Automated classification of retinopathy of prematurity in newborns

La Retinopatia de l'Prematur (ROP) és una malaltia que afecta els nadons prematurs mostrant-se com un subdesenvolupament dels vasos retinians. El diagnòstic precoç d'aquesta malaltia és un tot un repte ja que requereix de professionals altament qualificats amb coneixements molt específics. Actualment a Espanya, només uns pocs hospitals compten amb els equipaments especialitzats per al tractament i diagnòstic d'aquesta patologia. Aquest projecte final de màster, té com a objectiu final desenvolupar una eina preliminar per a la classificació de l'extensió aquesta malaltia. Aquesta applicació, ha estat disenyada per a ser integrada en una plataforma de suport a la diagnosi de la Retinopatia i poder evaluar la malaltia, proporcionant informació detallada sobre les imatge analitzades. Aquest projecte, també estableix les bases per a la comparació entre l'enfocament clínic, que utilitzen els metges, i la naturalesa "Black-Box" natural de la Xarxa Neuronal Artificial per classificar l'extensió de la malaltia. L'algoritme desenvolupat és capaç de: segmentar els vasos oculars utilitzant una xarxa neuronal convolucional U-Net; extreure les característiques representatives de la malaltia a partir de la segmentació; i classificar aquestes característiques en casos ROP i casos ROP Plus, mitjançant l'ús d'una gamma de classificadors. Les principals característiques analitzades són la tortuositat i el gruix dels vasos, indicadors de la malaltia emprats pels patolegs experts. La xarxa de segmentació ha obtingut una precisió global de l'96,15%. Els resultats dels diferents classificadors indiquen un trade-off entre la precisió i el volum d'imatges analitzades. S'ha obtingut una precisió de l'100% emprant un classificador de doble threshold en el analisis de l'12,5% de les imatges. En canvi, mitjançant l'ús d'un classificador "decision tree", s'ha obtingut una precisió del 70,8% analitzant el 100% de les imatges.La Retinopatía del Prematuro (ROP) es una enfermedad que afecta a los bebés prematuros mostrándose como el subdesarrollo de los vasos retinianos. El diagnóstico precoz de dicha enfermedad es un desafío ya que requiere de profesionales altamente capacitados con conocimientos muy específicos. Actualmente en España, solo unos pocos hospitales están dotados con los equipamientos especializados para el tratamiento y diagnóstico de esta patología Este proyecto final de master, tiene como objetivo final desarrollar una herramienta preliminar para la clasificación de la extensión dicha enfermedad. Esta aplicación, ha sido diseñada para ser integrada en una plataforma de soporte al diagnóstico de la Retinopatía y evaluar la enfermedad, proporcionando información detallada sobre las imágenes analizadas. Este proyecto también sienta las bases para la comparación entre el enfoque clínico, que utilizan los médicos, y la naturaleza "Black-Box" natural de la Red Neuronal Artificial para clasificar la extensión de la enfermedad. El algoritmo desarrollado es capaz de: segmentar los vasos oculares utilizando una red neuronal convolucional U-Net; extraer las características representativas de la enfermedad a partir de la segmentación; y clasificar estas características en casos ROP y casos ROP Plus, mediante el empleo de una gama de clasificadores. Las principales características analizadas son la tortuosidad y el grosor de los vasos, indicadores cauterizantes de la enfermedad empleados por los patólogos expertos. La red de segmentación ha logrado una precisión global del 96,15%. Los resultados de los diferentes clasificadores indican un trade-off entre la precisión y el volumen de imágenes analizadas. Se ha obtenido una precisión del 100% empleando un clasificador de doble threshold en el análisis del 12,5% de las imágenes. En cambio, mediante el uso de un clasificador “decision tree”, se ha obtenido una precisión del 70,8% analizando el 100% de las imágenes.Retinopathy of Prematurity (ROP) is a disease in preterm babies with underdevelopment in retinal vessels. Early diagnosis of the disease is challenging and requires skilled professionals with very specific knowledge. Currently, in Spain, only a few hospitals have departments specialized in this pathology and, therefore, are able to diagnose and treat it accordingly. This master project aims to develop the first preliminary instrument for the classification of the extent of Retinopathy disease. This tool has been built to be integrated into a diagnostic support platform to detect the presence of retinopathy and evaluate the sickness, providing insightful information regarding the specific image. This project also lays the base for the comparison between the clinical approach that the doctors use and the “black box” approach the Artificial Neural Network uses to predict the extent of the disease. The developed algorithm is able to: segment ocular vessels using a U-Net Convolutional Neural Network; extract the critical features from the segmentation; and classify those features into ROP cases and ROP Plus cases by employing a range of different classifiers. The main features analyzed by the related specialists and thus selected are tortuosity and thickness of the vessels. The segmentation Network achieved a global accuracy of 96.15%. The results of the different classifiers indicate a trade-off between accuracy and the volume of computed images. An accuracy of 100% was achieved with a Double Threshold classifier on 12.5% of the images. Instead, by using a Decision tree classifier, an accuracy of 70.8% was achieved when computing 100% of the images

