Pathological Evidence Exploration in Deep Retinal Image Diagnosis

Though deep learning has shown successful performance in classifying the label and severity stage of certain disease, most of them give few evidence on how to make prediction. Here, we propose to exploit the interpretability of deep learning application in medical diagnosis. Inspired by Koch's Postulates, a well-known strategy in medical research to identify the property of pathogen, we define a pathological descriptor that can be extracted from the activated neurons of a diabetic retinopathy detector. To visualize the symptom and feature encoded in this descriptor, we propose a GAN based method to synthesize pathological retinal image given the descriptor and a binary vessel segmentation. Besides, with this descriptor, we can arbitrarily manipulate the position and quantity of lesions. As verified by a panel of 5 licensed ophthalmologists, our synthesized images carry the symptoms that are directly related to diabetic retinopathy diagnosis. The panel survey also shows that our generated images is both qualitatively and quantitatively superior to existing methods.Comment: to appear in AAAI (2019). The first two authors contributed equally to the paper. Corresponding Author: Feng L

Uncertainty-inspired Open Set Learning for Retinal Anomaly Identification

Failure to recognize samples from the classes unseen during training is a major limit of artificial intelligence (AI) in real-world implementation of retinal anomaly classification. To resolve this obstacle, we propose an uncertainty-inspired open-set (UIOS) model which was trained with fundus images of 9 common retinal conditions. Besides the probability of each category, UIOS also calculates an uncertainty score to express its confidence. Our UIOS model with thresholding strategy achieved an F1 score of 99.55%, 97.01% and 91.91% for the internal testing set, external testing set and non-typical testing set, respectively, compared to the F1 score of 92.20%, 80.69% and 64.74% by the standard AI model. Furthermore, UIOS correctly predicted high uncertainty scores, which prompted the need for a manual check, in the datasets of rare retinal diseases, low-quality fundus images, and non-fundus images. This work provides a robust method for real-world screening of retinal anomalies

Robust AMD Stage Grading with Exclusively OCTA Modality Leveraging 3D Volume.

Age-related Macular Degeneration (AMD) is a degenerative eye disease that causes central vision loss. Optical Coherence Tomography Angiography (OCTA) is an emerging imaging modality that aids in the diagnosis of AMD by displaying the pathogenic vessels in the subretinal space. In this paper, we investigate the effectiveness of OCTA from the view of deep classifiers. To the best of our knowledge, this is the first study that solely uses OCTA for AMD stage grading. By developing a 2D classifier based on OCTA projections, we identify that segmentation errors in retinal layers significantly affect the accuracy of classification. To address this issue, we propose analyzing 3D OCTA volumes directly using a 2D convolutional neural network trained with additional projection supervision. Our experimental results show that we achieve over 80% accuracy on a four-stage grading task on both error-free and error-prone test sets, which is significantly higher than 60%, the accuracy of human experts. This demonstrates that OCTA provides sufficient information for AMD stage grading and the proposed 3D volume analyzer is more robust when dealing with OCTA data with segmentation errors

Machine learning strategies for diagnostic imaging support on histopathology and optical coherence tomography

