical intensity variations in the image. The weighted geodesic distance is efficiently calculated from an Eikonal equation via the fast sweeping method. Segmentation then proceeds by solving an ordinary differential equation of the geodesic distance. The performance of the proposed method is compared with manual segmentation. Extensive experiments demonstrate that the proposed method is robust to complex retinal structures with large curvature variations and irregularities and it outperforms the parametric active contour algorithm as well as graph based approaches for segmenting retinal layers in both healthy and pathological images

Supervised machine learning based multi-task artificial intelligence classification of retinopathies

Artificial intelligence (AI) classification holds promise as a novel and affordable screening tool for clinical management of ocular diseases. Rural and underserved areas, which suffer from lack of access to experienced ophthalmologists may particularly benefit from this technology. Quantitative optical coherence tomography angiography (OCTA) imaging provides excellent capability to identify subtle vascular distortions, which are useful for classifying retinovascular diseases. However, application of AI for differentiation and classification of multiple eye diseases is not yet established. In this study, we demonstrate supervised machine learning based multi-task OCTA classification. We sought 1) to differentiate normal from diseased ocular conditions, 2) to differentiate different ocular disease conditions from each other, and 3) to stage the severity of each ocular condition. Quantitative OCTA features, including blood vessel tortuosity (BVT), blood vascular caliber (BVC), vessel perimeter index (VPI), blood vessel density (BVD), foveal avascular zone (FAZ) area (FAZ-A), and FAZ contour irregularity (FAZ-CI) were fully automatically extracted from the OCTA images. A stepwise backward elimination approach was employed to identify sensitive OCTA features and optimal-feature-combinations for the multi-task classification. For proof-of-concept demonstration, diabetic retinopathy (DR) and sickle cell retinopathy (SCR) were used to validate the supervised machine leaning classifier. The presented AI classification methodology is applicable and can be readily extended to other ocular diseases, holding promise to enable a mass-screening platform for clinical deployment and telemedicine.Comment: Supplemental material attached at the en

Joint Diabetic Macular Edema Segmentation and Characterization in OCT Images

This version of the article has been accepted for publication, after peer review and is subject to Springer Nature’s AM terms of use, but is not the Version of Record and does not reflect post-acceptance improvements, or any corrections. The Version of Record is available online at: https://doi.org/10.1007/s10278-020-00360-y[Abstract]: The automatic identification and segmentation of edemas associated with diabetic macular edema (DME) constitutes a crucial ophthalmological issue as they provide useful information for the evaluation of the disease severity. According to clinical knowledge, the DME disorder can be categorized into three main pathological types: serous retinal detachment (SRD), cystoid macular edema (CME), and diffuse retinal thickening (DRT). The implementation of computational systems for their automatic extraction and characterization may help the clinicians in their daily clinical practice, adjusting the diagnosis and therapies and consequently the life quality of the patients. In this context, this paper proposes a fully automatic system for the identification, segmentation and characterization of the three ME types using optical coherence tomography (OCT) images. In the case of SRD and CME edemas, different approaches were implemented adapting graph cuts and active contours for their identification and precise delimitation. In the case of the DRT edemas, given their fuzzy regional appearance that requires a complex extraction process, an exhaustive analysis using a learning strategy was designed, exploiting intensity, texture, and clinical-based information. The different steps of this methodology were validated with a heterogeneous set of 262 OCT images, using the manual labeling provided by an expert clinician. In general terms, the system provided satisfactory results, reaching Dice coefficient scores of 0.8768, 0.7475, and 0.8913 for the segmentation of SRD, CME, and DRT edemas, respectively.This work is supported by the Instituto de Salud Carlos III, Government of Spain, and FEDER funds through the DTS18/00136 research project and by Ministerio de Ciencia, Innovación y Universidades, Government of Spain through the DPI2015-69948-R and RTI2018-095894-B-I00 research projects. Also, this work has received financial support from the European Union (European Regional Development Fund - ERDF) and the Xunta de Galicia, Centro de Investigación del Sistema Universitário de Galicia, Ref. ED431G 2019/01; and Grupos de Referencia Competitiva, Ref. ED431C 2016-047.Xunta de Galicia; ED431G 2019/01Xunta de Galicia; ED431C 2016-04

Active Contours and Image Segmentation: The Current State Of the Art

Image segmentation is a fundamental task in image analysis responsible for partitioning an image into multiple sub-regions based on a desired feature. Active contours have been widely used as attractive image segmentation methods because they always produce sub-regions with continuous boundaries, while the kernel-based edge detection methods, e.g. Sobel edge detectors, often produce discontinuous boundaries. The use of level set theory has provided more flexibility and convenience in the implementation of active contours. However, traditional edge-based active contour models have been applicable to only relatively simple images whose sub-regions are uniform without internal edges. Here in this paper we attempt to brief the taxonomy and current state of the art in Image segmentation and usage of Active Contours

Geodesic Graph Cut Based Retinal Fluid Segmentation in Optical Coherence Tomography

