提出自动分析OCT图像中脉络膜的深度学习方法,助力全身健康评估。
Choroidal image analysis for OCT image sequences with applications in systemic health
- 构建四阶段递进式分析流程,从半自动到全自动化
- 开发Choroidalyzer实现脉络膜区域与血管的全自动分割
- 在肾移植、阿尔茨海默病风险和重症监护中验证临床潜力
脉络膜是视网膜后方高度血管化的组织,与中枢神经系统相连,血流远超脑和肾脏,因此其血流变化可反映全身疾病状态。光学相干断层扫描(OCT)可实现高分辨率脉络膜成像,但传统分析方法仍依赖人工或半自动,影响可重复性与临床应用。本论文开发了四套递进式分析方法:首先提出两种半自动方法(GPET用于区域,MMCQ用于血管),提升效率但仍需人工干预;随后引入DeepGPET,基于深度学习实现区域分割,显著提升执行速度与可复现性,但缺乏血管分析与特征量化;进一步提出Choroidalyzer,一个端到端深度学习管道,可自动分割脉络膜空间与血管,生成临床有意义且可重复的特征。通过严格评估,验证其在三项系统健康应用中的价值:OCTANE(评估肾移植患者与供体的脉络膜变化)、PREVENT(探索中年期阿尔茨海默病风险因素与脉络膜关联)、D-RISCii(评估危重症患者脉络膜变异及OCT可行性)。本研究贡献多个开源工具,推动脉络膜标准化测量,并揭示其作为全身健康生物标志物的潜力。
原文摘要 · Abstract (English)
The choroid, a highly vascular layer behind the retina, is an extension of the central nervous system and has parallels with the renal cortex, with blood flow far exceeding that of the brain and kidney. Thus, there has been growing interest of choroidal blood flow reflecting physiological status of systemic disease. Optical coherence tomography (OCT) enables high-resolution imaging of the choroid, but conventional analysis methods remain manual or semi-automatic, limiting reproducibility, standardisation and clinical utility. In this thesis, I develop several new methods to analyse the choroid in OCT image sequences, with each successive method improving on its predecessors. I first develop two semi-automatic approaches for choroid region (Gaussian Process Edge Tracing, GPET) and vessel (Multi-scale Median Cut Quantisation, MMCQ) analysis, which improve on manual approaches but remain user-dependent. To address this, I introduce DeepGPET, a deep learning-based region segmentation method which improves on execution time, reproducibility, and end-user accessibility, but lacks choroid vessel analysis and automatic feature measurement. Improving on this, I developed Choroidalyzer, a deep learning-based pipeline to segment the choroidal space and vessels and generate fully automatic, clinically meaningful and reproducible choroidal features. I provide rigorous evaluation of these four approaches and consider their potential clinical value in three applications into systemic health: OCTANE, assessing choroidal changes in renal transplant recipients and donors; PREVENT, exploring choroidal associations with Alzheimer's risk factors at mid-life; D-RISCii, assessing choroidal variation and feasibility of OCT in critical care. In short, this thesis contributes many open-source tools for standardised choroidal measurement and highlights the choroid's potential as a biomarker in systemic health.
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