Tesis por compendio[ES] Esta tesis presenta soluciones de vanguardia basadas en algoritmos de computer vision (CV) y machine learning (ML) para ayudar a los expertos en el diagnóstico clínico. Se centra en dos áreas relevantes en el campo de la imagen médica: la patología digital y la oftalmología. Este trabajo propone diferentes paradigmas de machine learning y deep learning para abordar diversos escenarios de supervisión en el estudio del cáncer de próstata, el cáncer de vejiga y el glaucoma. En particular, se consideran métodos supervisados convencionales para segmentar y clasificar estructuras específicas de la próstata en imágenes histológicas digitalizadas. Para el reconocimiento de patrones específicos de la vejiga, se llevan a cabo enfoques totalmente no supervisados basados en técnicas de deep-clustering. Con respecto a la detección del glaucoma, se aplican algoritmos de memoria a corto plazo (LSTMs) que permiten llevar a cabo un aprendizaje recurrente a partir de volúmenes de tomografía por coherencia óptica en el dominio espectral (SD-OCT). Finalmente, se propone el uso de redes neuronales prototípicas (PNN) en un marco de few-shot learning para determinar el nivel de gravedad del glaucoma a partir de imágenes OCT circumpapilares. Los métodos de inteligencia artificial (IA) que se detallan en esta tesis proporcionan una valiosa herramienta de ayuda al diagnóstico por imagen, ya sea para el diagnóstico histológico del cáncer de próstata y vejiga o para la evaluación del glaucoma a partir de datos de OCT.[CA] Aquesta tesi presenta solucions d'avantguarda basades en algorismes de *computer *vision (CV) i *machine *learning (ML) per a ajudar als experts en el diagnòstic clínic. Se centra en dues àrees rellevants en el camp de la imatge mèdica: la patologia digital i l'oftalmologia. Aquest treball proposa diferents paradigmes de *machine *learning i *deep *learning per a abordar diversos escenaris de supervisió en l'estudi del càncer de pròstata, el càncer de bufeta i el glaucoma. En particular, es consideren mètodes supervisats convencionals per a segmentar i classificar estructures específiques de la pròstata en imatges histològiques digitalitzades. Per al reconeixement de patrons específics de la bufeta, es duen a terme enfocaments totalment no supervisats basats en tècniques de *deep-*clustering. Respecte a la detecció del glaucoma, s'apliquen algorismes de memòria a curt termini (*LSTMs) que permeten dur a terme un aprenentatge recurrent a partir de volums de tomografia per coherència òptica en el domini espectral (SD-*OCT). Finalment, es proposa l'ús de xarxes neuronals *prototípicas (*PNN) en un marc de *few-*shot *learning per a determinar el nivell de gravetat del glaucoma a partir d'imatges *OCT *circumpapilares. Els mètodes d'intel·ligència artificial (*IA) que es detallen en aquesta tesi proporcionen una valuosa eina d'ajuda al diagnòstic per imatge, ja siga per al diagnòstic histològic del càncer de pròstata i bufeta o per a l'avaluació del glaucoma a partir de dades d'OCT.[EN] This thesis presents cutting-edge solutions based on computer vision (CV) and machine learning (ML) algorithms to assist experts in clinical diagnosis. It focuses on two relevant areas at the forefront of medical imaging: digital pathology and ophthalmology. This work proposes different machine learning and deep learning paradigms to address various supervisory scenarios in the study of prostate cancer, bladder cancer and glaucoma. In particular, conventional supervised methods are considered for segmenting and classifying prostate-specific structures in digitised histological images. For bladder-specific pattern recognition, fully unsupervised approaches based on deep-clustering techniques are carried out. Regarding glaucoma detection, long-short term memory algorithms (LSTMs) are applied to perform recurrent learning from spectral-domain optical coherence tomography (SD-OCT) volumes. Finally, the use of prototypical neural networks (PNNs) in a few-shot learning framework is proposed to determine the severity level of glaucoma from circumpapillary OCT images. The artificial intelligence (AI) methods detailed in this thesis provide a valuable tool to aid diagnostic imaging, whether for the histological diagnosis of prostate and bladder cancer or glaucoma assessment from OCT data.García Pardo, JG. (2022). Machine learning strategies for diagnostic imaging support on histopathology and optical coherence tomography [Tesis doctoral]. Universitat Politècnica de València. https://doi.org/10.4995/Thesis/10251/182400Compendi

Swept-Source Optical Coherence Tomography and Optical Coherence Tomography Angiography in Selected Posterior Uveitides

