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Independent validation studies of automatic diabetic retinopathy screening systems have recently shown a drop of screening performance on external data. Beyond diabetic retinopathy, this study investigates the generalizability of deep learning (DL) algorithms for screening various ocular anomalies in fundus photographs, across heterogeneous populations and imaging protocols. The following datasets are considered: OPHDIAT (France, diabetic population), OphtaMaine (France, general population), RIADD (India, general population) and ODIR (China, general population). Two multi-disease DL algorithms were developed: a Single-Dataset (SD) network, trained on the largest dataset (OPHDIAT), and a Multiple-Dataset (MD) network, trained on multiple datasets simultaneously. To assess their generalizability, both algorithms were evaluated whenever training and test data originate from overlapping datasets or from disjoint datasets. The SD network achieved a mean per-disease area under the receiver operating characteristic curve (mAUC) of 0.9571 on OPHDIAT. However, it generalized poorly to the other three datasets (mAUC < 0.9). When all four datasets were involved in training, the MD network significantly outperformed the SD network (p = 0.0058), indicating improved generality. However, in leave-one-dataset-out experiments, performance of the MD network was significantly lower on populations unseen during training than on populations involved in training (p < 0.0001), indicating imperfect generalizability. [ABSTRACT FROM AUTHOR]

Dry eye disease (DED) is a common eye condition worldwide and a primary reason for visits to the ophthalmologist. DED diagnosis is performed through a combination of tests, some of which are unfortunately invasive, non‐reproducible and lack accuracy. The following review describes methods that diagnose and measure the extent of eye dryness, enabling clinicians to quantify its severity. Our aim with this paper is to review classical methods as well as those that incorporate automation. For only four ways of quantifying DED, we take a deeper look into what main elements can benefit from automation and the different ways studies have incorporated it. Like numerous medical fields, Artificial Intelligence (AI) appears to be the path towards quality DED diagnosis. This review categorises diagnostic methods into the following: classical, semi‐automated and promising AI‐based automated methods. [ABSTRACT FROM AUTHOR]

Highlights • The challenge on automatic tool annotation for cataract surgery is presented. • Tool usage was manually annotated for 21 tools in 50 cataract surgery videos. • Various deep learning solutions were proposed by 14 teams. • Lessons learnt from the differential analysis of these solutions are presented. • Automatic annotations are almost as accurate as manual annotations. Graphical abstract Abstract Surgical tool detection is attracting increasing attention from the medical image analysis community. The goal generally is not to precisely locate tools in images, but rather to indicate which tools are being used by the surgeon at each instant. The main motivation for annotating tool usage is to design efficient solutions for surgical workflow analysis, with potential applications in report generation, surgical training and even real-time decision support. Most existing tool annotation algorithms focus on laparoscopic surgeries. However, with 19 million interventions per year, the most common surgical procedure in the world is cataract surgery. The CATARACTS challenge was organized in 2017 to evaluate tool annotation algorithms in the specific context of cataract surgery. It relies on more than nine hours of videos, from 50 cataract surgeries, in which the presence of 21 surgical tools was manually annotated by two experts. With 14 participating teams, this challenge can be considered a success. As might be expected, the submitted solutions are based on deep learning. This paper thoroughly evaluates these solutions: in particular, the quality of their annotations are compared to that of human interpretations. Next, lessons learnt from the differential analysis of these solutions are discussed. We expect that they will guide the design of efficient surgery monitoring tools in the near future. [ABSTRACT FROM AUTHOR]

