Bianca S. Gerendas

Anna Breger, Felix Goldbach, Bianca S. Gerendas et al.

Optical coherence tomography angiography (OCTA) is a novel noninvasive imaging modality for visualization of retinal blood flow in the human retina. Using specific OCTA imaging biomarkers for the identification of pathologies, automated image segmentations of the blood vessels can improve subsequent analysis and diagnosis. We present a novel segmentation method for vessel density identification based on frequency representations of the image, in particular, using so-called Gabor filter banks. The algorithm is evaluated qualitatively and quantitatively on an OCTA image in-house data set from $10$ eyes acquired by a Cirrus HD-OCT device. Qualitatively, the segmentation outcomes received very good visual evaluation feedback by experts. Quantitatively, we compared the resulting vessel density values with automated in-built values provided by the device. The results underline the visual evaluation. For the evaluation of the FAZ identification substep, manual annotations of $2$ expert graders were used, showing that our results coincide well in visual and quantitative manners. Lastly, we suggest the computation of adaptive local vessel density maps that allow straightforward analysis of retinal blood flow in a local manner.

Philipp Seeböck, David Romo-Bucheli, Sebastian Waldstein et al.

Optical coherence tomography (OCT) has become the most important imaging modality in ophthalmology. A substantial amount of research has recently been devoted to the development of machine learning (ML) models for the identification and quantification of pathological features in OCT images. Among the several sources of variability the ML models have to deal with, a major factor is the acquisition device, which can limit the ML model's generalizability. In this paper, we propose to reduce the image variability across different OCT devices (Spectralis and Cirrus) by using CycleGAN, an unsupervised unpaired image transformation algorithm. The usefulness of this approach is evaluated in the setting of retinal fluid segmentation, namely intraretinal cystoid fluid (IRC) and subretinal fluid (SRF). First, we train a segmentation model on images acquired with a source OCT device. Then we evaluate the model on (1) source, (2) target and (3) transformed versions of the target OCT images. The presented transformation strategy shows an F1 score of 0.4 (0.51) for IRC (SRF) segmentations. Compared with traditional transformation approaches, this means an F1 score gain of 0.2 (0.12).

Thomas Schlegl, Hrvoje Bogunovic, Sophie Klimscha et al.

The automatic detection of disease related entities in retinal imaging data is relevant for disease- and treatment monitoring. It enables the quantitative assessment of large amounts of data and the corresponding study of disease characteristics. The presence of hyperreflective foci (HRF) is related to disease progression in various retinal diseases. Manual identification of HRF in spectral-domain optical coherence tomography (SD-OCT) scans is error-prone and tedious. We present a fully automated machine learning approach for segmenting HRF in SD-OCT scans. Evaluation on annotated OCT images of the retina demonstrates that a residual U-Net allows to segment HRF with high accuracy. As our dataset comprised data from different retinal diseases including age-related macular degeneration, diabetic macular edema and retinal vein occlusion, the algorithm can safely be applied in all of them though different pathophysiological origins are known.

Philipp Seeböck, Sebastian Waldstein, Sophie Klimscha et al.

The identification and quantification of markers in medical images is critical for diagnosis, prognosis and management of patients in clinical practice. Supervised- or weakly supervised training enables the detection of findings that are known a priori. It does not scale well, and a priori definition limits the vocabulary of markers to known entities reducing the accuracy of diagnosis and prognosis. Here, we propose the identification of anomalies in large-scale medical imaging data using healthy examples as a reference. We detect and categorize candidates for anomaly findings untypical for the observed data. A deep convolutional autoencoder is trained on healthy retinal images. The learned model generates a new feature representation, and the distribution of healthy retinal patches is estimated by a one-class support vector machine. Results demonstrate that we can identify pathologic regions in images without using expert annotations. A subsequent clustering categorizes findings into clinically meaningful classes. In addition the learned features outperform standard embedding approaches in a classification task.