Accuracy of Deep Learning Algorithms for the Diagnosis of Retinopathy of Prematurity by Fundus Images: A Systematic Review and Meta-Analysis

Background. Retinopathy of prematurity (ROP) occurs in preterm infants and may contribute to blindness. Deep learning (DL) models have been used for ophthalmologic diagnoses. We performed a systematic review and meta-analysis of published evidence to summarize and evaluate the diagnostic accuracy of DL algorithms for ROP by fundus images. Methods. We searched PubMed, EMBASE, Web of Science, and Institute of Electrical and Electronics Engineers Xplore Digital Library on June 13, 2021, for studies using a DL algorithm to distinguish individuals with ROP of different grades, which provided accuracy measurements. ,e pooled sensitivity and specificity values and the area under the curve (AUC) of summary receiver operating characteristics curves (SROC) summarized overall test performance. ,e performances in validation and test datasets were assessed together and separately. Subgroup analyses were conducted between the definition and grades of ROP. ,reshold and nonthreshold effects were tested to assess biases and evaluate accuracy factors associated with DL models. Results. Nine studies with fifteen classifiers were included in our meta-analysis. A total of 521,586 objects were applied to DL models. For combined validation and test datasets in each study, the pooled sensitivity and specificity were 0.953 (95% confidence intervals (CI): 0.946–0.959) and 0.975 (0.973–0.977), respectively, and the AUC was 0.984 (0.978–0.989). For the validation dataset and test dataset, the AUC was 0.977 (0.968–0.986) and 0.987 (0.982–0.992), respectively. In the subgroup analysis of ROP vs. normal and differentiation of two ROP grades, the AUC was 0.990 (0.944–0.994) and 0.982 (0.964–0.999), respectively. Conclusions. Our study shows that DL models can play an essential role in detecting and grading ROP with high sensitivity, specificity, and repeatability. ,e application of a DL-based automated system may improve ROP screening and diagnosis in the future

Artificial intelligence in retinal disease: clinical application, challenges, and future directions

Retinal diseases are a leading cause of blindness in developed countries, accounting for the largest share of visually impaired children, working-age adults (inherited retinal disease), and elderly individuals (age-related macular degeneration). These conditions need specialised clinicians to interpret multimodal retinal imaging, with diagnosis and intervention potentially delayed. With an increasing and ageing population, this is becoming a global health priority. One solution is the development of artificial intelligence (AI) software to facilitate rapid data processing. Herein, we review research offering decision support for the diagnosis, classification, monitoring, and treatment of retinal disease using AI. We have prioritised diabetic retinopathy, age-related macular degeneration, inherited retinal disease, and retinopathy of prematurity. There is cautious optimism that these algorithms will be integrated into routine clinical practice to facilitate access to vision-saving treatments, improve efficiency of healthcare systems, and assist clinicians in processing the ever-increasing volume of multimodal data, thereby also liberating time for doctor-patient interaction and co-development of personalised management plans

Novel Fundus Image Preprocessing for Retcam Images to Improve Deep Learning Classification of Retinopathy of Prematurity