This paper investigates the automatic monitoring of tool usage during a surgery, with potential applications in report generation, surgical training and real-time decision support. Two surgeries are considered: cataract surgery, the most common surgical procedure, and cholecystectomy, one of the most common digestive surgeries. Tool usage is monitored in videos recorded either through a microscope (cataract surgery) or an endoscope (cholecystectomy). Following state-of-the-art video analysis solutions, each frame of the video is analyzed by convolutional neural networks (CNNs) whose outputs are fed to recurrent neural networks (RNNs) in order to take temporal relationships between events into account. Novelty lies in the way those CNNs and RNNs are trained. Computational complexity prevents the end-to-end training of “CNN+RNN” systems. Therefore, CNNs are usually trained first, independently from the RNNs. This approach is clearly suboptimal for surgical tool analysis: many tools are very similar to one another, but they can generally be differentiated based on past events. CNNs should be trained to extract the most useful visual features in combination with the temporal context. A novel boosting strategy is proposed to achieve this goal: the CNN and RNN parts of the system are simultaneously enriched by progressively adding weak classifiers (either CNNs or RNNs) trained to improve the overall classification accuracy. Experiments were performed in a dataset of 50 cataract surgery videos, where the usage of 21 surgical tools was manually annotated, and a dataset of 80 cholecystectomy videos, where the usage of 7 tools was manually annotated. Very good classification performance are achieved in both datasets: tool usage could be labeled with an average area under the ROC curve of A z = 0.9961 and A z = 0.9939 , respectively, in offline mode (using past, present and future information), and A z = 0.9957 and A z = 0.9936 , respectively, in online mode (using past and present information only). [ABSTRACT FROM AUTHOR]

This paper describes a computer-aided detection and diagnosis system for breast cancer, the most common form of cancer among women, using mammography. The system relies on the Multiple-Instance Learning (MIL) paradigm, which has proven useful for medical decision support in previous works from our team. In the proposed framework, breasts are first partitioned adaptively into regions. Then, features derived from the detection of lesions (masses and microcalcifications) as well as textural features, are extracted from each region and combined in order to classify mammography examinations as “normal” or “abnormal”. Whenever an abnormal examination record is detected, the regions that induced that automated diagnosis can be highlighted. Two strategies are evaluated to define this anomaly detector. In a first scenario, manual segmentations of lesions are used to train an SVM that assigns an anomaly index to each region; local anomaly indices are then combined into a global anomaly index. In a second scenario, the local and global anomaly detectors are trained simultaneously, without manual segmentations, using various MIL algorithms (DD, APR, mi-SVM, MI-SVM and MILBoost). Experiments on the DDSM dataset show that the second approach, which is only weakly-supervised, surprisingly outperforms the first approach, even though it is strongly-supervised. This suggests that anomaly detectors can be advantageously trained on large medical image archives, without the need for manual segmentation. [ABSTRACT FROM AUTHOR]

With the increased prevalence of retinal pathologies, automating the detection of these pathologies is becoming more and more relevant. In the past few years, many algorithms have been developed for the automated detection of a specific pathology, typically diabetic retinopathy, using eye fundus photography. No matter how good these algorithms are, we believe many clinicians would not use automatic detection tools focusing on a single pathology and ignoring any other pathology present in the patient’s retinas. To solve this issue, an algorithm for characterizing the appearance of abnormal retinas, as well as the appearance of the normal ones, is presented. This algorithm does not focus on individual images: it considers examination records consisting of multiple photographs of each retina, together with contextual information about the patient. Specifically, it relies on data mining in order to learn diagnosis rules from characterizations of fundus examination records. The main novelty is that the content of examination records (images and context) is characterized at multiple levels of spatial and lexical granularity: 1) spatial flexibility is ensured by an adaptive decomposition of composite retinal images into a cascade of regions, 2) lexical granularity is ensured by an adaptive decomposition of the feature space into a cascade of visual words. This multigranular representation allows for great flexibility in automatically characterizing normality and abnormality: it is possible to generate diagnosis rules whose precision and generalization ability can be traded off depending on data availability. A variation on usual data mining algorithms, originally designed to mine static data, is proposed so that contextual and visual data at adaptive granularity levels can be mined. This framework was evaluated in e-ophtha , a dataset of 25,702 examination records from the OPHDIAT screening network, as well as in the publicly-available Messidor dataset. It was successfully applied to the detection of patients that should be referred to an ophthalmologist and also to the specific detection of several pathologies. [ABSTRACT FROM AUTHOR]

