Feature Definition and Comprehensive Analysis on the Robust Identification of Intraretinal Cystoid Regions Using Optical Coherence Tomography Images

Financiado para publicación en acceso aberto: Universidade da Coruña/CISUG[Abstract] Currently, optical coherence tomography is one of the most used medical imaging modalities, offering cross-sectional representations of the studied tissues. This image modality is specially relevant for the analysis of the retina, since it is the internal part of the human body that allows an almost direct examination without invasive techniques. One of the most representative cases of use of this medical imaging modality is for the identification and characterization of intraretinal fluid accumulations, critical for the diagnosis of one of the main causes of blindness in developed countries: the Diabetic Macular Edema. The study of these fluid accumulations is particularly interesting, both from the point of view of pattern recognition and from the different branches of health sciences. As these fluid accumulations are intermingled with retinal tissues, they present numerous variants according to their severity, and change their appearance depending on the configuration of the device; they are a perfect subject for an in-depth research, as they are considered to be a problem without a strict solution. In this work, we propose a comprehensive and detailed analysis of the patterns that characterize them. We employed a pool of 11 different texture and intensity feature families (giving a total of 510 markers) which we have analyzed using three different feature selection strategies and seven complementary classification algorithms. By doing so, we have been able to narrow down and explain the factors affecting this kind of accumulations and tissue lesions by means of machine learning techniques with a pipeline specially designed for this purpose.Instituto de Salud Carlos III, Government of Spain, DTS18/00136 research project; Ministerio de Ciencia e Innovación y Universidades, Government of Spain, RTI2018-095894-B-I00 research project, Ayudas para la formación de profesorado universitario (FPU), grant ref. FPU18/02271; Ministerio de Ciencia e Innovación, Government of Spain through the research project with reference PID2019-108435RB-I00; Consellería de Cultura, Educación e Universidade, Xunta de Galicia, Grupos de Referencia Competitiva, grant ref. ED431C 2020/24 and through the postdoctoral grant contract ref. ED481B 2021/059; Axencia Galega de Innovación (GAIN), Xunta de Galicia, grant ref. IN845D 2020/38; CITIC, Centro de Investigación de Galicia ref. ED431G 2019/01, receives financial support from Consellería de Educación, Universidade e Formación Profesional, Xunta de Galicia, through the ERDF (80%) and Secretaría Xeral de Universidades (20%). Open Access funding provided thanks to the CRUE-CSIC agreement with Springer Nature. Funding for open access charge: Universidade da Coruña/CISUGXunta de Galicia; ED431C 2020/24Xunta de Galicia; ED481B 2021/059Xunta de Galicia; IN845D 2020/38Xunta de Galicia; ED431G 2019/0

A retinal vasculature tracking system guided by a deep architecture

Many diseases such as diabetic retinopathy (DR) and cardiovascular diseases show their early signs on retinal vasculature. Analysing the vasculature in fundus images may provide a tool for ophthalmologists to diagnose eye-related diseases and to monitor their progression. These analyses may also facilitate the discovery of new relations between changes on retinal vasculature and the existence or progression of related diseases or to validate present relations. In this thesis, a data driven method, namely a Translational Deep Belief Net (a TDBN), is adapted to vasculature segmentation. The segmentation performance of the TDBN on low resolution images was found to be comparable to that of the best-performing methods. Later, this network is used for the implementation of super-resolution for the segmentation of high resolution images. This approach provided an acceleration during segmentation, which relates to down-sampling ratio of an input fundus image. Finally, the TDBN is extended for the generation of probability maps for the existence of vessel parts, namely vessel interior, centreline, boundary and crossing/bifurcation patterns in centrelines. These probability maps are used to guide a probabilistic vasculature tracking system. Although segmentation can provide vasculature existence in a fundus image, it does not give quantifiable measures for vasculature. The latter has more practical value in medical clinics. In the second half of the thesis, a retinal vasculature tracking system is presented. This system uses Particle Filters to describe vessel morphology and topology. Apart from previous studies, the guidance for tracking is provided with the combination of probability maps generated by the TDBN. The experiments on a publicly available dataset, REVIEW, showed that the consistency of vessel widths predicted by the proposed method was better than that obtained from observers. Moreover, very noisy and low contrast vessel boundaries, which were hardly identifiable to the naked eye, were accurately estimated by the proposed tracking system. Also, bifurcation/crossing locations during the course of tracking were detected almost completely. Considering these promising initial results, future work involves analysing the performance of the tracking system on automatic detection of complete vessel networks in fundus images.Open Acces