Age-related macular degeneration (AMD) is a leading cause of blindness in developed countries. Its most damaging form is characterized by accumulation of fluid inside the retina, whose quantification is of utmost importance for evaluating the disease progression. In this paper we propose an automated method for retinal fluid segmentation from 3D images acquired with optical coherence tomography (OCT). It combines a machine learning approach with an effective segmentation framework based on geodesic graph cut. After an image preprocessing step, an artificial neural network is trained based on textural features to assign to each voxel a probability of belonging to a fluid. The obtained probability maps are used to compute minimal geodesic distances from a set of identified seed points to the remaining unassigned voxels. Finally, the segmentation is solved optimally and efficiently using graph cut optimization. The method is evaluated on a clinical longitudinal dataset consisting of 30 OCT scans from 10 patients taken at 3 different stages of treatment. Manual annotations from two retinal specialists were taken as the gold standard. The segmentation method achieved mean precision of 0.88 and recall of 0.83, with the combined F1 score of 0.85. The segmented fluid volumes were within the measured inter-observer variability. The results demonstrate that the proposed method is a promising step towards accurate quantification of retinal fluid

Machine learning methods for the characterization and classification of complex data

This thesis work presents novel methods for the analysis and classification of medical images and, more generally, complex data. First, an unsupervised machine learning method is proposed to order anterior chamber OCT (Optical Coherence Tomography) images according to a patient's risk of developing angle-closure glaucoma. In a second study, two outlier finding techniques are proposed to improve the results of above mentioned machine learning algorithm, we also show that they are applicable to a wide variety of data, including fraud detection in credit card transactions. In a third study, the topology of the vascular network of the retina, considering it a complex tree-like network is analyzed and we show that structural differences reveal the presence of glaucoma and diabetic retinopathy. In a fourth study we use a model of a laser with optical injection that presents extreme events in its intensity time-series to evaluate machine learning methods to forecast such extreme events.El presente trabajo de tesis desarrolla nuevos métodos para el análisis y clasificación de imágenes médicas y datos complejos en general. Primero, proponemos un método de aprendizaje automático sin supervisión que ordena imágenes OCT (tomografía de coherencia óptica) de la cámara anterior del ojo en función del grado de riesgo del paciente de padecer glaucoma de ángulo cerrado. Luego, desarrollamos dos métodos de detección automática de anomalías que utilizamos para mejorar los resultados del algoritmo anterior, pero que su aplicabilidad va mucho más allá, siendo útil, incluso, para la detección automática de fraudes en transacciones de tarjetas de crédito. Mostramos también, cómo al analizar la topología de la red vascular de la retina considerándola una red compleja, podemos detectar la presencia de glaucoma y de retinopatía diabética a través de diferencias estructurales. Estudiamos también un modelo de un láser con inyección óptica que presenta eventos extremos en la serie temporal de intensidad para evaluar diferentes métodos de aprendizaje automático para predecir dichos eventos extremos.Aquesta tesi desenvolupa nous mètodes per a l’anàlisi i la classificació d’imatges mèdiques i dades complexes. Hem proposat, primer, un mètode d’aprenentatge automàtic sense supervisió que ordena imatges OCT (tomografia de coherència òptica) de la cambra anterior de l’ull en funció del grau de risc del pacient de patir glaucoma d’angle tancat. Després, hem desenvolupat dos mètodes de detecció automàtica d’anomalies que hem utilitzat per millorar els resultats de l’algoritme anterior, però que la seva aplicabilitat va molt més enllà, sent útil, fins i tot, per a la detecció automàtica de fraus en transaccions de targetes de crèdit. Mostrem també, com en analitzar la topologia de la xarxa vascular de la retina considerant-la una xarxa complexa, podem detectar la presència de glaucoma i de retinopatia diabètica a través de diferències estructurals. Finalment, hem estudiat un làser amb injecció òptica, el qual presenta esdeveniments extrems en la sèrie temporal d’intensitat. Hem avaluat diferents mètodes per tal de predir-los.Postprint (published version

Automatic Segmentation of the Retinal Nerve Fiber Layer by Means of Mathematical Morphology and Deformable Models in 2D Optical Coherence Tomography Imaging

