Deep neural networks (DNNs) are vulnerable to adversarial examples that can trigger misclassification of DNNs but may be imperceptible to human perception. Adversarial attack has been an important way to evaluate the robustness of DNNs. Existing attack methods on the construction of adversarial examples use such $\ell_p$ distance as a similarity metric to perturb samples. However, this kind of metric is incompatible with the underlying real-world image formation and human visual perception. In this paper, we first propose an internal Wasserstein distance (IWD) to measure image similarity between a sample and its adversarial example. We apply IWD to perform adversarial attack and defense. Specifically, we develop a novel attack method by capturing the distribution of patches in original samples. In this case, our approach is able to generate semantically similar but diverse adversarial examples that are more difficult to defend by existing defense methods. Relying on IWD, we also build a new defense method that seeks to learn robust models to defend against unseen adversarial examples. We provide both thorough theoretical and empirical evidence to support our methods.
Cataract is one of the leading causes of reversible visual impairment and blindness globally. Over the years, researchers have achieved significant progress in developing state-of-the-art artificial intelligence techniques for automatic cataract classification and grading, helping clinicians prevent and treat cataract in time. This paper provides a comprehensive survey of recent advances in machine learning for cataract classification and grading based on ophthalmic images. We summarize existing literature from two research directions: conventional machine learning techniques and deep learning techniques. This paper also provides insights into existing works of both merits and limitations. In addition, we discuss several challenges of automatic cataract classification and grading based on machine learning techniques and present possible solutions to these challenges for future research.
Deep hashing methods have been proved to be effective for the large-scale medical image search assisting reference-based diagnosis for clinicians. However, when the salient region plays a maximal discriminative role in ophthalmic image, existing deep hashing methods do not fully exploit the learning ability of the deep network to capture the features of salient regions pointedly. The different grades or classes of ophthalmic images may be share similar overall performance but have subtle differences that can be differentiated by mining salient regions. To address this issue, we propose a novel end-to-end network, named Attention-based Saliency Hashing (ASH), for learning compact hash-code to represent ophthalmic images. ASH embeds a spatial-attention module to focus more on the representation of salient regions and highlights their essential role in differentiating ophthalmic images. Benefiting from the spatial-attention module, the information of salient regions can be mapped into the hash-code for similarity calculation. In the training stage, we input the image pairs to share the weights of the network, and a pairwise loss is designed to maximize the discriminability of the hash-code. In the retrieval stage, ASH obtains the hash-code by inputting an image with an end-to-end manner, then the hash-code is used to similarity calculation to return the most similar images. Extensive experiments on two different modalities of ophthalmic image datasets demonstrate that the proposed ASH can further improve the retrieval performance compared to the state-of-the-art deep hashing methods due to the huge contributions of the spatial-attention module.
Generative Adversarial Networks (GAN) have many potential medical imaging applications, including data augmentation, domain adaptation, and model explanation. Due to the limited embedded memory of Graphical Processing Units (GPUs), most current 3D GAN models are trained on low-resolution medical images. In this work, we propose a novel end-to-end GAN architecture that can generate high-resolution 3D images. We achieve this goal by separating training and inference. During training, we adopt a hierarchical structure that simultaneously generates a low-resolution version of the image and a randomly selected sub-volume of the high-resolution image. The hierarchical design has two advantages: First, the memory demand for training on high-resolution images is amortized among subvolumes. Furthermore, anchoring the high-resolution subvolumes to a single low-resolution image ensures anatomical consistency between subvolumes. During inference, our model can directly generate full high-resolution images. We also incorporate an encoder with a similar hierarchical structure into the model to extract features from the images. Experiments on 3D thorax CT and brain MRI demonstrate that our approach outperforms state of the art in image generation, image reconstruction, and clinical-relevant variables prediction.
Currently, diabetic retinopathy (DR) grading from fundus images has attracted incremental interests in both academic and industrial communities. Most convolutional neural networks (CNNs) based algorithms treat DR grading as a classification task via image-level annotations. However, they have not fully explored the valuable information from the DR-related lesions. In this paper, we present a robust framework, which can collaboratively utilize both patch-level lesion and image-level grade annotations, for DR severity grading. By end-to-end optimizing the entire framework, the fine-grained lesion and image-level grade information can be bidirectionally exchanged to exploit more discriminative features for DR grading. Compared with the recent state-of-the-art algorithms and three over 9-years clinical experienced ophthalmologists, the proposed algorithm shows favorable performance. Testing on the datasets from totally different scenarios and distributions (such as label and camera), our algorithm is proved robust in facing image quality and distribution problems that commonly exist in real-world practice. Extensive ablation studies dissect the proposed framework and indicate the effectiveness and necessity of each motivation. The code and some valuable annotations are now publicly available.