Artificial Intelligence Techniques in Medical Imaging: A Systematic Review

This scientific review presents a comprehensive overview of medical imaging modalities and their diverse applications in artificial intelligence (AI)-based disease classification and segmentation. The paper begins by explaining the fundamental concepts of AI, machine learning (ML), and deep learning (DL). It provides a summary of their different types to establish a solid foundation for the subsequent analysis. The prmary focus of this study is to conduct a systematic review of research articles that examine disease classification and segmentation in different anatomical regions using AI methodologies. The analysis includes a thorough examination of the results reported in each article, extracting important insights and identifying emerging trends. Moreover, the paper critically discusses the challenges encountered during these studies, including issues related to data availability and quality, model generalization, and interpretability. The aim is to provide guidance for optimizing technique selection. The analysis highlights the prominence of hybrid approaches, which seamlessly integrate ML and DL techniques, in achieving effective and relevant results across various disease types. The promising potential of these hybrid models opens up new opportunities for future research in the field of medical diagnosis. Additionally, addressing the challenges posed by the limited availability of annotated medical images through the incorporation of medical image synthesis and transfer learning techniques is identified as a crucial focus for future research efforts

Exploring variability in medical imaging

Although recent successes of deep learning and novel machine learning techniques improved the perfor- mance of classification and (anomaly) detection in computer vision problems, the application of these methods in medical imaging pipeline remains a very challenging task. One of the main reasons for this is the amount of variability that is encountered and encapsulated in human anatomy and subsequently reflected in medical images. This fundamental factor impacts most stages in modern medical imaging processing pipelines. Variability of human anatomy makes it virtually impossible to build large datasets for each disease with labels and annotation for fully supervised machine learning. An efficient way to cope with this is to try and learn only from normal samples. Such data is much easier to collect. A case study of such an automatic anomaly detection system based on normative learning is presented in this work. We present a framework for detecting fetal cardiac anomalies during ultrasound screening using generative models, which are trained only utilising normal/healthy subjects. However, despite the significant improvement in automatic abnormality detection systems, clinical routine continues to rely exclusively on the contribution of overburdened medical experts to diagnosis and localise abnormalities. Integrating human expert knowledge into the medical imaging processing pipeline entails uncertainty which is mainly correlated with inter-observer variability. From the per- spective of building an automated medical imaging system, it is still an open issue, to what extent this kind of variability and the resulting uncertainty are introduced during the training of a model and how it affects the final performance of the task. Consequently, it is very important to explore the effect of inter-observer variability both, on the reliable estimation of model’s uncertainty, as well as on the model’s performance in a specific machine learning task. A thorough investigation of this issue is presented in this work by leveraging automated estimates for machine learning model uncertainty, inter-observer variability and segmentation task performance in lung CT scan images. Finally, a presentation of an overview of the existing anomaly detection methods in medical imaging was attempted. This state-of-the-art survey includes both conventional pattern recognition methods and deep learning based methods. It is one of the first literature surveys attempted in the specific research area.Open Acces

Computational Intelligence in Healthcare

This book is a printed edition of the Special Issue Computational Intelligence in Healthcare that was published in Electronic

Computational Intelligence in Healthcare

The number of patient health data has been estimated to have reached 2314 exabytes by 2020. Traditional data analysis techniques are unsuitable to extract useful information from such a vast quantity of data. Thus, intelligent data analysis methods combining human expertise and computational models for accurate and in-depth data analysis are necessary. The technological revolution and medical advances made by combining vast quantities of available data, cloud computing services, and AI-based solutions can provide expert insight and analysis on a mass scale and at a relatively low cost. Computational intelligence (CI) methods, such as fuzzy models, artificial neural networks, evolutionary algorithms, and probabilistic methods, have recently emerged as promising tools for the development and application of intelligent systems in healthcare practice. CI-based systems can learn from data and evolve according to changes in the environments by taking into account the uncertainty characterizing health data, including omics data, clinical data, sensor, and imaging data. The use of CI in healthcare can improve the processing of such data to develop intelligent solutions for prevention, diagnosis, treatment, and follow-up, as well as for the analysis of administrative processes. The present Special Issue on computational intelligence for healthcare is intended to show the potential and the practical impacts of CI techniques in challenging healthcare applications