This paper introduces a new algorithm for recognizing surgical tasks in real-time in a video stream. The goal is to communicate information to the surgeon in due time during a video-monitored surgery. The proposed algorithm is applied to cataract surgery, which is the most common eye surgery. To compensate for eye motion and zoom level variations, cataract surgery videos are first normalized. Then, the motion content of short video subsequences is characterized with spatiotemporal polynomials: a multiscale motion characterization based on adaptive spatiotemporal polynomials is presented. The proposed solution is particularly suited to characterize deformable moving objects with fuzzy borders, which are typically found in surgical videos. Given a target surgical task, the system is trained to identify which spatiotemporal polynomials are usually extracted from videos when and only when this task is being performed. These key spatiotemporal polynomials are then searched in new videos to recognize the target surgical task. For improved performances, the system jointly adapts the spatiotemporal polynomial basis and identifies the key spatiotemporal polynomials using the multiple-instance learning paradigm. The proposed system runs in real-time and outperforms the previous solution from our group, both for surgical task recognition (A_z = 0.851 on average, as opposed to A_z = 0.794 previously) and for the joint segmentation and recognition of surgical tasks (A_z = 0.856 on average, as opposed to A_z = 0.832 previously). [ABSTRACT FROM PUBLISHER]

In ophthalmology, it is now common practice to record every surgical procedure and to archive the resulting videos for documentation purposes. In this paper, we present a solution to automatically segment and categorize surgical tasks in real-time during the surgery, using the video recording. The goal would be to communicate information to the surgeon in due time, such as recommendations to the less experienced surgeons. The proposed solution relies on the content-based video retrieval paradigm: it reuses previously archived videos to automatically analyze the current surgery, by analogy reasoning. Each video is segmented, in real-time, into an alternating sequence of idle phases, during which no clinically-relevant motions are visible, and action phases. As soon as an idle phase is detected, the previous action phase is categorized and the next action phase is predicted. A conditional random field is used for categorization and prediction. The proposed system was applied to the automatic segmentation and categorization of cataract surgery tasks. A dataset of 186 surgeries, performed by ten different surgeons, was manually annotated: ten possibly overlapping surgical tasks were delimited in each surgery. Using the content of action phases and the duration of idle phases as sources of evidence, an average recognition performance of Az = 0.832 \pm 0.070 was achieved. [ABSTRACT FROM AUTHOR]

Abstract: A novel multiple-instance learning framework, for automated image classification, is presented in this paper. Given reference images marked by clinicians as relevant or irrelevant, the image classifier is trained to detect patterns, of arbitrary size, that only appear in relevant images. After training, similar patterns are sought in new images in order to classify them as either relevant or irrelevant images. Therefore, no manual segmentations are required. As a consequence, large image datasets are available for training. The proposed framework was applied to diabetic retinopathy screening in 2-D retinal image datasets: Messidor (1200 images) and e-ophtha, a dataset of 25,702 examination records from the Ophdiat screening network (107,799 images). In this application, an image (or an examination record) is relevant if the patient should be referred to an ophthalmologist. Trained on one half of Messidor, the classifier achieved high performance on the other half of Messidor () and on e-ophtha (). We observed, in a subset of 273 manually segmented images from e-ophtha, that all eight types of diabetic retinopathy lesions are detected. [Copyright &y& Elsevier]

Adaptive wavelet-based image characterizations have been proposed in previous works for content-based image retrieval (CBIR) applications. In these applications, the same wavelet basis was used to characterize each query image: This wavelet basis was tuned to maximize the retrieval performance in a training data set. We take it one step further in this paper: A different wavelet basis is used to characterize each query image. A regression function, which is tuned to maximize the retrieval performance in the training data set, is used to estimate the best wavelet filter, i.e., in terms of expected retrieval performance, for each query image. A simple image characterization, which is based on the standardized moments of the wavelet coefficient distributions, is presented. An algorithm is proposed to compute this image characterization almost instantly for every possible separable or nonseparable wavelet filter. Therefore, using a different wavelet basis for each query image does not considerably increase computation times. On the other hand, significant retrieval performance increases were obtained in a medical image data set, a texture data set, a face recognition data set, and an object picture data set. This additional flexibility in wavelet adaptation paves the way to relevance feedback on image characterization itself and not simply on the way image characterizations are combined. [ABSTRACT FROM AUTHOR]

