Detection and characterisation of vessels in retinal images.

Doctor of Philosophy in Mathematics, Statistics & Computer Science. University of KwaZulu-Natal, Durban 2015.As retinopathies such as diabetic retinopathy (DR) and retinopathy of prematurity (ROP) continue to be the major causes of blindness globally, regular retinal examinations of patients can assist in the early detection of the retinopathies. The manual detection of retinal vessels is a very tedious and time consuming task as it requires about two hours to manually detect vessels in each retinal image. Automatic vessel segmentation has been helpful in achieving speed, improved diagnosis and progress monitoring of these diseases but has been challenging due to complexities such as the varying width of the retinal vessels from very large to very small, low contrast of thin vessels with respect to background and noise due to nonhomogeneous illumination in the retinal images. Although several supervised and unsupervised segmentation methods have been proposed in the literature, the segmentation of thinner vessels, connectivity loss of the vessels and time complexity remain the major challenges. In order to address these problems, this research work investigated di erent unsupervised segmentation approaches to be used in the robust detection of large and thin retinal vessels in a timely e cient manner. Firstly, this thesis conducted a study on the use of di erent global thresholding techniques combined with di erent pre-processing and post-processing techniques. Two histogram-based global thresholding techniques namely, Otsu and Isodata were able to detect large retinal vessels but fail to segment the thin vessels because these thin vessels have very low contrast and are di cult to distinguish from the background tissues using the histogram of the retinal images. Two new multi-scale approaches of computing global threshold based on inverse di erence moment and sum-entropy combined with phase congruence are investigated to improve the detection of vessels. One of the findings of this study is that the multi-scale approaches of computing global threshold combined with phase congruence based techniques improved on the detection of large vessels and some of the thin vessels. They, however, failed to maintain the width of the detected vessels. The reduction in the width of the detected large and thin vessels results in low sensitivity rates while relatively good accuracy rates were maintained. Another study on the use of fuzzy c-means and GLCM sum entropy combined on phase congruence for vessel segmentation showed that fuzzy c-means combined with phase congruence achieved a higher average accuracy rates of 0.9431 and 0.9346 but a longer running time of 27.1 seconds when compared with the multi-scale based sum entropy thresholding combined with phase congruence with the average accuracy rates of 0.9416 and 0.9318 with a running time of 10.3 seconds. The longer running time of the fuzzy c-means over the sum entropy thresholding is, however, attributed to the iterative nature of fuzzy c-means. When compared with the literature, both methods achieved considerable faster running time. This thesis investigated two novel local adaptive thresholding techniques for the segmentation of large and thin retinal vessels. The two novel local adaptive thresholding techniques applied two di erent Haralick texture features namely, local homogeneity and energy. Although these two texture features have been applied for supervised image segmentation in the literature, their novelty in this thesis lies in that they are applied using an unsupervised image segmentation approach. Each of these local adaptive thresholding techniques locally applies a multi-scale approach on each of the texture information considering the pixel of interest in relationship with its spacial neighbourhood to compute the local adaptive threshold. The localised multi-scale approach of computing the thresholds handled the challenge of the vessels' width variation. Experiments showed significant improvements in the average accuracy and average sensitivity rates of these techniques when compared with the previously discussed global thresholding methods and state of the art. The two novel local adaptive thresholding techniques achieved a higher reduction of false vessels around the border of the optic disc when compared with some of the previous techniques in the literature. These techniques also achieved a highly improved computational time of 1.9 to 3.9 seconds to segment the vessels in each retinal image when compared with the state of the art. Hence, these two novel local adaptive thresholding techniques are proposed for