Thomas P. Karnowski

Detection of Anatomic Structures in Human Retinal Imagery

The widespread availability of electronic imaging devices throughout the medical community is leading to a growing body of research on image processing and analysis to diagnose retinal disease such as diabetic retinopathy (DR). Productive computer-based screening of large, at-risk populations at low cost requires robust, automated image analysis. In this paper we present results for the automatic detection of the optic nerve and localization of the macula using digital red-free fundus photography. Our method relies on the accurate segmentation of the vasculature of the retina followed by the determination of spatial features describing the density, average thickness, and average orientation of the vasculature in relation to the position of the optic nerve. Localization of the macula follows using knowledge of the optic nerve location to detect the horizontal raphe of the retina using a geometric model of the vasculature. We report 90.4% detection performance for the optic nerve and 92.5% localization performance for the macula for red-free fundus images representing a population of 345 images corresponding to 269 patients with 18 different pathologies associated with DR and other common retinal diseases such as age-related macular degeneration.

Exudate-based diabetic macular edema detection in fundus images using publicly available datasets

Diabetic macular edema (DME) is a common vision threatening complication of diabetic retinopathy. In a large scale screening environment DME can be assessed by detecting exudates (a type of bright lesions) in fundus images. In this work, we introduce a new methodology for diagnosis of DME using a novel set of features based on colour, wavelet decomposition and automatic lesion segmentation. These features are employed to train a classifier able to automatically diagnose DME through the presence of exudation. We present a new publicly available dataset with ground-truth data containing 169 patients from various ethnic groups and levels of DME. This and other two publicly available datasets are employed to evaluate our algorithm. We are able to achieve diagnosis performance comparable to retina experts on the MESSIDOR (an independently labelled dataset with 1200 images) with cross-dataset testing (e.g., the classifier was trained on an independent dataset and tested on MESSIDOR). Our algorithm obtained an AUC between 0.88 and 0.94 depending on the dataset/features used. Additionally, it does not need ground truth at lesion level to reject false positives and is computationally efficient, as it generates a diagnosis on an average of 4.4s (9.3s, considering the optic nerve localisation) per image on an 2.6 GHz platform with an unoptimised Matlab implementation.

Automated diagnosis of retinopathy by content-based image retrieval.

Purpose: To describe a novel computer-based image analysis method that is being developed to assist and automate the diagnosis of retinal disease. Methods: Content-based image retrieval is the process of retrieving related images from large database collections using their pictorial content. The content feature list becomes the index for storage, search, and retrieval of related images from a library based upon specific visual characteristics. Low-level analyses use feature description models and higher-level analyses use perceptual organization and spatial relationships, including clinical metadata, to extract semantic information. Results: We defined, extracted, and tested a large number of region- and lesion-based features from a dataset of 395 retinal images. Using a statistical hold-one-out method, independent queries for each image were submitted to the system and a diagnostic prediction was formulated. The diagnostic sensitivity for all stratified levels of age-related macular degeneration ranged from 75% to 100%. Similarly, the sensitivity of detection and accuracy for proliferative diabetic retinopathy ranged from 75% to 91.7% and for nonproliferative diabetic retinopathy, ranged from 75% to 94.7%. The overall purity of the diagnosis (specificity) for all disease states in the dataset was 91.3%. Conclusions: The probabilistic nature of content-based image retrieval permits us to make statistically relevant predictions regarding the presence, severity, and manifestations of common retinal diseases from digital images in an automated and deterministic manner.

Automatic retina exudates segmentation without a manually labelled training set

Diabetic macular edema (DME) is a common vision threatening complication of diabetic retinopathy which can be assessed by detecting exudates (a type of bright lesion) in fundus images. In this work, two new methods for the detection of exudates are presented which do not use a supervised learning step; therefore, they do not require labelled lesion training sets which are time consuming to create, difficult to obtain and prone to human error. We introduce a new dataset of fundus images from various ethnic groups and levels of DME which we have made publicly available. We evaluate our algorithm with this dataset and compare our results with two recent exudate segmentation algorithms. In all of our tests, our algorithms perform better or comparable with an order of magnitude reduction in computational time.

Elliptical local vessel density: A fast and robust quality metric for retinal images

A great effort of the research community is geared towards the creation of an automatic screening system able to promptly detect diabetic retinopathy with the use of fundus cameras. In addition, there are some documented approaches for automatically judging the image quality. We propose a new set of features independent of field of view or resolution to describe the morphology of the patients vessels. Our initial results suggest that these features can be used to estimate the image quality in a time one order of magnitude shorter than previous techniques.