[EN] Glaucoma is a neurodegenerative disease process that leads to progressive damage of the optic nerve to produce visual impairment and blindness. Spectral-domain OCT technology enables peripapillary circular scans of the retina and the measurement of the thickness of the retinal nerve fiber layer (RNFL) for the assessment of the disease status or progression in glaucoma patients. This paper describes a new approach to segment and measure the retinal nerve fiber layer in peripapillary OCT images. The proposed method consists of two stages. In the first one, morphological operators robustly detect the coarse location of the layer boundaries, despite the speckle noise and diverse artifacts in the OCT image. In the second stage, deformable models are initialized with the results of the previous stage to perform a fine segmentation of the boundaries, providing an accurate measurement of the entire RNFL. The results of the RNFL segmentation were qualitatively assessed by ophthalmologists, and the measurements of the thickness of the RNFL were quantitatively compared with those provided by the OCT inbuilt software as well as the state-of-the-art methods.This work was partially funded by Spanish National projects AES2017-PI17/00771 and AES2017-PI17/00821 (Instituto de Salud Carlos III), PID2019-105142RB-C21 (AI4SKIN) (Spanish Ministry of Economy and Competitiveness), PTA2017-14610-I (State Research Spanish Agency), regional project 20901/PI/18 (Fundacion Seneca) and Polytechnic University of Valencia (PAID-01-20).Berenguer-Vidal, R.; Verdú-Monedero, R.; Morales-Sánchez, J.; Sellés-Navarro, I.; Del Amor, R.; García-Pardo, JG.; Naranjo Ornedo, V. (2021). Automatic Segmentation of the Retinal Nerve Fiber Layer by Means of Mathematical Morphology and Deformable Models in 2D Optical Coherence Tomography Imaging. Sensors. 21(23):1-30. https://doi.org/10.3390/s21238027S130212

Robust multi-view approaches for retinal layer segmentation in glaucoma patients via transfer learning

Background: Glaucoma is the leading global cause of irreversible blindness. Glaucoma patients experience a progressive deterioration of the retinal nervous tissues that begins with a loss of peripheral vision. An early diagnosis is essential in order to prevent blindness. Ophthalmologists measure the deterioration caused by this disease by assessing the retinal layers in different regions of the eye, using different optical coherence tomography (OCT) scanning patterns to extract images, generating different views from multiple parts of the retina. These images are used to measure the thickness of the retinal layers in different regions. Methods: We present two approaches for the multi-region segmentation of the retinal layers in OCT images of glaucoma patients. These approaches can extract the relevant anatomical structures for glaucoma assessment from three different OCT scan patterns: circumpapillary circle scans, macular cube scans and optic disc (OD) radial scans. By employing transfer learning to take advantage of the visual patterns present in a related domain, these approaches use state-of-the-art segmentation modules to achieve a robust, fully automatic segmentation of the retinal layers. The first approach exploits inter-view similarities by using a single module to segment all of the scan patterns, considering them as a single domain. The second approach uses view-specific modules for the segmentation of each scan pattern, automatically detecting the suitable module to analyse each image. Results: The proposed approaches produced satisfactory results with the first approach achieving a dice coefficient of 0.85±0.06 and the second one 0.87±0.08 for all segmented layers. The first approach produced the best results for the radial scans. Concurrently, the view-specific second approach achieved the best results for the better represented circle and cube scan patterns. Conclusions: To the extent of our knowledge, this is the first proposal in the literature for the multi-view segmentation of the retinal layers of glaucoma patients, demonstrating the applicability of machine learningbased systems for aiding in the diagnosis of this relevant pathology

3D Segmentation & Measurement of Macular Holes

Macular holes are blinding conditions where a hole develops in the central part of retina, resulting in reduced central vision. The prognosis and treatment options are related to a number of variables including the macular hole size and shape. In this work we introduce a method to segment and measure macular holes in three-dimensional (3D) data. High-resolution spectral domain optical coherence tomography (SD-OCT) allows precise imaging of the macular hole geometry in three dimensions, but the measurement of these by human observers is time consuming and prone to high inter- and intra-observer variability, being characteristically measured in 2D rather than 3D. This work introduces several novel techniques to automatically retrieve accurate 3D measurements of the macular hole, including surface area, base area, base diameter, top area, top diameter, height, and minimum diameter. Specifically, it is introducing a multi-scale 3D level set segmentation approach based on a state-of-the-art level set method, and introducing novel curvature-based cutting and 3D measurement procedures. The algorithm is fully automatic, and we validate the extracted measurements both qualitatively and quantitatively, where the results show the method to be robust across a variety of scenarios. A segmentation software package is presented for targeting medical and biological applications, with a high level of visual feedback and several usability enhancements over existing packages. Specifically, it is providing a substantially faster graphics processing unit (GPU) implementation of the local Gaussian distribution fitting (LGDF) energy model, which can segment inhomogeneous objects with poorly defined boundaries as often encountered in biomedical images. It also provides interactive brushes to guide the segmentation process in a semi-automated framework. The speed of implementation allows us to visualise the active surface in real-time with a built-in ray tracer, where users may halt evolution at any timestep to correct implausible segmentation by painting new blocking regions or new seeds. Quantitative and qualitative validation is presented, demonstrating the practical efficacy of the interactive elements for a variety of real-world datasets. The size of macular holes is known to be one of the strongest predictors of surgical success both anatomically and functionally. Furthermore, it is used to guide the choice of treatment, the optimum surgical approach and to predict outcome. Our automated 3D image segmentation algorithm has extracted 3D shape-based macular hole measurements and described the dimensions and morphology. Our approach is able to robustly and accurately measure macular hole dimensions. This thesis is considered as a significant contribution for clinical applications particularly in the field of macular hole segmentation and shape analysis