the segmentation of the vessels in the retinal images. This thesis further investigated the combination of di erence image and kmeans clustering technique for the segmentation of large and thin vessels in retinal images. The pre-processing phase computed a di erence image and k-means clustering technique was used for the vessel detection. While investigating this vessel segmentation method, this thesis established the need for a difference image that preserves the vessel details of the retinal image. Investigating the di erent low pass filters, median filter yielded the best di erence image required by k-means clustering for the segmentation of the retinal vessels. Experiments showed that the median filter based di erence images combined with k-means clustering technique achieved higher average accuracy and average sensitivity rates when compared with the previously discussed global thresholding methods and the state of the art. The median filter based di erence images combined with k-means clustering technique (that is, DIMDF) also achieved a higher reduction of false vessels around the border of the optic disc when compared with some previous techniques in the literature. These methods also achieved a highly improved computational time of 3.4 to 4 seconds when compared with the literature. Hence, the median filter based di erence images combined with k-means clustering technique are proposed for the segmentation of the vessels in retinal images. The characterisation of the detected vessels using tortuosity measure was also investigated in this research. Although several vessel tortuosity methods have been discussed in the literature, there is still need for an improved method that e ciently detects vessel tortuosity. The experimental study conducted in this research showed that the detection of the stationary points helps in detecting the change of direction and twists in the vessels. The combination of the vessel twist frequency obtained using the stationary points and distance metric for the computation of normalised and nonnormalised tortuosity index (TI) measure was investigated. Experimental results showed that the non-normalised TI measure had a stronger correlation with the expert's ground truth when compared with the distance metric and normalised TI measures. Hence, a non-normalised TI measure that combines the vessel twist frequency based on the stationary points and distance metric is proposed for the measurement of vessel tortuosity

Deteksi Region dengan Completed Local Binary Pattern dan Color Feature untuk Segmentasi Exudate menggunakan Metode Saliency pada Retina Fundus Images

Salah satu pertanda awal dari penyakit tersebut adalah munculnya luka berupa exudates yang terjadi karena terdapat lipid atau lemak bocor pada pembuluh darah abnormal dan bisa menyebabkan kebutaan bila berada di sekitar daerah macula. Deteksi dini kemunculan exudates diharapkan mampu untuk menurunkan resiko kebutaan terhadap penderita penyakit diabetic retinopathy. Salah satu tantangan dalam proses pendeteksian exudates adalah ukuran dari objek tersebut yang cukup kecil dibandingkan keseluruhan image. Dalam penelitian ini mengusulkan pendeteksian region atau daerah exudates menggunakan CLBP dan color feature untuk segmentasi exudates dengan saliency method. Terdapat tiga tahapan utama dalam penelitian ini, yaitu penghapusan optic disk, pendeteksian lokasi exudates, dan segmentasi exudates. Penghapusan optic disk dilakukan dengan menggunakan algoritma midpoint circle. Pada tahapan pendeteksian lokasi exudates, image akan dibagi menjadi sub-sub image yang lebih kecil kemudian diklasifikasikan menjadi exudates patch dan exudate-free patch berdasarkan fitur yang diperoleh dengan CLBP dan color feature. Sub image yang diklasifikasikan sebagai exudates patch kemudian disegmentasi dengan menggunakan saliency method dan renyi entropi thresholding. Evaluasi metode dilakukan pada dataset diaretDB1 dengan menghitung nilai akurasi, sensitivity, dan specificity. Metode yang diajukan dapat mendeteksi exudates secara lebih akurat dengan rata-rata nilai akurasi 99.63 %, sensitivity 83.23%, dan specificity 99.57%. ==============================================================================================Diabetic retinopathy is a complication of diabetes that attacks the eye organs. One of the early signs of the disease is the appearance of an exudate wound that occurs because there is lipid or leaked fatty in the abnormal blood vessels and can cause blindness if it appears around the macula. Early detection of exudates is expected to reduce the risk of blindness to diabetic retinopathy patients. One of the problems in the detection process of exudates