Lin Li

Puijin Cheng, Li Lin, Yijin Huang et al.

The quality of a fundus image can be compromised by numerous factors, many of which are challenging to be appropriately and mathematically modeled. In this paper, we introduce a novel diffusion model based framework, named Learning Enhancement from Degradation (LED), for enhancing fundus images. Specifically, we first adopt a data-driven degradation framework to learn degradation mappings from unpaired high-quality to low-quality images. We then apply a conditional diffusion model to learn the inverse enhancement process in a paired manner. The proposed LED is able to output enhancement results that maintain clinically important features with better clarity. Moreover, in the inference phase, LED can be easily and effectively integrated with any existing fundus image enhancement framework. We evaluate the proposed LED on several downstream tasks with respect to various clinically-relevant metrics, successfully demonstrating its superiority over existing state-of-the-art methods both quantitatively and qualitatively. The source code is available at https://github.com/QtacierP/LED.

Zhiyuan Cai, Li Lin, Huaqing He et al.

A large-scale labeled dataset is a key factor for the success of supervised deep learning in computer vision. However, a limited number of annotated data is very common, especially in ophthalmic image analysis, since manual annotation is time-consuming and labor-intensive. Self-supervised learning (SSL) methods bring huge opportunities for better utilizing unlabeled data, as they do not need massive annotations. With an attempt to use as many as possible unlabeled ophthalmic images, it is necessary to break the dimension barrier, simultaneously making use of both 2D and 3D images. In this paper, we propose a universal self-supervised Transformer framework, named Uni4Eye, to discover the inherent image property and capture domain-specific feature embedding in ophthalmic images. Uni4Eye can serve as a global feature extractor, which builds its basis on a Masked Image Modeling task with a Vision Transformer (ViT) architecture. We employ a Unified Patch Embedding module to replace the origin patch embedding module in ViT for jointly processing both 2D and 3D input images. Besides, we design a dual-branch multitask decoder module to simultaneously perform two reconstruction tasks on the input image and its gradient map, delivering discriminative representations for better convergence. We evaluate the performance of our pre-trained Uni4Eye encoder by fine-tuning it on six downstream ophthalmic image classification tasks. The superiority of Uni4Eye is successfully established through comparisons to other state-of-the-art SSL pre-training methods.

Huaqing He, Li Lin, Zhiyuan Cai et al.

Fundus photography has been routinely used to document the presence and severity of various retinal degenerative diseases such as age-related macula degeneration, glaucoma, and diabetic retinopathy, for which the fovea, optic disc (OD), and optic cup (OC) are important anatomical landmarks. Identification of those anatomical landmarks is of great clinical importance. However, the presence of lesions, drusen, and other abnormalities during retinal degeneration severely complicates automatic landmark detection and segmentation. Most existing works treat the identification of each landmark as a single task and typically do not make use of any clinical prior information. In this paper, we present a novel method, named JOINED, for prior guided multi-task learning for joint OD/OC segmentation and fovea detection. An auxiliary branch for distance prediction, in addition to a segmentation branch and a detection branch, is constructed to effectively utilize the distance information from each image pixel to landmarks of interest. Our proposed JOINED pipeline consists of a coarse stage and a fine stage. At the coarse stage, we obtain the OD/OC coarse segmentation and the heatmap localization of fovea through a joint segmentation and detection module. Afterwards, we crop the regions of interest for subsequent fine processing and use predictions obtained at the coarse stage as additional information for better performance and faster convergence. Experimental results reveal that our proposed JOINED outperforms existing state-of-the-art approaches on the publicly-available GAMMA, PALM, and REFUGE datasets of fundus images. Furthermore, JOINED ranked the 5th on the OD/OC segmentation and fovea detection tasks in the GAMMA challenge hosted by the MICCAI2021 workshop OMIA8.

Linkai Peng, Li Lin, Pujin Cheng et al.