A novel content-based heterogeneous information retrieval framework, particularly well suited to browse medical databases and support new generation computer aided diagnosis (CADx) systems, is presented in this paper. It was designed to retrieve possibly incomplete documents, consisting of several images and semantic information, from a database; more complex data types such as videos can also be included in the framework. The proposed retrieval method relies on image processing, in order to characterize each individual image in a document by their digital content, and information fusion. Once the available images in a query document are characterized, a degree of match, between the query document and each reference document stored in the database, is defined for each attribute (an image feature or a metadata). A Bayesian network is used to recover missing information if need be. Finally, two novel information fusion methods are proposed to combine these degrees of match, in order to rank the reference documents by decreasing relevance for the query. In the first method, the degrees of match are fused by the Bayesian network itself. In the second method, they are fused by the Dezert–Smarandache theory: the second approach lets us model our confidence in each source of information (i.e., each attribute) and take it into account in the fusion process for a better retrieval performance. The proposed methods were applied to two heterogeneous medical databases, a diabetic retinopathy database and a mammography screening database, for computer aided diagnosis. Precisions at five of 0.809 \pm 0.158 and 0.821 \pm 0.177, respectively, were obtained for these two databases, which is very promising. [ABSTRACT FROM AUTHOR]

We present in this paper a novel way to adapt multidimensional wavelet filter bank, based on the nonseparable lifting scheme framework, to any specific problem. It allows the design of filter banks with a desired number of degrees of freedom, while controlling the number of vanishing moments of the primal wavelet (Ñ moments) and of the dual wavelet (N moments). The prediction and update filters, in the lifting scheme based filter banks, are defined as Neville filters of order Ñ and N, respectively. However, in order to introduce some degrees of freedom in the design, these filters are not defined as the simplest Neville filters. The proposed method is convenient: the same algorithm is used whatever the dimensionality of the signal, and whatever the lattice used. The method is applied to content-based image retrieval (CBIR): an image signature is derived from this new adaptive nonseparable wavelet transform. The method is evaluated on four image databases and compared to a similar CBIR system, based on an adaptive separable wavelet transform. The mean precision at five of the nonseparable wavelet based system is notably higher on three out of the four databases, and comparable on the other one. The proposed method also compares favorably with the dual-tree complex wavelet transform, an overcomplete nonseparable wavelet transform. [ABSTRACT FROM AUTHOR]

In this paper, we propose an automatic method to detect microaneurysms in retina photographs. Microaneurysms are the most frequent and usually the first lesions to appear as a consequence of diabetic retinopathy. So, their detection is necessary for both screening the pathology and follow up (progression measurement). Automating this task, which is currently performed manually, would bring more objectivity and reproducibility. We propose to detect them by locally matching a lesion template in subbands of wavelet transformed images. To improve the method performance, we have searched for the best adapted wavelet within the lifting scheme framework. The optimization process is based on a genetic algorithm followed by Powell's direction set descent. Results are evaluated on 120 retinal images analyzed by an expert and the optimal wavelet is compared to different conventional mother wavelets. These images are of three different modalities: there are color photographs, green filtered photographs, and angiographs. Depending on the imaging modality, microaneurysms were detected with a sensitivity of respectively 89.62%, 90.24%, and 93.74% and a positive predictive value of respectively 89.50%, 89.75%, and 91.67%, which is better than previously published methods. [ABSTRACT FROM AUTHOR]