is that the size of the object is quite small compared to the overall image. This study proposes to detect the exudate region using CLBP and color feature for segmentation exudates with saliency method. There are three main stages in this research, such as optical disk removal, location detection of exudates, and exudates segmentation. Optical disc removal is done by using midpoint circle algorithm. At the detection stage of the exudates location, the image will be divided into blocks then classified it into exudate patch and exudate-free patch based on features that obtained using CLBP and color features. Sub images that are classified as exudate patch then segmented by using the saliency method and renyi entropy thresholding. The method evaluation is performed on the diaretDB1 dataset by calculating the accuracy, sensitivity, and specificity values. The proposed method can detect exudates more accurately as shown with the average of accuracy, sensitivity, and specificity value of 99.63%, 83.23% , and 99.57% respectively

Segmentation and Characterization of Small Retinal Vessels in Fundus Images Using the Tensor Voting Approach

RÉSUMÉ La rétine permet de visualiser facilement une partie du réseau vasculaire humain. Elle offre ainsi un aperçu direct sur le développement et le résultat de certaines maladies liées au réseau vasculaire dans son entier. Chaque complication visible sur la rétine peut avoir un impact sur la capacité visuelle du patient. Les plus petits vaisseaux sanguins sont parmi les premières structures anatomiques affectées par la progression d’une maladie, être capable de les analyser est donc crucial. Les changements dans l’état, l’aspect, la morphologie, la fonctionnalité, ou même la croissance des petits vaisseaux indiquent la gravité des maladies. Le diabète est une maladie métabolique qui affecte des millions de personnes autour du monde. Cette maladie affecte le taux de glucose dans le sang et cause des changements pathologiques dans différents organes du corps humain. La rétinopathie diabétique décrit l’en- semble des conditions et conséquences du diabète au niveau de la rétine. Les petits vaisseaux jouent un rôle dans le déclenchement, le développement et les conséquences de la rétinopa- thie. Dans les dernières étapes de cette maladie, la croissance des nouveaux petits vaisseaux, appelée néovascularisation, présente un risque important de provoquer la cécité. Il est donc crucial de détecter tous les changements qui ont lieu dans les petits vaisseaux de la rétine dans le but de caractériser les vaisseaux sains et les vaisseaux anormaux. La caractérisation en elle-même peut faciliter la détection locale d’une rétinopathie spécifique. La segmentation automatique des structures anatomiques comme le réseau vasculaire est une étape cruciale. Ces informations peuvent être fournies à un médecin pour qu’elles soient considérées lors de son diagnostic. Dans les systèmes automatiques d’aide au diagnostic, le rôle des petits vaisseaux est significatif. Ne pas réussir à les détecter automatiquement peut conduire à une sur-segmentation du taux de faux positifs des lésions rouges dans les étapes ultérieures. Les efforts de recherche se sont concentrés jusqu’à présent sur la localisation précise des vaisseaux de taille moyenne. Les modèles existants ont beaucoup plus de difficultés à extraire les petits vaisseaux sanguins. Les modèles existants ne sont pas robustes à la grande variance d’apparence des vaisseaux ainsi qu’à l’interférence avec l’arrière-plan. Les modèles de la littérature existante supposent une forme générale qui n’est pas suffisante pour s’adapter à la largeur étroite et la courbure qui caractérisent les petits vaisseaux sanguins. De plus, le contraste avec l’arrière-plan dans les régions des petits vaisseaux est très faible. Les méthodes de segmentation ou de suivi produisent des résultats fragmentés ou discontinus. Par ailleurs, la segmentation des petits vaisseaux est généralement faite aux dépends de l’amplification du bruit. Les modèles déformables sont inadéquats pour segmenter les petits vaisseaux. Les forces utilisées ne sont pas assez flexibles pour compenser le faible contraste, la largeur, et vii la variance des vaisseaux. Enfin, les approches de type apprentissage machine nécessitent un entraînement avec une base de données étiquetée. Il est très difficile d’obtenir ces bases de données dans le cas des petits vaisseaux. Cette thèse étend les travaux de recherche antérieurs en fournissant une nouvelle mé- thode de segmentation des petits vaisseaux rétiniens. La détection de ligne à échelles multiples (MSLD) est une méthode récente qui démontre une bonne performance de segmentation dans