Xinjian Chen

Meng Wang, Tian Lin, Lianyu Wang et al.

Failure to recognize samples from the classes unseen during training is a major limitation of artificial intelligence in the real-world implementation for recognition and classification of retinal anomalies. We established an uncertainty-inspired open-set (UIOS) model, which was trained with fundus images of 9 retinal conditions. Besides assessing the probability of each category, UIOS also calculated 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 target categories (TC)-JSIEC dataset and TC-unseen 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 would prompt the need for a manual check in the datasets of non-target categories retinal diseases, low-quality fundus images, and non-fundus images. UIOS provides a robust method for real-world screening of retinal anomalies.

Rui Jin, Derun Li, Dehui Xiang et al.

Prostate cancer represents a major threat to health. Early detection is vital in reducing the mortality rate among prostate cancer patients. One approach involves using multi-modality (CT, MRI, US, etc.) computer-aided diagnosis (CAD) systems for the prostate region. However, prostate segmentation is challenging due to imperfections in the images and the prostate's complex tissue structure. The advent of precision medicine and a significant increase in clinical capacity have spurred the need for various data-driven tasks in the field of medical imaging. Recently, numerous machine learning and data mining tools have been integrated into various medical areas, including image segmentation. This article proposes a new classification method that differentiates supervision types, either in number or kind, during the training phase. Subsequently, we conducted a survey on artificial intelligence (AI)-based automatic prostate segmentation methods, examining the advantages and limitations of each. Additionally, we introduce variants of evaluation metrics for the verification and performance assessment of the segmentation method and summarize the current challenges. Finally, future research directions and development trends are discussed, reflecting the outcomes of our literature survey, suggesting high-precision detection and treatment of prostate cancer as a promising avenue.

Meng Wang, Tian Lin, Qingshan Hou et al.

Artificial intelligence (AI) shows remarkable potential in medical imaging diagnostics, yet most current models require retraining when applied across different clinical settings, limiting their scalability. We introduce GlobeReady, a clinician-friendly AI platform that enables fundus disease diagnosis that operates without retraining, fine-tuning, or the needs for technical expertise. GlobeReady demonstrates high accuracy across imaging modalities: 93.9-98.5% for 11 fundus diseases using color fundus photographs (CPFs) and 87.2-92.7% for 15 fundus diseases using optic coherence tomography (OCT) scans. By leveraging training-free local feature augmentation, GlobeReady platform effectively mitigates domain shifts across centers and populations, achieving accuracies of 88.9-97.4% across five centers on average in China, 86.3-96.9% in Vietnam, and 73.4-91.0% in Singapore, and 90.2-98.9% in the UK. Incorporating a bulit-in confidence-quantifiable diagnostic mechanism further enhances the platform's accuracy to 94.9-99.4% with CFPs and 88.2-96.2% with OCT, while enabling identification of out-of-distribution cases with 86.3% accuracy across 49 common and rare fundus diseases using CFPs, and 90.6% accuracy across 13 diseases using OCT. Clinicians from countries rated GlobeReady highly for usability and clinical relevance (average score 4.6/5). These findings demonstrate GlobeReady's robustness, generalizability and potential to support global ophthalmic care without technical barriers.

Yuanyuan Peng, Aidi Lin, Meng Wang et al.

Inability to express the confidence level and detect unseen classes has limited the clinical implementation of artificial intelligence in the real-world. We developed a foundation model with uncertainty estimation (FMUE) to detect 11 retinal conditions on optical coherence tomography (OCT). In the internal test set, FMUE achieved a higher F1 score of 96.76% than two state-of-the-art algorithms, RETFound and UIOS, and got further improvement with thresholding strategy to 98.44%. In the external test sets obtained from other OCT devices, FMUE achieved an accuracy of 88.75% and 92.73% before and after thresholding. Our model is superior to two ophthalmologists with a higher F1 score (95.17% vs. 61.93% &71.72%). Besides, our model correctly predicts high uncertainty scores for samples with ambiguous features, of non-target-category diseases, or with low-quality to prompt manual checks and prevent misdiagnosis. FMUE provides a trustworthy method for automatic retinal anomalies detection in the real-world clinical open set environment.

Meng Wang, Tian Lin, Aidi Lin et al.

