We present a new interactive method for tubular structure extraction. The main application and motivation for this work is vessel tracking in 2D and 3D images. The basic tools are minimal paths solved using the fast marching algorithm. This allows interactive tools for the physician by clicking on a small number of points in order to obtain a minimal path between two points or a set of paths in the case of a tree structure. Our method is based on a variant of the minimal path method that models the vessel as a centerline and surface. This is done by adding one dimension for the local radius around the centerline. The crucial step of our method is the definition of the local metrics to minimize. We have chosen to exploit the tubular structure of the vessels one wants to extract to built an anisotropic metric. The designed metric is well oriented along the direction of the vessel, admits higher velocity on the centerline, and provides a good estimate of the vessel radius. Based on the optimally oriented flux this measure is required to be robust against the disturbance introduced by noise or adjacent structures with intensity similar to the target vessel. We obtain promising results on noisy synthetic and real 2D and 3D images and we present a clinical validation.

The global burden of diabetic retinopathy (DR) continues to worsen and DR remains a leading cause of vision loss worldwide. Here, we describe an algorithm to predict DR progression by means of deep learning (DL), using as input color fundus photographs (CFPs) acquired at a single visit from a patient with DR. The proposed DL models were designed to predict future DR progression, defined as 2-step worsening on the Early Treatment Diabetic Retinopathy Diabetic Retinopathy Severity Scale, and were trained against DR severity scores assessed after 6, 12, and 24 months from the baseline visit by masked, well-trained, human reading center graders. The performance of one of these models (prediction at month 12) resulted in an area under the curve equal to 0.79. Interestingly, our results highlight the importance of the predictive signal located in the peripheral retinal fields, not routinely collected for DR assessments, and the importance of microvascular abnormalities. Our findings show the feasibility of predicting future DR progression by leveraging CFPs of a patient acquired at a single visit. Upon further development on larger and more diverse datasets, such an algorithm could enable early diagnosis and referral to a retina specialist for more frequent monitoring and even consideration of early intervention. Moreover, it could also improve patient recruitment for clinical trials targeting DR.

Although tracing linear structures in 2D images and 3D image stacks has received much attention over the years, full automation remains elusive. In this paper, we formulate the delineation problem as one of solving a Quadratic Mixed Integer Program (Q-MIP) in a graph of potential paths, which can be done optimally up to a very small tolerance. We further propose a novel approach to weighting these paths, which results in a Q-MIP solution that accurately matches the ground truth.We demonstrate that our approach outperforms a stateof-the-art technique based on the k-Minimum Spanning Tree formulation on a 2D dataset of aerial images and a 3D dataset of confocal microscopy stacks.