• A machine learning framework is proposed to detect rare conditions in images. • This framework is evaluated in a dataset of 164,660 retinal screening examinations. • 37 conditions can be detected accurately in fundus photographs. • The location of pathological signs can be highlighted in images. • This is expected to increase the confidence in AI-based eye screening. In the last decades, large datasets of fundus photographs have been collected in diabetic retinopathy (DR) screening networks. Through deep learning, these datasets were used to train automatic detectors for DR and a few other frequent pathologies, with the goal to automate screening. One challenge limits the adoption of such systems so far: automatic detectors ignore rare conditions that ophthalmologists currently detect, such as papilledema or anterior ischemic optic neuropathy. The reason is that standard deep learning requires too many examples of these conditions. However, this limitation can be addressed with few-shot learning, a machine learning paradigm where a classifier has to generalize to a new category not seen in training, given only a few examples of this category. This paper presents a new few-shot learning framework that extends convolutional neural networks (CNNs), trained for frequent conditions, with an unsupervised probabilistic model for rare condition detection. It is based on the observation that CNNs often perceive photographs containing the same anomalies as similar, even though these CNNs were trained to detect unrelated conditions. This observation was based on the t-SNE visualization tool, which we decided to incorporate in our probabilistic model. Experiments on a dataset of 164,660 screening examinations from the OPHDIAT screening network show that 37 conditions, out of 41, can be detected with an area under the ROC curve (AUC) greater than 0.8 (average AUC: 0.938). In particular, this framework significantly outperforms other frameworks for detecting rare conditions, including multitask learning, transfer learning and Siamese networks, another few-shot learning solution. We expect these richer predictions to trigger the adoption of automated eye pathology screening, which will revolutionize clinical practice in ophthalmology. [ABSTRACT FROM AUTHOR]

Quantitative Gait Analysis (QGA) is considered as an objective measure of gait performance. In this study, we aim at designing an artificial intelligence that can efficiently predict the progression of gait quality using kinematic data obtained from QGA. For this purpose, a gait database collected from 734 patients with gait disorders is used. As the patient walks, kinematic data is collected during the gait session. This data is processed to generate the Gait Profile Score (GPS) for each gait cycle. Tracking potential GPS variations enables detecting changes in gait quality. In this regard, our work is driven by predicting such future variations. Two approaches were considered: signal-based and image-based. The signal-based one uses raw gait cycles, while the image-based one employs a two-dimensional Fast Fourier Transform (2D FFT) representation of gait cycles. Several architectures were developed, and the obtained Area Under the Curve (AUC) was above 0.72 for both approaches. To the best of our knowledge, our study is the first to apply neural networks for gait prediction tasks. [ABSTRACT FROM AUTHOR]

Finding correspondences between structural entities decomposing images is of high interest for computer vision applications. In particular, we analyze how to accurately track superpixels - visual primitives generated by aggregating adjacent pixels sharing similar characteristics - over extended time periods relying on unsupervised learning and temporal integration. A two-step video processing pipeline dedicated to long-term superpixel tracking is proposed. First, unsupervised learning-based superpixel matching provides correspondences between consecutive and distant frames using new context-rich features extended from greyscale to multi-channel and forward-backward consistency constraints. Resulting elementary matches are then combined along multi-step paths running through the whole sequence with various inter-frame distances. This produces a large set of candidate long-term superpixel pairings upon which majority voting is performed. Video object tracking experiments demonstrate the accuracy of our elementary estimator against state-of-the-art methods and proves the ability of multi-step integration to provide accurate long-term superpixel matches compared to usual direct and sequential integration. • A video processing pipeline dedicated to long-term superpixel tracking is proposed. • Multi-step superpixel pairings are estimated in an unsupervised learning fashion. • Unsupervised learning exploits robust context-rich features extended to multi-channel. • Elementary matches are combined through multi-step integration and majority voting. • Accurate long-term superpixel matches are shown for video object tracking experiments. [ABSTRACT FROM AUTHOR]