les images de la rétine, tandis que le vote tensoriel est une méthode proposée pour reconnecter les pixels. Une approche combinant un algorithme de détection de ligne et de vote tensoriel est proposée. L’application des détecteurs de lignes a prouvé son efficacité à segmenter les vais- seaux de tailles moyennes. De plus, les approches d’organisation perceptuelle comme le vote tensoriel ont démontré une meilleure robustesse en combinant les informations voisines d’une manière hiérarchique. La méthode de vote tensoriel est plus proche de la perception humain que d’autres modèles standards. Comme démontré dans ce manuscrit, c’est un outil pour segmenter les petits vaisseaux plus puissant que les méthodes existantes. Cette combinaison spécifique nous permet de surmonter les défis de fragmentation éprouvés par les méthodes de type modèle déformable au niveau des petits vaisseaux. Nous proposons également d’utiliser un seuil adaptatif sur la réponse de l’algorithme de détection de ligne pour être plus robuste aux images non-uniformes. Nous illustrons également comment une combinaison des deux méthodes individuelles, à plusieurs échelles, est capable de reconnecter les vaisseaux sur des distances variables. Un algorithme de reconstruction des vaisseaux est également proposé. Cette dernière étape est nécessaire car l’information géométrique complète est requise pour pouvoir utiliser la segmentation dans un système d’aide au diagnostic. La segmentation a été validée sur une base de données d’images de fond d’oeil à haute résolution. Cette base contient des images manifestant une rétinopathie diabétique. La seg- mentation emploie des mesures de désaccord standards et aussi des mesures basées sur la perception. En considérant juste les petits vaisseaux dans les images de la base de données, l’amélioration dans le taux de sensibilité que notre méthode apporte par rapport à la méthode standard de détection multi-niveaux de lignes est de 6.47%. En utilisant les mesures basées sur la perception, l’amélioration est de 7.8%. Dans une seconde partie du manuscrit, nous proposons également une méthode pour caractériser les rétines saines ou anormales. Certaines images contiennent de la néovascula- risation. La caractérisation des vaisseaux en bonne santé ou anormale constitue une étape essentielle pour le développement d’un système d’aide au diagnostic. En plus des défis que posent les petits vaisseaux sains, les néovaisseaux démontrent eux un degré de complexité encore plus élevé. Ceux-ci forment en effet des réseaux de vaisseaux à la morphologie com- plexe et inhabituelle, souvent minces et à fortes courbures. Les travaux existants se limitent viii à l’utilisation de caractéristiques de premier ordre extraites des petits vaisseaux segmentés. Notre contribution est d’utiliser le vote tensoriel pour isoler les jonctions vasculaires et d’uti- liser ces jonctions comme points d’intérêts. Nous utilisons ensuite une statistique spatiale de second ordre calculée sur les jonctions pour caractériser les vaisseaux comme étant sains ou pathologiques. Notre méthode améliore la sensibilité de la caractérisation de 9.09% par rapport à une méthode de l’état de l’art. La méthode développée s’est révélée efficace pour la segmentation des vaisseaux réti- niens. Des tenseurs d’ordre supérieur ainsi que la mise en œuvre d’un vote par tenseur via un filtrage orientable pourraient être étudiés pour réduire davantage le temps d’exécution et résoudre les défis encore présents au niveau des jonctions vasculaires. De plus, la caractéri- sation pourrait être améliorée pour la détection de la rétinopathie proliférative en utilisant un apprentissage supervisé incluant des cas de rétinopathie diabétique non proliférative ou d’autres pathologies. Finalement, l’incorporation des méthodes proposées dans des systèmes d’aide au diagnostic pourrait favoriser le dépistage régulier pour une détection précoce des rétinopathies et d’autres pathologies oculaires dans le but de réduire la cessité au sein de la population.