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Automated detection of blood vessel structures is becoming of crucial interest for better management of vascular disease. In this paper, we propose a new infinite active contour model that uses hybrid region information of the image to approach this problem. More specifically, an infinite perimeter regularizer, provided by using L(2) Lebesgue measure of the γ -neighborhood of boundaries, allows for better detection of small oscillatory (branching) structures than the traditional models based on the length of a feature's boundaries (i.e., H(1) Hausdorff measure). Moreover, for better general segmentation performance, the proposed model takes the advantage of using different types of region information, such as the combination of intensity information and local phase based enhancement map. The local phase based enhancement map is used for its superiority in preserving vessel edges while the given image intensity information will guarantee a correct feature's segmentation. We evaluate the performance of the proposed model by applying it to three public retinal image datasets (two datasets of color fundus photography and one fluorescein angiography dataset). The proposed model outperforms its competitors when compared with other widely used unsupervised and supervised methods. For example, the sensitivity (0.742), specificity (0.982) and accuracy (0.954) achieved on the DRIVE dataset are very close to those of the second observer's annotations.

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The detection of curvilinear structures in medical images, e.g., blood vessels or nerve fibers, is important in aiding management of many diseases. In this work, we propose a general unifying curvilinear structure segmentation network that works on different medical imaging modalities: optical coherence tomography angiography (OCT-A), color fundus image, and corneal confocal microscopy (CCM). Instead of the U-Net based convolutional neural network, we propose a novel network (CS-Net) which includes a self-attention mechanism in the encoder and decoder. Two types of attention modules are utilized-spatial attention and channel attention, to further integrate local features with their global dependencies adaptively. The proposed network has been validated on five datasets: two color fundus datasets, two corneal nerve datasets and one OCT-A dataset. Experimental results show that our method outperforms state-of-the-art methods, for example, sensitivities of corneal nerve fiber segmentation were at least 2% higher than the competitors. As a complementary output, we made manual annotations of two corneal nerve datasets which have been released for public access.

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Aims/hypothesis Corneal confocal microscopy is a rapid non-invasive ophthalmic imaging technique that identifies peripheral and central neurodegenerative disease. Quantification of corneal sub-basal nerve plexus morphology, however, requires either time-consuming manual annotation or a less-sensitive automated image analysis approach. We aimed to develop and validate an artificial intelligence-based, deep learning algorithm for the quantification of nerve fibre properties relevant to the diagnosis of diabetic neuropathy and to compare it with a validated automated analysis program, ACCMetrics. Methods Our deep learning algorithm, which employs a convolutional neural network with data augmentation, was developed for the automated quantification of the corneal sub-basal nerve plexus for the diagnosis of diabetic neuropathy. The algorithm was trained using a high-end graphics processor unit on 1698 corneal confocal microscopy images; for external validation, it was further tested on 2137 images. The algorithm was developed to identify total nerve fibre length, branch points, tail points, number and length of nerve segments, and fractal numbers. Sensitivity analyses were undertaken to determine the AUC for ACCMetrics and our algorithm for the diagnosis of diabetic neuropathy. Uazman Alam and Yalin Zheng are joint senior authors.

Glaucoma is a group of eye diseases which can cause vision loss by damaging the optic nerve. Early glaucoma detection is key to preventing vision loss yet there is a lack of noticeable early symptoms. Colour fundus photography allows the optic disc (OD) to be examined to diagnose glaucoma. Typically, this is done by measuring the vertical cup-to-disc ratio (CDR); however, glaucoma is characterised by thinning of the rim asymmetrically in the inferior-superior-temporal-nasal regions in increasing order. Automatic delineation of the OD features has potential to improve glaucoma management by allowing for this asymmetry to be considered in the measurements. Here, we propose a new deep-learning-based method to segment the OD and optic cup (OC). The core of the proposed method is DenseNet with a fully-convolutional network, whose symmetric U-shaped architecture allows pixel-wise classification. The predicted OD and OC boundaries are then used to estimate the CDR on two axes for glaucoma diagnosis. We assess the proposed method's performance using a large retinal colour fundus dataset, outperforming state-of-the-art segmentation methods. Furthermore, we generalise our method to segment four fundus datasets from different devices without further training, outperforming the state-of-the-art on two and achieving comparable results on the remaining two.

Automated detection of vascular structures is of great importance in understanding the mechanism, diagnosis, and treatment of many vascular pathologies. However, automatic vascular detection continues to be an open issue because of difficulties posed by multiple factors, such as poor contrast, inhomogeneous backgrounds, anatomical variations, and the presence of noise during image acquisition. In this paper, we propose a novel 2-D/3-D symmetry filter to tackle these challenging issues for enhancing vessels from different imaging modalities. The proposed filter not only considers local phase features by using a quadrature filter to distinguish between lines and edges, but also uses the weighted geometric mean of the blurred and shifted responses of the quadrature filter, which allows more tolerance of vessels with irregular appearance. As a result, this filter shows a strong response to the vascular features under typical imaging conditions. Results based on eight publicly available datasets (six 2-D data sets, one 3-D data set, and one 3-D synthetic data set) demonstrate its superior performance to other state-of-the-art methods.