Is attention all you need in medical image analysis? A review

Medical imaging is a key component in clinical diagnosis, treatment planning and clinical trial design, accounting for almost 90% of all healthcare data. CNNs achieved performance gains in medical image analysis (MIA) over the last years. CNNs can efficiently model local pixel interactions and be trained on small-scale MI data. The main disadvantage of typical CNN models is that they ignore global pixel relationships within images, which limits their generalisation ability to understand out-of-distribution data with different 'global' information. The recent progress of Artificial Intelligence gave rise to Transformers, which can learn global relationships from data. However, full Transformer models need to be trained on large-scale data and involve tremendous computational complexity. Attention and Transformer compartments (Transf/Attention) which can well maintain properties for modelling global relationships, have been proposed as lighter alternatives of full Transformers. Recently, there is an increasing trend to co-pollinate complementary local-global properties from CNN and Transf/Attention architectures, which led to a new era of hybrid models. The past years have witnessed substantial growth in hybrid CNN-Transf/Attention models across diverse MIA problems. In this systematic review, we survey existing hybrid CNN-Transf/Attention models, review and unravel key architectural designs, analyse breakthroughs, and evaluate current and future opportunities as well as challenges. We also introduced a comprehensive analysis framework on generalisation opportunities of scientific and clinical impact, based on which new data-driven domain generalisation and adaptation methods can be stimulated

Detection and Classification of Diabetic Retinopathy Pathologies in Fundus Images

Diabetic Retinopathy (DR) is a disease that affects up to 80% of diabetics around the world. It is the second greatest cause of blindness in the Western world, and one of the leading causes of blindness in the U.S. Many studies have demonstrated that early treatment can reduce the number of sight-threatening DR cases, mitigating the medical and economic impact of the disease. Accurate, early detection of eye disease is important because of its potential to reduce rates of blindness worldwide. Retinal photography for DR has been promoted for decades for its utility in both disease screening and clinical research studies. In recent years, several research centers have presented systems to detect pathology in retinal images. However, these approaches apply specialized algorithms to detect specific types of lesion in the retina. In order to detect multiple lesions, these systems generally implement multiple algorithms. Furthermore, some of these studies evaluate their algorithms on a single dataset, thus avoiding potential problems associated with the differences in fundus imaging devices, such as camera resolution. These methodologies primarily employ bottom-up approaches, in which the accurate segmentation of all the lesions in the retina is the basis for correct determination. A disadvantage of bottom-up approaches is that they rely on the accurate segmentation of all lesions in order to measure performance. On the other hand, top-down approaches do not depend on the segmentation of specific lesions. Thus, top-down methods can potentially detect abnormalities not explicitly used in their training phase. A disadvantage of these methods is that they cannot identify specific pathologies and require large datasets to build their training models. In this dissertation, I merged the advantages of the top-down and bottom-up approaches to detect DR with high accuracy. First, I developed an algorithm based on a top-down approach to detect abnormalities in the retina due to DR. By doing so, I was able to evaluate DR pathologies other than microaneurysms and exudates, which are the main focus of most current approaches. In addition, I demonstrated good generalization capacity of this algorithm by applying it to other eye diseases, such as age-related macular degeneration. Due to the fact that high accuracy is required for sight-threatening conditions, I developed two bottom-up approaches, since it has been proven that bottom-up approaches produce more accurate results than top-down approaches for particular structures. Consequently, I developed an algorithm to detect exudates in the macula. The presence of this pathology is considered to be a surrogate for clinical significant macular edema (CSME), a sight-threatening condition of DR. The analysis of the optic disc is usually not taken into account in DR screening systems. However, there is a pathology called neovascularization that is present in advanced stages of DR, making its detection of crucial clinical importance. In order to address this problem, I developed an algorithm to detect neovascularization in the optic disc. These algorithms are based on amplitude-modulation and frequency-modulation (AM-FM) representations, morphological image processing methods, and classification algorithms. The methods were tested on a diverse set of large databases and are considered to be the state-of the art in this field