Retinopathy of Prematurity (ROP) is a potentially blinding eye disorder because of damage to the eye's retina which can affect babies born prematurely. Screening of ROP is essential for early detection and treatment. This is a laborious and manual process which requires trained physician performing dilated ophthalmological examination which can be subjective resulting in lower diagnosis success for clinically significant disease. Automated diagnostic methods can assist ophthalmologists increase diagnosis accuracy using deep learning. Several research groups have highlighted various approaches. This paper proposes the use of new novel fundus preprocessing methods using pretrained transfer learning frameworks to create hybrid models to give higher diagnosis accuracy. The evaluations show that these novel methods in comparison to traditional imaging processing contribute to higher accuracy in classifying Plus disease, Stages of ROP and Zones. We achieve accuracy of 97.65% for Plus disease, 89.44% for Stage, 90.24% for Zones with limited training dataset.Comment: 10 pages, 4 figures, 7 tables. arXiv admin note: text overlap with arXiv:1904.08796 by other author

A Survey on Deep Learning in Medical Image Analysis

Deep learning algorithms, in particular convolutional networks, have rapidly become a methodology of choice for analyzing medical images. This paper reviews the major deep learning concepts pertinent to medical image analysis and summarizes over 300 contributions to the field, most of which appeared in the last year. We survey the use of deep learning for image classification, object detection, segmentation, registration, and other tasks and provide concise overviews of studies per application area. Open challenges and directions for future research are discussed.Comment: Revised survey includes expanded discussion section and reworked introductory section on common deep architectures. Added missed papers from before Feb 1st 201

An In-Depth Statistical Review of Retinal Image Processing Models from a Clinical Perspective

The burgeoning field of retinal image processing is critical in facilitating early diagnosis and treatment of retinal diseases, which are amongst the leading causes of vision impairment globally. Despite rapid advancements, existing machine learning models for retinal image processing are characterized by significant limitations, including disparities in pre-processing, segmentation, and classification methodologies, as well as inconsistencies in post-processing operations. These limitations hinder the realization of accurate, reliable, and clinically relevant outcomes. This paper provides an in-depth statistical review of extant machine learning models used in retinal image processing, meticulously comparing them based on their internal operating characteristics and performance levels. By adopting a robust analytical approach, our review delineates the strengths and weaknesses of current models, offering comprehensive insights that are instrumental in guiding future research and development in this domain. Furthermore, this review underscores the potential clinical impacts of these models, highlighting their pivotal role in enhancing diagnostic accuracy, prognostic assessments, and therapeutic interventions for retinal disorders. In conclusion, our work not only bridges the existing knowledge gap in the literature but also paves the way for the evolution of more sophisticated and clinically-aligned retinal image processing models, ultimately contributing to improved patient outcomes and advancements in ophthalmic care

On Interpretability of Deep Learning based Skin Lesion Classifiers using Concept Activation Vectors

Deep learning based medical image classifiers have shown remarkable prowess in various application areas like ophthalmology, dermatology, pathology, and radiology. However, the acceptance of these Computer-Aided Diagnosis (CAD) systems in real clinical setups is severely limited primarily because their decision-making process remains largely obscure. This work aims at elucidating a deep learning based medical image classifier by verifying that the model learns and utilizes similar disease-related concepts as described and employed by dermatologists. We used a well-trained and high performing neural network developed by REasoning for COmplex Data (RECOD) Lab for classification of three skin tumours, i.e. Melanocytic Naevi, Melanoma and Seborrheic Keratosis and performed a detailed analysis on its latent space. Two well established and publicly available skin disease datasets, PH2 and derm7pt, are used for experimentation. Human understandable concepts are mapped to RECOD image classification model with the help of Concept Activation Vectors (CAVs), introducing a novel training and significance testing paradigm for CAVs. Our results on an independent evaluation set clearly shows that the classifier learns and encodes human understandable concepts in its latent representation. Additionally, TCAV scores (Testing with CAVs) suggest that the neural network indeed makes use of disease-related concepts in the correct way when making predictions. We anticipate that this work can not only increase confidence of medical practitioners on CAD but also serve as a stepping stone for further development of CAV-based neural network interpretation methods.Comment: Accepted for the IEEE International Joint Conference on Neural Networks (IJCNN) 202