Optical coherence tomography angiography (OCTA) can deliver enhanced diagnosis for diabetic retinopathy (DR). This study evaluated a deep learning (DL) algorithm for automatic DR severity assessment using high-resolution and ultra-widefield (UWF) OCTA. Diabetic patients were examined with 6 × 6 mm 2 high-resolution OCTA and 15 × 15 mm 2 UWF-OCTA using PLEX®Elite 9000. A novel DL algorithm was trained for automatic DR severity inference using both OCTA acquisitions. The algorithm employed a unique hybrid fusion framework, integrating structural and flow information from both acquisitions. It was trained on data from 875 eyes of 444 patients. Tested on 53 patients (97 eyes), the algorithm achieved a good area under the receiver operating characteristic curve (AUC) for detecting DR (0.8868), moderate non-proliferative DR (0.8276), severe non-proliferative DR (0.8376), and proliferative/treated DR (0.9070). These results significantly outperformed detection with the 6 × 6 mm 2 (AUC = 0.8462, 0.7793, 0.7889, and 0.8104, respectively) or 15 × 15 mm 2 (AUC = 0.8251, 0.7745, 0.7967, and 0.8786, respectively) acquisitions alone. Thus, combining high-resolution and UWF-OCTA acquisitions holds the potential for improved early and late-stage DR detection, offering a foundation for enhancing DR management and a clear path for future works involving expanded datasets and integrating additional imaging modalities. [ABSTRACT FROM AUTHOR]

Abstract: Nowadays, many surgeries, including eye surgeries, are video-monitored. We present in this paper an automatic video analysis system able to recognize surgical tasks in real-time. The proposed system relies on the Content-Based Video Retrieval (CBVR) paradigm. It characterizes short subsequences in the video stream and searches for video subsequences with similar structures in a video archive. Fixed-length feature vectors are built for each subsequence: the feature vectors are unchanged by variations in duration and temporal structure among the target surgical tasks. Therefore, it is possible to perform fast nearest neighbor searches in the video archive. The retrieved video subsequences are used to recognize the current surgical task by analogy reasoning. The system can be trained to recognize any surgical task using weak annotations only. It was applied to a dataset of 23 epiretinal membrane surgeries and a dataset of 100 cataract surgeries. Three surgical tasks were annotated in the first dataset. Nine surgical tasks were annotated in the second dataset. To assess its generality, the system was also applied to a dataset of 1,707 movie clips in which 12 human actions were annotated. High task recognition scores were measured in all three datasets. Real-time task recognition will be used in future works to communicate with surgeons (trainees in particular) or with surgical devices. [Copyright &y& Elsevier]

Diabetic Retinopathy (DR), an ocular complication of diabetes, is a leading cause of blindness worldwide. Traditionally, DR is monitored using Color Fundus Photography (CFP), a widespread 2-D imaging modality. However, DR classifications based on CFP have poor predictive power, resulting in suboptimal DR management. Optical Coherence Tomography Angiography (OCTA) is a recent 3-D imaging modality offering enhanced structural and functional information (blood flow) with a wider field of view. This paper investigates automatic DR severity assessment using 3-D OCTA. A straightforward solution to this task is a 3-D neural network classifier. However, 3-D architectures have numerous parameters and typically require many training samples. A lighter solution consists in using 2-D neural network classifiers processing 2-D en-face (or frontal) projections and/or 2-D cross-sectional slices. Such an approach mimics the way ophthalmologists analyze OCTA acquisitions: (1) en-face flow maps are often used to detect avascular zones and neovascularization, and (2) cross-sectional slices are commonly analyzed to detect macular edemas, for instance. However, arbitrary data reduction or selection might result in information loss. Two complementary strategies are thus proposed to optimally summarize OCTA volumes with 2-D images: (1) a parametric en-face projection optimized through deep learning and (2) a cross-sectional slice selection process controlled through gradient-based attribution. The full summarization and DR classification pipeline is trained from end to end. The automatic 2-D summary can be displayed in a viewer or printed in a report to support the decision. We show that the proposed 2-D summarization and classification pipeline outperforms direct 3-D classification with the advantage of improved interpretability. • An algorithm to quickly and efficiently classify 3-D images is presented. • 3-D images are summarized by one or a few 2-D images as an intermediate step. • The pipeline is trained from end to end: the 2-D summary is thus problem-specific. • This multiview 2-D summarization allows interpretability and knowledge discovery. • It is applied to diabetic retinopathy severity assessment using OCT angiography. [ABSTRACT FROM AUTHOR]