----------ABSTRACT As an easily accessible site for the direct observation of the circulation system, human retina can offer a unique insight into diseases development or outcome. Retinal vessels are repre- sentative of the general condition of the whole systematic circulation, and thus can act as a "window" to the status of the vascular network in the whole body. Each complication on the retina can have an adverse impact on the patient’s sight. In this direction, small vessels’ relevance is very high as they are among the first anatomical structures that get affected as diseases progress. Moreover, changes in the small vessels’ state, appearance, morphology, functionality, or even growth indicate the severity of the diseases. This thesis will focus on the retinal lesions due to diabetes, a serious metabolic disease affecting millions of people around the world. This disorder disturbs the natural blood glucose levels causing various pathophysiological changes in different systems across the human body. Diabetic retinopathy is the medical term that describes the condition when the fundus and the retinal vessels are affected by diabetes. As in other diseases, small vessels play a crucial role in the onset, the development, and the outcome of the retinopathy. More importantly, at the latest stage, new small vessels, or neovascularizations, growth constitutes a factor of significant risk for blindness. Therefore, there is a need to detect all the changes that occur in the small retinal vessels with the aim of characterizing the vessels to healthy or abnormal. The characterization, in turn, can facilitate the detection of a specific retinopathy locally, like the sight-threatening proliferative diabetic retinopathy. Segmentation techniques can automatically isolate important anatomical structures like the vessels, and provide this information to the physician to assist him in the final decision. In comprehensive systems for the automatization of DR detection, small vessels role is significant as missing them early in a CAD pipeline might lead to an increase in the false positive rate of red lesions in subsequent steps. So far, the efforts have been concentrated mostly on the accurate localization of the medium range vessels. In contrast, the existing models are weak in case of the small vessels. The required generalization to adapt an existing model does not allow the approaches to be flexible, yet robust to compensate for the increased variability in the appearance as well as the interference with the background. So far, the current template models (matched filtering, line detection, and morphological processing) assume a general shape for the vessels that is not enough to approximate the narrow, curved, characteristics of the small vessels. Additionally, due to the weak contrast in the small vessel regions, the current segmentation and the tracking methods produce fragmented or discontinued results. Alternatively, the small vessel segmentation can be accomplished at the expense of x background noise magnification, in the case of using thresholding or the image derivatives methods. Furthermore, the proposed deformable models are not able to propagate a contour to the full extent of the vasculature in order to enclose all the small vessels. The deformable model external forces are ineffective to compensate for the low contrast, the low width, the high variability in the small vessel appearance, as well as the discontinuities. Internal forces, also, are not able to impose a global shape constraint to the contour that could be able to approximate the variability in the appearance of the vasculature in different categories of vessels. Finally, machine learning approaches require the training of a classifier on a labelled set. Those sets are difficult to be obtained, especially in the case of the smallest vessels. In the case of the unsupervised methods, the user has to predefine the number of clusters and perform an effective initialization of the cluster centers in order to converge to the global minimum. This dissertation expanded the previous research work and provides a new segmentation method for the smallest retinal vessels. Multi-scale line detection (MSLD) is a recent method that demonstrates good segmentation performance in the retinal images, while tensor voting is a method first proposed for reconnecting pixels. For the first time, we combined the line detection with the tensor voting framework. The application of the line detectors has been proved an effective way to segment medium-sized vessels. Additionally, perceptual organization approaches like tensor voting, demonstrate increased robustness by combining information coming from the neighborhood in a hierarchical way. Tensor voting is closer than standard models to the way human perception functions. As we show, it is a more powerful tool to segment small vessels than the existing methods. This specific combination allows us to overcome the apparent fragmentation challenge of the template methods at the smallest vessels. Moreover, we thresholded the line detection response adaptively to compensate for non-uniform images. We also combined the two individual methods in a multi-scale scheme in order to reconnect vessels at variable distances. Finally, we reconstructed the vessels from their extracted centerlines based on pixel painting