Unsupervised domain adaptation has been proposed recently to tackle the so-called domain shift between training data and test data with different distributions. However, most of them only focus on single-target domain adaptation and cannot be applied to the scenario with multiple target domains. In this paper, we propose RVms, a novel unsupervised multi-target domain adaptation approach to segment retinal vessels (RVs) from multimodal and multicenter retinal images. RVms mainly consists of a style augmentation and transfer (SAT) module and a dual-teacher knowledge distillation (DTKD) module. SAT augments and clusters images into source-similar domains and source-dissimilar domains via Bezier and Fourier transformations. DTKD utilizes the augmented and transformed data to train two teachers, one for source-similar domains and the other for source-dissimilar domains. Afterwards, knowledge distillation is performed to iteratively distill different domain knowledge from teachers to a generic student. The local relative intensity transformation is employed to characterize RVs in a domain invariant manner and promote the generalizability of teachers and student models. Moreover, we construct a new multimodal and multicenter vascular segmentation dataset from existing publicly-available datasets, which can be used to benchmark various domain adaptation and domain generalization methods. Through extensive experiments, RVms is found to be very close to the target-trained Oracle in terms of segmenting the RVs, largely outperforming other state-of-the-art methods.

Juntao Chen, Li Lin, Pujin Cheng et al.

Medical image quality assessment (MIQA) is a vital prerequisite in various medical image analysis applications. Most existing MIQA algorithms are fully supervised that request a large amount of annotated data. However, annotating medical images is time-consuming and labor-intensive. In this paper, we propose an unsupervised anomaly-aware framework with test-time clustering for optical coherence tomography angiography (OCTA) image quality assessment in a setting wherein only a set of high-quality samples are accessible in the training phase. Specifically, a feature-embedding-based low-quality representation module is proposed to quantify the quality of OCTA images and then to discriminate between outstanding quality and non-outstanding quality. Within the non-outstanding quality class, to further distinguish gradable images from ungradable ones, we perform dimension reduction and clustering of multi-scale image features extracted by the trained OCTA quality representation network. Extensive experiments are conducted on one publicly accessible dataset sOCTA-3*3-10k, with superiority of our proposed framework being successfully established.

Li Lin, Linkai Peng, Huaqing He et al.

Weakly-supervised learning (WSL) has been proposed to alleviate the conflict between data annotation cost and model performance through employing sparsely-grained (i.e., point-, box-, scribble-wise) supervision and has shown promising performance, particularly in the image segmentation field. However, it is still a very challenging task due to the limited supervision, especially when only a small number of labeled samples are available. Additionally, almost all existing WSL segmentation methods are designed for star-convex structures which are very different from curvilinear structures such as vessels and nerves. In this paper, we propose a novel sparsely annotated segmentation framework for curvilinear structures, named YoloCurvSeg. A very essential component of YoloCurvSeg is image synthesis. Specifically, a background generator delivers image backgrounds that closely match the real distributions through inpainting dilated skeletons. The extracted backgrounds are then combined with randomly emulated curves generated by a Space Colonization Algorithm-based foreground generator and through a multilayer patch-wise contrastive learning synthesizer. In this way, a synthetic dataset with both images and curve segmentation labels is obtained, at the cost of only one or a few noisy skeleton annotations. Finally, a segmenter is trained with the generated dataset and possibly an unlabeled dataset. The proposed YoloCurvSeg is evaluated on four publicly available datasets (OCTA500, CORN, DRIVE and CHASEDB1) and the results show that YoloCurvSeg outperforms state-of-the-art WSL segmentation methods by large margins. With only one noisy skeleton annotation (respectively 0.14\%, 0.03\%, 1.40\%, and 0.65\% of the full annotation), YoloCurvSeg achieves more than 97\% of the fully-supervised performance on each dataset. Code and datasets will be released at https://github.com/llmir/YoloCurvSeg.

Yijin Huang, Li Lin, Pujin Cheng et al.

Although deep learning based diabetic retinopathy (DR) classification methods typically benefit from well-designed architectures of convolutional neural networks, the training setting also has a non-negligible impact on the prediction performance. The training setting includes various interdependent components, such as objective function, data sampling strategy and data augmentation approach. To identify the key components in a standard deep learning framework (ResNet-50) for DR grading, we systematically analyze the impact of several major components. Extensive experiments are conducted on a publicly-available dataset EyePACS. We demonstrate that (1) the DR grading framework is sensitive to input resolution, objective function, and composition of data augmentation, (2) using mean square error as the loss function can effectively improve the performance with respect to a task-specific evaluation metric, namely the quadratically-weighted Kappa, (3) utilizing eye pairs boosts the performance of DR grading and (4) using data resampling to address the problem of imbalanced data distribution in EyePACS hurts the performance. Based on these observations and an optimal combination of the investigated components, our framework, without any specialized network design, achieves the state-of-the-art result (0.8631 for Kappa) on the EyePACS test set (a total of 42670 fundus images) with only image-level labels. We also examine the proposed training practices on other fundus datasets and other network architectures to evaluate their generalizability. Our codes and pre-trained model are available at https://github.com/YijinHuang/pytorch-classification.

