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

Renyi’s entropy based multilevel thresholding using a novel meta-heuristics algorithm

Multi-level image thresholding is the most direct and effective method for image segmentation, which is a key step for image analysis and computer vision, however, as the number of threshold values increases, exhaustive search does not work efficiently and effectively and evolutionary algorithms often fall into a local optimal solution. In the paper, a meta-heuristics algorithm based on the breeding mechanism of Chinese hybrid rice is proposed to seek the optimal multi-level thresholds for image segmentation and Renyi’s entropy is utilized as the fitness function. Experiments have been run on four scanning electron microscope images of cement and four standard images, moreover, it is compared with other six classical and novel evolutionary algorithms: genetic algorithm, particle swarm optimization algorithm, differential evolution algorithm, ant lion optimization algorithm, whale optimization algorithm, and salp swarm algorithm. Meanwhile, some indicators, including the average fitness values, standard deviation, peak signal to noise ratio, and structural similarity index are used as evaluation criteria in the experiments. The experimental results show that the proposed method prevails over the other algorithms involved in the paper on most indicators and it can segment cement scanning electron microscope image effectively

Automatic analysis of retinal images to aid in the diagnosis and grading of diabetic retinopathy

Diabetic retinopathy (DR) is the most common complication of diabetes mellitus and one of the leading causes of preventable blindness in the adult working population. Visual loss can be prevented from the early stages of DR, when the treatments are effective. Therefore, early diagnosis is paramount. However, DR may be clinically asymptomatic until the advanced stage, when vision is already affected and treatment may become difficult. For this reason, diabetic patients should undergo regular eye examinations through screening programs. Traditionally, DR screening programs are run by trained specialists through visual inspection of the retinal images. However, this manual analysis is time consuming and expensive. With the increasing incidence of diabetes and the limited number of clinicians and sanitary resources, the early detection of DR becomes non-viable. For this reason, computed-aided diagnosis (CAD) systems are required to assist specialists for a fast, reliable diagnosis, allowing to reduce the workload and the associated costs. We hypothesize that the application of novel, automatic algorithms for fundus image analysis could contribute to the early diagnosis of DR. Consequently, the main objective of the present Doctoral Thesis is to study, design and develop novel methods based on the automatic analysis of fundus images to aid in the screening, diagnosis, and treatment of DR. In order to achieve the main goal, we built a private database and used five retinal public databases: DRIMDB, DIARETDB1, DRIVE, Messidor and Kaggle. The stages of fundus image processing covered in this Thesis are: retinal image quality assessment (RIQA), the location of the optic disc (OD) and the fovea, the segmentation of RLs and EXs, and the DR severity grading. RIQA was studied with two different approaches. The first approach was based on the combination of novel, global features. Results achieved 91.46% accuracy, 92.04% sensitivity, and 87.92% specificity using the private database. We developed a second approach aimed at RIQA based on deep learning. We achieved 95.29% accuracy with the private database and 99.48% accuracy with the DRIMDB database. The location of the OD and the fovea was performed using a combination of saliency maps. The proposed methods were evaluated over the private database and the public databases DRIVE, DIARETDB1 and Messidor. For the OD, we achieved 100% accuracy for all databases except Messidor (99.50%). As for the fovea location, we also reached 100% accuracy for all databases except Messidor (99.67%). The joint segmentation of RLs and EXs was accomplished by decomposing the fundus image into layers. Results were computed per pixel and per image. Using the private database, 88.34% per-image accuracy (ACCi) was reached for the RL detection and 95.41% ACCi for EX detection. An additional method was proposed for the segmentation of RLs based on superpixels. Evaluating this method with the