IEEE J Biomed Health Inform. 2022 May;26(5):2216-2227. doi: 10.1109/JBHI.2021.3119519. Epub 2022 May 5.
Diabetic retinopathy (DR) is a leading cause of permanent blindness among the working-age people. Automatic DR grading can help ophthalmologists make timely treatment for patients. However, the existing grading methods are usually trained with high resolution (HR) fundus images, such that the grading performance decreases a lot given low resolution (LR) images, which are common in clinic. In this paper, we mainly focus on DR grading with LR fundus images. According to our analysis on the DR task, we find that: 1) image super-resolution (ISR) can boost the performance of both DR grading and lesion segmentation; 2) the lesion segmentation regions of fundus images are highly consistent with pathological regions for DR grading. Based on our findings, we propose a convolutional neural network (CNN)-based method for joint learning of multi-level tasks for DR grading, called DeepMT-DR, which can simultaneously handle the low-level task of ISR, the mid-level task of lesion segmentation and the high-level task of disease severity classification on LR fundus images. Moreover, a novel task-aware loss is developed to encourage ISR to focus on the pathological regions for its subsequent tasks: lesion segmentation and DR grading. Extensive experimental results show that our DeepMT-DR method significantly outperforms other state-of-the-art methods for DR grading over three datasets. In addition, our method achieves comparable performance in two auxiliary tasks of ISR and lesion segmentation.
糖尿病性视网膜病变(DR)是导致工作年龄段人群永久性失明的主要原因之一。自动 DR 分级可以帮助眼科医生及时为患者进行治疗。然而,现有的分级方法通常是用高分辨率(HR)眼底图像进行训练的,因此在临床上常见的低分辨率(LR)图像中,分级性能会大大降低。本文主要关注 LR 眼底图像的 DR 分级。根据我们对 DR 任务的分析,我们发现:1)图像超分辨率(ISR)可以提高 DR 分级和病变分割的性能;2)眼底图像的病变分割区域与 DR 分级的病理区域高度一致。基于我们的发现,我们提出了一种基于卷积神经网络(CNN)的联合学习多任务方法,用于 DR 分级,称为 DeepMT-DR,它可以同时处理 LR 眼底图像上的低水平任务(ISR)、中级任务(病变分割)和高水平任务(疾病严重程度分类)。此外,还开发了一种新的任务感知损失,以鼓励 ISR 关注其后续任务(病变分割和 DR 分级)的病理区域。广泛的实验结果表明,我们的 DeepMT-DR 方法在三个数据集上的 DR 分级明显优于其他最先进的方法。此外,我们的方法在 ISR 和病变分割这两个辅助任务上也取得了相当的性能。