Retinal vessel segmentation is a fundamental step in screening, diagnosis, and treatment of various cardiovascular and ophthalmic diseases. Robustness is one of the most critical requirements for practical utilization, since the test images may be captured using different fundus cameras, or be affected by various pathological changes. We investigate this problem from a data augmentation perspective, with the merits of no additional training data or inference time. In this paper, we propose two new data augmentation modules, namely, channel-wise random Gamma correction and channel-wise random vessel augmentation. Given a training color fundus image, the former applies random gamma correction on each color channel of the entire image, while the latter intentionally enhances or decreases only the fine-grained blood vessel regions using morphological transformations. With the additional training samples generated by applying these two modules sequentially, a model could learn more invariant and discriminating features against both global and local disturbances. Experimental results on both real-world and synthetic datasets demonstrate that our method can improve the performance and robustness of a classic convolutional neural network architecture. Source codes are available https://github.com/PaddlePaddle/Research/tree/master/CV/robust_vessel_segmentation
There are extensive researches focusing on automated diabetic reti-nopathy (DR) detection from fundus images. However, the accuracy drop is ob-served when applying these models in real-world DR screening, where the fun-dus camera brands are different from the ones used to capture the training im-ages. How can we train a classification model on labeled fundus images ac-quired from only one camera brand, yet still achieves good performance on im-ages taken by other brands of cameras? In this paper, we quantitatively verify the impact of fundus camera brands related domain shift on the performance of DR classification models, from an experimental perspective. Further, we pro-pose camera-oriented residual-CycleGAN to mitigate the camera brand differ-ence by domain adaptation and achieve increased classification performance on target camera images. Extensive ablation experiments on both the EyePACS da-taset and a private dataset show that the camera brand difference can signifi-cantly impact the classification performance and prove that our proposed meth-od can effectively improve the model performance on the target domain. We have inferred and labeled the camera brand for each image in the EyePACS da-taset and will publicize the camera brand labels for further research on domain adaptation.
Retinal image segmentation plays an important role in automatic disease diagnosis. This task is very challenging because the complex structure and texture information are mixed in a retinal image, and distinguishing the information is difficult. Existing methods handle texture and structure jointly, which may lead biased models toward recognizing textures and thus results in inferior segmentation performance. To address it, we propose a segmentation strategy that seeks to separate structure and texture components and significantly improve the performance. To this end, we design a structure-texture demixing network (STD-Net) that can process structures and textures differently and better. Extensive experiments on two retinal image segmentation tasks (i.e., blood vessel segmentation, optic disc and cup segmentation) demonstrate the effectiveness of the proposed method.
Anterior chamber angle (ACA) classification is a key step in the diagnosis of angle-closure glaucoma in Anterior Segment Optical Coherence Tomography (AS-OCT). Existing automated analysis methods focus on a binary classification system (i.e., open angle or angle-closure) in a 2D AS-OCT slice. However, clinical diagnosis requires a more discriminating ACA three-class system (i.e., open, narrow, or synechiae angles) for the benefit of clinicians who seek better to understand the progression of the spectrum of angle-closure glaucoma types. To address this, we propose a novel sequence multi-scale aggregation deep network (SMA-Net) for open-narrow-synechiae ACA classification based on an AS-OCT sequence. In our method, a Multi-Scale Discriminative Aggregation (MSDA) block is utilized to learn the multi-scale representations at slice level, while a ConvLSTM is introduced to study the temporal dynamics of these representations at sequence level. Finally, a multi-level loss function is used to combine the slice-based and sequence-based losses. The proposed method is evaluated across two AS-OCT datasets. The experimental results show that the proposed method outperforms existing state-of-the-art methods in applicability, effectiveness, and accuracy. We believe this work to be the first attempt to classify ACAs into open, narrow, or synechia types grading using AS-OCT sequences.
Precise characterization and analysis of iris shape from Anterior Segment OCT (AS-OCT) are of great importance in facilitating diagnosis of angle-closure-related diseases. Existing methods focus solely on analyzing structural properties identified from the 2D slice, while accurate characterization of morphological changes of iris shape in 3D AS-OCT may be able to reveal in addition the risk of disease progression. In this paper, we propose a novel framework for reconstruction and quantification of 3D iris surface from AS-OCT imagery. We consider it to be the first work to detect angle-closure glaucoma by means of 3D representation. An iris segmentation network with wavelet refinement block (WRB) is first proposed to generate the initial shape of the iris from single AS-OCT slice. The 3D iris surface is then reconstructed using a guided optimization method with Poisson-disk sampling. Finally, a set of surface-based features are extracted, which are used in detecting of angle-closure glaucoma. Experimental results demonstrate that our method is highly effective in iris segmentation and surface reconstruction. Moreover, we show that 3D-based representation achieves better performance in angle-closure glaucoma detection than does 2D-based feature.