private database, we obtained 84.45% ACCi. Results were validated using the DIARETDB1 database. Finally, we proposed a deep learning framework for the automatic DR severity grading. The method was based on a novel attention mechanism which performs a separate attention of the dark and the bright structures of the retina. The Kaggle DR detection dataset was used for development and validation. The International Clinical DR Scale was considered, which is made up of 5 DR severity levels. Classification results for all classes achieved 83.70% accuracy and a Quadratic Weighted Kappa of 0.78. The methods proposed in this Doctoral Thesis form a complete, automatic DR screening system, contributing to aid in the early detection of DR. In this way, diabetic patients could receive better attention for their ocular health avoiding vision loss. In addition, the workload of specialists could be relieved while healthcare costs are reduced.La retinopatía diabética (RD) es la complicación más común de la diabetes mellitus y una de las principales causas de ceguera prevenible en la población activa adulta. El diagnóstico precoz es primordial para prevenir la pérdida visual. Sin embargo, la RD es clínicamente asintomática hasta etapas avanzadas, cuando la visión ya está afectada. Por eso, los pacientes diabéticos deben someterse a exámenes oftalmológicos periódicos a través de programas de cribado. Tradicionalmente, estos programas están a cargo de especialistas y se basan de la inspección visual de retinografías. Sin embargo, este análisis manual requiere mucho tiempo y es costoso. Con la creciente incidencia de la diabetes y la escasez de recursos sanitarios, la detección precoz de la RD se hace inviable. Por esta razón, se necesitan sistemas de diagnóstico asistido por ordenador (CAD) que ayuden a los especialistas a realizar un diagnóstico rápido y fiable, que permita reducir la carga de trabajo y los costes asociados. El objetivo principal de la presente Tesis Doctoral es estudiar, diseñar y desarrollar nuevos métodos basados en el análisis automático de retinografías para ayudar en el cribado, diagnóstico y tratamiento de la RD. Las etapas estudiadas fueron: la evaluación de la calidad de la imagen retiniana (RIQA), la localización del disco óptico (OD) y la fóvea, la segmentación de RL y EX y la graduación de la severidad de la RD. RIQA se estudió con dos enfoques diferentes. El primer enfoque se basó en la combinación de características globales. Los resultados lograron una precisión del 91,46% utilizando la base de datos privada. El segundo enfoque se basó en aprendizaje profundo. Logramos un 95,29% de precisión con la base de datos privada y un 99,48% con la base de datos DRIMDB. La localización del OD y la fóvea se realizó mediante una combinación de mapas de saliencia. Los métodos propuestos fueron evaluados sobre la base de datos privada y las bases de datos públicas DRIVE, DIARETDB1 y Messidor. Para el OD, logramos una precisión del 100% para todas las bases de datos excepto Messidor (99,50%). En cuanto a la ubicación de la fóvea, también alcanzamos un 100% de precisión para todas las bases de datos excepto Messidor (99,67%). La segmentación conjunta de RL y EX se logró descomponiendo la imagen del fondo de ojo en capas. Utilizando la base de datos privada, se alcanzó un 88,34% de precisión por imagen (ACCi) para la detección de RL y un 95,41% de ACCi para la detección de EX. Se propuso un método adicional para la segmentación de RL basado en superpíxeles. Evaluando este método con la base de datos privada, obtuvimos 84.45% ACCi. Los resultados se validaron utilizando la base de datos DIARETDB1. Finalmente, propusimos un método de aprendizaje profundo para la graduación automática de la gravedad de la DR. El método se basó en un mecanismo de atención. Se utilizó la base de datos Kaggle y la Escala Clínica Internacional de RD (5 niveles de severidad). Los resultados de clasificación para todas las clases alcanzaron una precisión del 83,70% y un Kappa ponderado cuadrático de 0,78. Los métodos propuestos en esta Tesis Doctoral forman un sistema completo y automático de cribado de RD, contribuyendo a ayudar en la detección precoz de la RD. De esta forma, los pacientes diabéticos podrían recibir una mejor atención para su salud ocular evitando la pérdida de visión. Además, se podría aliviar la carga de trabajo de los especialistas al mismo tiempo que se reducen los costes sanitarios.Escuela de DoctoradoDoctorado en Tecnologías de la Información y las Telecomunicacione