• An explanatory artificial intelligence framework is presented for image classification. • It classifies each pixel and the image as a whole with image-level supervision only. • A novel self-supervised approach is presented for foreground/background separation. • The image classification process can be explained visually and possibly in text form. • For diabetic retinopathy grading, explainability does not reduce classification performance. [Display omitted] In recent years, Artificial Intelligence (AI) has proven its relevance for medical decision support. However, the "black-box" nature of successful AI algorithms still holds back their wide-spread deployment. In this paper, we describe an eXplanatory Artificial Intelligence (XAI) that reaches the same level of performance as black-box AI, for the task of classifying Diabetic Retinopathy (DR) severity using Color Fundus Photography (CFP). This algorithm, called ExplAIn, learns to segment and categorize lesions in images; the final image-level classification directly derives from these multivariate lesion segmentations. The novelty of this explanatory framework is that it is trained from end to end, with image supervision only, just like black-box AI algorithms: the concepts of lesions and lesion categories emerge by themselves. For improved lesion localization, foreground/background separation is trained through self-supervision, in such a way that occluding foreground pixels transforms the input image into a healthy-looking image. The advantage of such an architecture is that automatic diagnoses can be explained simply by an image and/or a few sentences. ExplAIn is evaluated at the image level and at the pixel level on various CFP image datasets. We expect this new framework, which jointly offers high classification performance and explainability, to facilitate AI deployment. [ABSTRACT FROM AUTHOR]

• multi-view information fusion can improve computer-aided diagnosis of breast cancer • a new deep Siamese pipeline is proposed for mass detection from dual-view mammograms • multi-tasking abilities of deep models are used to learn matching and classification • dual-view matching improves both patch classification and examination-level detection • our automatic mass detector could act as second opinion for mammogram interpretation [Display omitted] Breast cancer screening benefits from the visual analysis of multiple views of routine mammograms. As for clinical practice, computer-aided diagnosis (CAD) systems could be enhanced by integrating multi-view information. In this work, we propose a new multi-tasking framework that combines craniocaudal (CC) and mediolateral-oblique (MLO) mammograms for automatic breast mass detection. Rather than addressing mass recognition only, we exploit multi-tasking properties of deep networks to jointly learn mass matching and classification, towards better detection performance. Specifically, we propose a unified Siamese network that combines patch-level mass/non-mass classification and dual-view mass matching to take full advantage of multi-view information. This model is exploited in a full image detection pipeline based on You-Only-Look-Once (YOLO) region proposals. We carry out exhaustive experiments to highlight the contribution of dual-view matching for both patch-level classification and examination-level detection scenarios. Results demonstrate that mass matching highly improves the full-pipeline detection performance by outperforming conventional single-task schemes with 94.78% as Area Under the Curve (AUC) score and a classification accuracy of 0.8791. Interestingly, mass classification also improves the performance of mass matching, which proves the complementarity of both tasks. Our method further guides clinicians by providing accurate dual-view mass correspondences, which suggests that it could act as a relevant second opinion for mammogram interpretation and breast cancer diagnosis. [ABSTRACT FROM AUTHOR]

Deep learning is quickly becoming the leading methodology for medical image analysis. Given a large medical archive, where each image is associated with a diagnosis, efficient pathology detectors or classifiers can be trained with virtually no expert knowledge about the target pathologies. However, deep learning algorithms, including the popular ConvNets, are black boxes: little is known about the local patterns analyzed by ConvNets to make a decision at the image level. A solution is proposed in this paper to create heatmaps showing which pixels in images play a role in the image-level predictions. In other words, a ConvNet trained for image-level classification can be used to detect lesions as well. A generalization of the backpropagation method is proposed in order to train ConvNets that produce high-quality heatmaps. The proposed solution is applied to diabetic retinopathy (DR) screening in a dataset of almost 90,000 fundus photographs from the 2015 Kaggle Diabetic Retinopathy competition and a private dataset of almost 110,000 photographs (e-ophtha). For the task of detecting referable DR, very good detection performance was achieved: A z = 0.954 in Kaggle’s dataset and A z = 0.949 in e-ophtha. Performance was also evaluated at the image level and at the lesion level in the DiaretDB1 dataset, where four types of lesions are manually segmented: microaneurysms, hemorrhages, exudates and cotton-wool spots. For the task of detecting images containing these four lesion types, the proposed detector, which was trained to detect referable DR, outperforms recent algorithms trained to detect those lesions specifically, with pixel-level supervision. At the lesion level, the proposed detector outperforms heatmap generation algorithms for ConvNets. This detector is part of the Messidor® system for mobile eye pathology screening. Because it does not rely on expert knowledge or manual segmentation for detecting relevant patterns, the proposed solution is a promising image mining tool, which has the potential to discover new biomarkers in images. [ABSTRACT FROM AUTHOR]

