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CANet: Cross-disease Attention Network for Joint Diabetic Retinopathy and Diabetic Macular Edema Grading (1911.01376v1)

Published 4 Nov 2019 in eess.IV and cs.CV

Abstract: Diabetic retinopathy (DR) and diabetic macular edema (DME) are the leading causes of permanent blindness in the working-age population. Automatic grading of DR and DME helps ophthalmologists design tailored treatments to patients, thus is of vital importance in the clinical practice. However, prior works either grade DR or DME, and ignore the correlation between DR and its complication, i.e., DME. Moreover, the location information, e.g., macula and soft hard exhaust annotations, are widely used as a prior for grading. Such annotations are costly to obtain, hence it is desirable to develop automatic grading methods with only image-level supervision. In this paper, we present a novel cross-disease attention network (CANet) to jointly grade DR and DME by exploring the internal relationship between the diseases with only image-level supervision. Our key contributions include the disease-specific attention module to selectively learn useful features for individual diseases, and the disease-dependent attention module to further capture the internal relationship between the two diseases. We integrate these two attention modules in a deep network to produce disease-specific and disease-dependent features, and to maximize the overall performance jointly for grading DR and DME. We evaluate our network on two public benchmark datasets, i.e., ISBI 2018 IDRiD challenge dataset and Messidor dataset. Our method achieves the best result on the ISBI 2018 IDRiD challenge dataset and outperforms other methods on the Messidor dataset. Our code is publicly available at https://github.com/xmengli999/CANet.

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Authors (6)
  1. Xiaomeng Li (109 papers)
  2. Xiaowei Hu (54 papers)
  3. Lequan Yu (89 papers)
  4. Lei Zhu (280 papers)
  5. Chi-Wing Fu (104 papers)
  6. Pheng-Ann Heng (196 papers)
Citations (271)

Summary

A Comprehensive Analysis of CANet: Cross-disease Attention Network for Joint Diabetic Retinopathy and Diabetic Macular Edema Grading

The paper presents CANet, a novel approach for automatic grading of Diabetic Retinopathy (DR) and Diabetic Macular Edema (DME) through a unified deep learning framework. CANet leverages a cross-disease attention network to jointly grade DR and DME by capturing the intricate relationships between these two interrelated conditions, utilizing only image-level supervision. The methodological innovation lies in the introduction of disease-specific and disease-dependent attention modules, which individually and collectively enhance the model's grading capabilities.

Methodological Contributions

  1. Disease-Specific Attention Module: This module is designed to learn distinct features pertinent to each disease separately. It involves channel-wise and spatial-wise attention mechanisms to selectively prioritize meaningful features, effectively enhancing the network's ability to recognize and delineate disease-specific characteristics.
  2. Disease-Dependent Attention Module: This innovative module captures the inter-dependencies between DR and DME, leveraging the correlation between disease characteristics. By learning attention weights that gauge the risk of one disease complicating the other, the module aids in refining the overall grading performance by incorporating cross-disease insights.

The paper employs ResNet50 as the backbone for feature extraction, with the attention modules integrated on top. This structure not only allows the model to focus on pertinent disease features but also integrates cross-disease relational data, exploiting the associations between DR and DME effectively.

Experimental Evaluation

The effectiveness of CANet is evaluated on two benchmark datasets: the ISBI 2018 IDRiD challenge dataset and the Messidor dataset. Against various baseline models and methodologies, CANet demonstrates superior performance, achieving state-of-the-art results in both datasets. Specifically:

  • On the Messidor dataset, CANet achieves a 96.3% AUC for DR and 92.4% for DME, significantly outperforming prior models and methodologies that attempt DR and DME grading separately or as independent multi-task learning problems.
  • The integration of disease-specific and disease-dependent modules is shown to significantly enhance grading accuracy compared to conventional joint training approaches, as evidenced by thorough ablation studies within the paper.

Implications and Future Directions

The implications of CANet are substantial for clinical applications. The ability to accurately grade DR and its complication DME jointly, using only image-level annotations, reduces the dependency on expensive and labor-intensive lesion annotations. This makes CANet a potentially valuable tool in clinical environments where time and resources are constraints.

Furthermore, the paper highlights potential future avenues in deep learning-based medical image analysis, including extending the framework to handle multiple interrelated diseases in a single model. The adaptability of CANet suggests broader applicability in multi-disease contexts, potentially paving the way for integrated diagnostic models capable of comprehensive disease analysis.

In summary, CANet stands as a pivotal contribution to the field of automated retinal disease grading, combining advanced attention mechanisms to tackle the intricacies of disease interrelations. As AI continues to evolve, models like CANet will likely play an essential role in the future of medical diagnostics, enhancing both the accuracy of disease characterization and the efficacy of patient treatment plans.