Previous foundation models for fundus images were pre-trained with limited disease categories and knowledge base. Here we introduce a knowledge-rich vision-language model (RetiZero) that leverages knowledge from more than 400 fundus diseases. For RetiZero's pretraining, we compiled 341,896 fundus images paired with texts, sourced from public datasets, ophthalmic literature, and online resources, encompassing a diverse range of diseases across multiple ethnicities and countries. RetiZero exhibits remarkable performance in several downstream tasks, including zero-shot disease recognition, image-to-image retrieval, AI-assisted clinical diagnosis,few-shot fine-tuning, and internal- and cross-domain disease identification. In zero-shot scenarios, RetiZero achieves Top-5 accuracies of 0.843 for 15 diseases and 0.756 for 52 diseases. For image retrieval, it achieves Top-5 scores of 0.950 and 0.886 for the same sets, respectively. AI-assisted clinical diagnosis results show that RetiZero's Top-3 zero-shot performance surpasses the average of 19 ophthalmologists from Singapore, China, and the United States. RetiZero substantially enhances clinicians' accuracy in diagnosing fundus diseases, in particularly rare ones. These findings underscore the value of integrating the RetiZero into clinical settings, where various fundus diseases are encountered.

Zhun Fan, Jiajie Mo, Benzhang Qiu et al.

Retinal vessel segmentation is a crucial step in diagnosing and screening various diseases, including diabetes, ophthalmologic diseases, and cardiovascular diseases. In this paper, we propose an effective and efficient method for vessel segmentation in color fundus images using encoder-decoder based octave convolution networks. Compared with other convolution networks utilizing standard convolution for feature extraction, the proposed method utilizes octave convolutions and octave transposed convolutions for learning multiple-spatial-frequency features, thus can better capture retinal vasculatures with varying sizes and shapes. To provide the network the capability of learning how to decode multifrequency features, we extend octave convolution and propose a new operation named octave transposed convolution. A novel architecture of convolutional neural network, named as Octave UNet integrating both octave convolutions and octave transposed convolutions is proposed based on the encoder-decoder architecture of UNet, which can generate high resolution vessel segmentation in one single forward feeding without post-processing steps. Comprehensive experimental results demonstrate that the proposed Octave UNet outperforms the baseline UNet achieving better or comparable performance to the state-of-the-art methods with fast processing speed. Specifically, the proposed method achieves 0.9664 / 0.9713 / 0.9759 / 0.9698 accuracy, 0.8374 / 0.8664 / 0.8670 / 0.8076 sensitivity, 0.9790 / 0.9798 / 0.9840 / 0.9831 specificity, 0.8127 / 0.8191 / 0.8313 / 0.7963 F1 score, and 0.9835 / 0.9875 / 0.9905 / 0.9845 Area Under Receiver Operating Characteristic curve, on DRIVE, STARE, CHASE_DB1, and HRF datasets, respectively.

Zhun Fan, Jiewei Lu, Wenji Li et al.

In this paper, a hierarchical image matting model is proposed to extract blood vessels from fundus images. More specifically, a hierarchical strategy utilizing the continuity and extendibility of retinal blood vessels is integrated into the image matting model for blood vessel segmentation. Normally the matting models require the user specified trimap, which separates the input image into three regions manually: the foreground, background and unknown regions. However, since creating a user specified trimap is a tedious and time-consuming task, region features of blood vessels are used to generate the trimap automatically in this paper. The proposed model has low computational complexity and outperforms many other state-ofart supervised and unsupervised methods in terms of accuracy, which achieves a vessel segmentation accuracy of 96:0%, 95:7% and 95:1% in an average time of 10:72s, 15:74s and 50:71s on images from three publicly available fundus image datasets DRIVE, STARE, and CHASE DB1, respectively.

Naji Khosravan, Haydar Celik, Baris Turkbey et al.

This study introduced a novel system, called Gaze2Segment, integrating biological and computer vision techniques to support radiologists' reading experience with an automatic image segmentation task. During diagnostic assessment of lung CT scans, the radiologists' gaze information were used to create a visual attention map. This map was then combined with a computer-derived saliency map, extracted from the gray-scale CT images. The visual attention map was used as an input for indicating roughly the location of a object of interest. With computer-derived saliency information, on the other hand, we aimed at finding foreground and background cues for the object of interest. At the final step, these cues were used to initiate a seed-based delineation process. Segmentation accuracy of the proposed Gaze2Segment was found to be 86% with dice similarity coefficient and 1.45 mm with Hausdorff distance. To the best of our knowledge, Gaze2Segment is the first true integration of eye-tracking technology into a medical image segmentation task without the need for any further user-interaction.