The pathogenesis of uveitis entails changes in the structural morphology of the macula, choroid, and choroidal perfusion. Documentation of these pathologic alterations is pivotal in making a proper diagnosis and in follow-up of outcomes of therapy. The newly-introduced swept-source optical coherence tomography (SS-OCT) and optical coherence tomography angiography (SS-OCTA) were harbingers of a whole new era of noninvasive in vivo layer-to-layer dissection of macular and choroidal structural changes in uveitis and of disease-related vascular profile patterns. This new information unraveled new aspects of the underlying pathogenetic mechanisms in different uveitides and added to our understanding of the disease process. Monitoring choroidal thickness was introduced as a novel sensitive index for evaluation and titration of treatment response. Moreover, the ensuing complications of uveitis as poor pupillary dilatation due to posterior synechiae and mild to moderate opacities due to cataract or vitritis that frequently posed pertinacious impediments for reproducible imaging were overcome by SS-OCT features notably long-wavelength scanning laser and reduced sensitivity roll-off features. In the current manuscript we present our experience in diagnosis and management of selected posterior uveitides using SS-OCT and SS-OCTA

Reliable Joint Segmentation of Retinal Edema Lesions in OCT Images

Focusing on the complicated pathological features, such as blurred boundaries, severe scale differences between symptoms, background noise interference, etc., in the task of retinal edema lesions joint segmentation from OCT images and enabling the segmentation results more reliable. In this paper, we propose a novel reliable multi-scale wavelet-enhanced transformer network, which can provide accurate segmentation results with reliability assessment. Specifically, aiming at improving the model's ability to learn the complex pathological features of retinal edema lesions in OCT images, we develop a novel segmentation backbone that integrates a wavelet-enhanced feature extractor network and a multi-scale transformer module of our newly designed. Meanwhile, to make the segmentation results more reliable, a novel uncertainty segmentation head based on the subjective logical evidential theory is introduced to generate the final segmentation results with a corresponding overall uncertainty evaluation score map. We conduct comprehensive experiments on the public database of AI-Challenge 2018 for retinal edema lesions segmentation, and the results show that our proposed method achieves better segmentation accuracy with a high degree of reliability as compared to other state-of-the-art segmentation approaches. The code will be released on: https://github.com/LooKing9218/ReliableRESeg

Functional and Neural Mechanisms of Out-of-Body Experiences: Importance of Retinogeniculo-Cortical Oscillations

Current research on the various forms of autoscopic phenomena addresses the clinical and neurological correlates of out-of-body experiences, autoscopic hallucinations,and heautoscopy. Yet most of this research is based on functional magnetic resonance imaging results and focuses predominantly on abnormal cortical activity. Previously we proposed that visual consciousness resulted from the dynamic retinogeniculo-cortical oscillations, such that the photoreceptors dynamically integrated with visual and other vision-associated cortices, and was theorized to be mapped out by photoreceptor discs and rich retinal networks which synchronized with the retinotopic mapping and the associated cortex. The feedback from neural input that is received from the thalamus and cortex via retinogeniculo-cortical oscillations and sent to the retina is multifold higher than feed-forward input to the cortex. This can effectively translate into out-of-body experiences projected onto the screen formed by the retina as it is perceived via feedback and feed-forward oscillations from the reticular thalamic nucleus, or “internal searchlight”. This article explores the role of the reticular thalamic nucleus and the retinogeniculo-cortical oscillations as pivotal internal components in vision and various autoscopic phenomena

Deep Learning in Cardiology

The medical field is creating large amount of data that physicians are unable to decipher and use efficiently. Moreover, rule-based expert systems are inefficient in solving complicated medical tasks or for creating insights using big data. Deep learning has emerged as a more accurate and effective technology in a wide range of medical problems such as diagnosis, prediction and intervention. Deep learning is a representation learning method that consists of layers that transform the data non-linearly, thus, revealing hierarchical relationships and structures. In this review we survey deep learning application papers that use structured data, signal and imaging modalities from cardiology. We discuss the advantages and limitations of applying deep learning in cardiology that also apply in medicine in general, while proposing certain directions as the most viable for clinical use.Comment: 27 pages, 2 figures, 10 table