Purpose: We investigated the impact of target properties on vertical fusion amplitude (VFA) using a 3D display platform; the performance of the subjects allowed us to assess how central and peripheral retina regions interact during the fusion process. Material and Methods: Fourteen subjects were involved in the test. VFA was recorded by varying the viewing distance, target complexity, disparity velocity, lighting condition and background luminance. Base-up prisms were introduced to create vertical disparity in the peripheral retinal area, whereas an offset compensation was added in the central area. Data were analyzed in JMP software using T-test and repeated-measures ANOVA tests. Results: VFA is significantly affected by target properties including viewing distance, target complexity and disparity velocity; the impact from lighting condition and background luminance is not significant. Although central retina plays a crucial role in the fusion process, peripheral regions also affect the fusion performance when stimulus size on retina and contents disparity values are modified between central and peripheral vision. Conclusion: Vertical fusion is affected by various target properties. For the first time, peripheral vertical disparity direction effects on central fusion and eye motion response have been explored. Besides, a quantitative interaction of central and peripheral fusion is observed, which could be applied in clinical measurement on binocular disease concerning central and peripheral vision conflict. [ABSTRACT FROM AUTHOR]

The automatic detection of exudates in color eye fundus images is an important task in applications such as diabetic retinopathy screening. The presented work has been undertaken in the framework of the TeleOphta project, whose main objective is to automatically detect normal exams in a tele-ophthalmology network, thus reducing the burden on the readers. A new clinical database, e-ophtha EX, containing precisely manually contoured exudates, is introduced. As opposed to previously available databases, e-ophtha EX is very heterogeneous. It contains images gathered within the OPHDIAT telemedicine network for diabetic retinopathy screening. Image definition, quality, as well as patients condition or the retinograph used for the acquisition, for example, are subject to important changes between different examinations. The proposed exudate detection method has been designed for this complex situation. We propose new preprocessing methods, which perform not only normalization and denoising tasks, but also detect reflections and artifacts in the image. A new candidates segmentation method, based on mathematical morphology, is proposed. These candidates are characterized using classical features, but also novel contextual features. Finally, a random forest algorithm is used to detect the exudates among the candidates. The method has been validated on the e-ophtha EX database, obtaining an AUC of 0.95. It has been also validated on other databases, obtaining an AUC between 0.93 and 0.95, outperforming state-of-the-art methods. [ABSTRACT FROM AUTHOR]

The detection of microaneurysms in digital color fundus photographs is a critical first step in automated screening for diabetic retinopathy (DR), a common complication of diabetes. To accomplish this detection numerous methods have been published in the past but none of these was compared with each other on the same data. In this work we present the results of the first international microaneurysm detection competition, organized in the context of the Retinopathy Online Challenge (ROC), a multiyear online competition for various aspects of DR detection. For this competition, we compare the results of five different methods, produced by five different teams of researchers on the same set of data. The evaluation was performed in a uniform manner using an algorithm presented in this work. The set of data used for the competition consisted of 50 training images with available reference standard and 50 test images where the reference standard was witheld by the organizers (M. Niemeijer, B. van Ginneken, and M. D. Abràmoff). The results obtained on the test data was submitted through a website after which standardized evaluation software was used to determine the performance of each of the methods. A human expert detected microaneurysms in the test set to allow comparison with the performance of the automatic methods. The overall results show that microaneurysm detection is a challenging task for both the automatic methods as well as the human expert. There is room for improvement as the best performing system does not reach the performance of the human expert. The data associated with the ROC microaneurysm detection competition will remain publicly available and the website will continue accepting submissions. [ABSTRACT FROM AUTHOR]