Validating retinal fundus image analysis algorithms: Issues and a proposal

This paper concerns the validation of automatic retinal image analysis (ARIA) algorithms. For reasons of space and consistency, we concentrate on the validation of algorithms processing color fundus camera images, currently the largest section of the ARIA literature. We sketch the context (imaging instruments and target tasks) of ARIA validation, summarizing the main image analysis and validation techniques. We then present a list of recommendations focusing on the creation of large repositories of test data created by international consortia, easily accessible via moderated Web sites, including multicenter annotations by multiple experts, specific to clinical tasks, and capable of running submitted software automatically on the data stored, with clear and widely agreed-on performance criteria, to provide a fair comparison.

Microaneurysm detection with radon transform-based classification on retina images

The creation of an automatic diabetic retinopathy screening system using retina cameras is currently receiving considerable interest in the medical imaging community. The detection of microaneurysms is a key element in this effort. In this work, we propose a new microaneurysms segmentation technique based on a novel application of the radon transform, which is able to identify these lesions without any previous knowledge of the retina morphological features and with minimal image preprocessing. The algorithm has been evaluated on the Retinopathy Online Challenge public dataset, and its performance compares with the best current techniques. The performance is particularly good at low false positive ratios, which makes it an ideal candidate for diabetic retinopathy screening systems.

Microaneurysms Detection with the Radon Cliff Operator in Retinal Fundus Images

Diabetic Retinopathy (DR) is one of the leading causes of blindness in the industrialized world. Early detection is the key in providing effective treatment. However, the current number of trained eye care specialists is inadequate to screen the increasing number of diabetic patients. In recent years, automated and semi-automated systems to detect DR with color fundus images have been developed with encouraging, but not fully satisfactory results. In this study we present the initial results of a new technique for the detection and localization of microaneurysms, an early sign of DR. The algorithm is based on three steps: candidates selection, the actual microaneurysms detection and a final probability evaluation. We introduce the new Radon Cliff operator which is our main contribution to the field. Making use of the Radon transform, the operator is able to detect single noisy Gaussian-like circular structures regardless of their size or strength. The advantages over existing microaneurysms detectors are manifold: the size of the lesions can be unknown, it automatically distinguishes lesions from the vasculature and it provides a fair approach to microaneurysm localization even without post-processing the candidates with machine learning techniques, facilitating the training phase. The algorithm is evaluated on a publicly available dataset from the Retinopathy Online Challenge.

Textureless Macula Swelling Detection With Multiple Retinal Fundus Images

Retinal fundus images acquired with nonmydriatic digital fundus cameras are versatile tools for the diagnosis of various retinal diseases. Because of the ease of use of newer camera models and their relatively low cost, these cameras can be employed by operators with limited training for telemedicine or point-of-care (PoC) applications. We propose a novel technique that uses uncalibrated multiple-view fundus images to analyze the swelling of the macula. This innovation enables the detection and quantitative measurement of swollen areas by remote ophthalmologists. This capability is not available with a single image and prone to error with stereo fundus cameras. We also present automatic algorithms to measure features from the reconstructed image, which are useful in PoC automated diagnosis of early macular edema, e.g., before the appearance of exudation. The technique presented is divided into three parts: first, a preprocessing technique simultaneously enhances the dark microstructures of the macula and equalizes the image; second, all available views are registered using nonmorphological sparse features; finally, a dense pyramidal optical flow is calculated for all the images and statistically combined to build a naive height map of the macula. Results are presented on three sets of synthetic images and two sets of real-world images. These preliminary tests show the ability to infer a minimum swelling of 300 and to correlate the reconstruction with the swollen location.

Automated Feature Generation in Large-Scale Geospatial Libraries for Content-Based Indexing.

We describe a method for indexing and retrieving high-resolution image regions in large geospatial data libraries. An automated feature extraction method is used that generates a unique and specific structural description of each segment of a tessellated input image file. These tessellated regions are then merged into similar groups, or sub-regions, and indexed to provide flexible and varied retrieval in a query-by-example environment. The methods of tessellation, feature extraction, sub-region clustering, indexing, and retrieval are described and demonstrated using a geospatial library representing a 153 km2 region of land in East Tennessee at 0.5 m per pixel resolution.