Dataset Information

Technical and imaging factors influencing performance of deep learning systems for diabetic retinopathy.

ABSTRACT: Deep learning (DL) has been shown to be effective in developing diabetic retinopathy (DR) algorithms, possibly tackling financial and manpower challenges hindering implementation of DR screening. However, our systematic review of the literature reveals few studies studied the impact of different factors on these DL algorithms, that are important for clinical deployment in real-world settings. Using 455,491 retinal images, we evaluated two technical and three image-related factors in detection of referable DR. For technical factors, the performances of four DL models (VGGNet, ResNet, DenseNet, Ensemble) and two computational frameworks (Caffe, TensorFlow) were evaluated while for image-related factors, we evaluated image compression levels (reducing image size, 350, 300, 250, 200, 150?KB), number of fields (7-field, 2-field, 1-field) and media clarity (pseudophakic vs phakic). In detection of referable DR, four DL models showed comparable diagnostic performance (AUC 0.936-0.944). To develop the VGGNet model, two computational frameworks had similar AUC (0.936). The DL performance dropped when image size decreased below 250?KB (AUC 0.936, 0.900, p?p?p?

SUBMITTER: Yip MYT

PROVIDER: S-EPMC7090044 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Technical and imaging factors influencing performance of deep learning systems for diabetic retinopathy.

Yip Michelle Y T MYT Lim Gilbert G Lim Zhan Wei ZW Nguyen Quang D QD Chong Crystal C Y CCY Yu Marco M Bellemo Valentina V Xie Yuchen Y Lee Xin Qi XQ Hamzah Haslina H Ho Jinyi J Tan Tien-En TE Sabanayagam Charumathi C Grzybowski Andrzej A Tan Gavin S W GSW Hsu Wynne W Lee Mong Li ML Wong Tien Yin TY Ting Daniel S W DSW

NPJ digital medicine 20200323

Deep learning (DL) has been shown to be effective in developing diabetic retinopathy (DR) algorithms, possibly tackling financial and manpower challenges hindering implementation of DR screening. However, our systematic review of the literature reveals few studies studied the impact of different factors on these DL algorithms, that are important for clinical deployment in real-world settings. Using 455,491 retinal images, we evaluated two technical and three image-related factors in detection of ...[more]

PMID: 32219181

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Project description:Diabetic Retinopathy (DR) may result in various degrees of vision loss and even blindness if not diagnosed in a timely manner. Therefore, having an annual eye exam helps early detection to prevent vision loss in earlier stages, especially for diabetic patients. Recent technological advances made smartphone-based retinal imaging systems available on the market to perform small-sized, low-powered, and affordable DR screening in diverse environments. However, the accuracy of DR detection depends on the field of view and image quality. Since smartphone-based retinal imaging systems have much more compact designs than a traditional fundus camera, captured images are likely to be the low quality with a smaller field of view. Our motivation in this paper is to develop an automatic DR detection model for smartphone-based retinal images using the deep learning approach with the ResNet50 network. This study first utilized the well-known AlexNet, GoogLeNet, and ResNet50 architectures, using the transfer learning approach. Second, these frameworks were retrained with retina images from several datasets including EyePACS, Messidor, IDRiD, and Messidor-2 to investigate the effect of using images from the single, cross, and multiple datasets. Third, the proposed ResNet50 model is applied to smartphone-based synthetic images to explore the DR detection accuracy of smartphone-based retinal imaging systems. Based on the vision-threatening diabetic retinopathy detection results, the proposed approach achieved a high classification accuracy of 98.6%, with a 98.2% sensitivity and a 99.1% specificity while its AUC was 0.9978 on the independent test dataset. As the main contributions, DR detection accuracy was improved using the deep transfer learning approach for the ResNet50 network with publicly available datasets and the effect of the field of view in smartphone-based retinal imaging was studied. Although a smaller number of images were used in the training set compared with the existing studies, considerably acceptable high accuracies for validation and testing data were obtained.

Project description:ImportanceMore than 60 million people in India have diabetes and are at risk for diabetic retinopathy (DR), a vision-threatening disease. Automated interpretation of retinal fundus photographs can help support and scale a robust screening program to detect DR.ObjectiveTo prospectively validate the performance of an automated DR system across 2 sites in India.Design, setting, and participantsThis prospective observational study was conducted at 2 eye care centers in India (Aravind Eye Hospital and Sankara Nethralaya) and included 3049 patients with diabetes. Data collection and patient enrollment took place between April 2016 and July 2016 at Aravind and May 2016 and April 2017 at Sankara Nethralaya. The model was trained and fixed in March 2016.InterventionsAutomated DR grading system compared with manual grading by 1 trained grader and 1 retina specialist from each site. Adjudication by a panel of 3 retinal specialists served as the reference standard in the cases of disagreement.Main outcomes and measuresSensitivity and specificity for moderate or worse DR or referable diabetic macula edema.ResultsOf 3049 patients, 1091 (35.8%) were women and the mean (SD) age for patients at Aravind and Sankara Nethralaya was 56.6 (9.0) years and 56.0 (10.0) years, respectively. For moderate or worse DR, the sensitivity and specificity for manual grading by individual nonadjudicator graders ranged from 73.4% to 89.8% and from 83.5% to 98.7%, respectively. The automated DR system's performance was equal to or exceeded manual grading, with an 88.9% sensitivity (95% CI, 85.8-91.5), 92.2% specificity (95% CI, 90.3-93.8), and an area under the curve of 0.963 on the data set from Aravind Eye Hospital and 92.1% sensitivity (95% CI, 90.1-93.8), 95.2% specificity (95% CI, 94.2-96.1), and an area under the curve of 0.980 on the data set from Sankara Nethralaya.Conclusions and relevanceThis study shows that the automated DR system generalizes to this population of Indian patients in a prospective setting and demonstrates the feasibility of using an automated DR grading system to expand screening programs.

Dataset Information

Technical and imaging factors influencing performance of deep learning systems for diabetic retinopathy.

Publications

Technical and imaging factors influencing performance of deep learning systems for diabetic retinopathy.

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