Junde Wu, Huihui Fang, Fei Li et al.

Color fundus photography and Optical Coherence Tomography (OCT) are the two most cost-effective tools for glaucoma screening. Both two modalities of images have prominent biomarkers to indicate glaucoma suspected. Clinically, it is often recommended to take both of the screenings for a more accurate and reliable diagnosis. However, although numerous algorithms are proposed based on fundus images or OCT volumes in computer-aided diagnosis, there are still few methods leveraging both of the modalities for the glaucoma assessment. Inspired by the success of Retinal Fundus Glaucoma Challenge (REFUGE) we held previously, we set up the Glaucoma grAding from Multi-Modality imAges (GAMMA) Challenge to encourage the development of fundus \& OCT-based glaucoma grading. The primary task of the challenge is to grade glaucoma from both the 2D fundus images and 3D OCT scanning volumes. As part of GAMMA, we have publicly released a glaucoma annotated dataset with both 2D fundus color photography and 3D OCT volumes, which is the first multi-modality dataset for glaucoma grading. In addition, an evaluation framework is also established to evaluate the performance of the submitted methods. During the challenge, 1272 results were submitted, and finally, top-10 teams were selected to the final stage. We analysis their results and summarize their methods in the paper. Since all these teams submitted their source code in the challenge, a detailed ablation study is also conducted to verify the effectiveness of the particular modules proposed. We find many of the proposed techniques are practical for the clinical diagnosis of glaucoma. As the first in-depth study of fundus \& OCT multi-modality glaucoma grading, we believe the GAMMA Challenge will be an essential starting point for future research.

Zhiyuan Cai, Li Lin, Huaqing He et al.

Glaucoma is one of the ophthalmic diseases that may cause blindness, for which early detection and treatment are very important. Fundus images and optical coherence tomography (OCT) images are both widely-used modalities in diagnosing glaucoma. However, existing glaucoma grading approaches mainly utilize a single modality, ignoring the complementary information between fundus and OCT. In this paper, we propose an efficient multi-modality supervised contrastive learning framework, named COROLLA, for glaucoma grading. Through layer segmentation as well as thickness calculation and projection, retinal thickness maps are extracted from the original OCT volumes and used as a replacing modality, resulting in more efficient calculations with less memory usage. Given the high structure and distribution similarities across medical image samples, we employ supervised contrastive learning to increase our models' discriminative power with better convergence. Moreover, feature-level fusion of paired fundus image and thickness map is conducted for enhanced diagnosis accuracy. On the GAMMA dataset, our COROLLA framework achieves overwhelming glaucoma grading performance compared to state-of-the-art methods.

James Z. Wang, Yuanyuan Zhang, Liang Dong et al.

Currently, most people use PubMed to search the MEDLINE database, an important bibliographical information source for life science and biomedical information. However, PubMed has some drawbacks that make it difficult to find relevant publications pertaining to users' individual intentions, especially for non-expert users. To ameliorate the disadvantages of PubMed, we developed G-Bean, a graph based biomedical search engine, to search biomedical articles in MEDLINE database more efficiently.G-Bean addresses PubMed's limitations with three innovations: parallel document index creation,ontology-graph based query expansion, and retrieval and re-ranking of documents based on user's search intention.Performance evaluation with 106 OHSUMED benchmark queries shows that G-Bean returns more relevant results than PubMed does when using these queries to search the MEDLINE database. PubMed could not even return any search result for some OHSUMED queries because it failed to form the appropriate Boolean query statement automatically from the natural language query strings. G-Bean is available at http://bioinformatics.clemson.edu/G-Bean/index.php.G-Bean addresses PubMed's limitations with ontology-graph based query expansion, automatic document indexing, and user search intention discovery. It shows significant advantages in finding relevant articles from the MEDLINE database to meet the information need of the user.