as complete geometric information is required to be able to utilize the segmentation in a CAD system. The segmentation was validated on a high-resolution fundus image database that in- cludes diabetic retinopathy images of varying stages, using standard discrepancy as well as perceptual-based measures. When only the smallest vessels are considered, the improve- ments in the sensitivity rate for the database against the standard multi-scale line detection method is 6.47%. For the perceptual-based measure, the improvement is 7.8% against the basic method. The second objective of the thesis was to implement a method for the characterization of isolated retinal areas into healthy or abnormal cases. Some of the original images, from which xi these patches are extracted, contain neovascularizations. Investigation of image features for the vessels characterization to healthy or abnormal constitutes an essential step in the direction of developing CAD system for the automatization of DR screening. Given that the amount of data will significantly increase under CAD systems, the focus on this category of vessels can facilitate the referral of sight-threatening cases to early treatment. In addition to the challenges that small healthy vessels pose, neovessels demonstrate an even higher degree of complexity as they form networks of convolved, twisted, looped thin vessels. The existing work is limited to the use of first-order characteristics extracted from the small segmented vessels that limits the study of patterns. Our contribution is in using the tensor voting framework to isolate the retinal vascular junctions and in turn using those junctions as points of interests. Second, we exploited second-order statistics computed on the junction spatial distribution to characterize the vessels as healthy or neovascularizations. In fact, the second-order spatial statistics extracted from the junction distribution are combined with widely used features to improve the characterization sensitivity by 9.09% over the state of art. The developed method proved effective for the segmentation of the retinal vessels. Higher order tensors along with the implementation of tensor voting via steerable filtering could be employed to further reduce the execution time, and resolve the challenges at vascular junctions. Moreover, the characterization could be advanced to the detection of prolifera- tive retinopathy by extending the supervised learning to include non-proliferative diabetic retinopathy cases or other pathologies. Ultimately, the incorporation of the methods into CAD systems could facilitate screening for the effective reduction of the vision-threatening diabetic retinopathy rates, or the early detection of other than ocular pathologies

Analysis of Retinal Image Data to Support Glaucoma Diagnosis

Fundus kamera je široce dostupné zobrazovací zařízení, které umožňuje relativně rychlé a nenákladné vyšetření zadního segmentu oka – sítnice. Z těchto důvodů se mnoho výzkumných pracovišť zaměřuje právě na vývoj automatických metod diagnostiky nemocí sítnice s využitím fundus fotografií. Tato dizertační práce analyzuje současný stav vědeckého poznání v oblasti diagnostiky glaukomu s využitím fundus kamery a navrhuje novou metodiku hodnocení vrstvy nervových vláken (VNV) na sítnici pomocí texturní analýzy. Spolu s touto metodikou je navržena metoda segmentace cévního řečiště sítnice, jakožto další hodnotný příspěvek k současnému stavu řešené problematiky. Segmentace cévního řečiště rovněž slouží jako nezbytný krok předcházející analýzu VNV. Vedle toho práce publikuje novou volně dostupnou databázi snímků sítnice se zlatými standardy pro účely hodnocení automatických metod segmentace cévního řečiště.Fundus camera is widely available imaging device enabling fast and cheap examination of the human retina. Hence, many researchers focus on development of automatic methods towards assessment of various retinal diseases via fundus images. This dissertation summarizes recent state-of-the-art in the field of glaucoma diagnosis using fundus camera and proposes a novel methodology for assessment of the retinal nerve fiber layer (RNFL) via texture analysis. Along with it, a method for the retinal blood vessel segmentation is introduced as an additional valuable contribution to the recent state-of-the-art in the field of retinal image processing. Segmentation of the blood vessels also serves as a necessary step preceding evaluation of the RNFL via the proposed methodology. In addition, a new publicly available high-resolution retinal image database with gold standard data is introduced as a novel opportunity for other researches to evaluate their segmentation algorithms.