用AI从彩色眼底图识别糖尿病黄斑缺血,准确率达84.7%。
A graph neural network-based multispectral-view learning model for diabetic macular ischemia detection from color fundus photographs
- 通过重建24波段多光谱图像,增强对缺血组织细微变化的捕捉能力。
- 在1078张眼底图上实现84.7%准确率和0.900 AUROC,优于人工专家。
- 适合眼科医生用于糖尿病视网膜病变早期筛查,尤其关注黄斑区缺血。
糖尿病黄斑缺血(DMI)表现为黄斑区视网膜毛细血管丢失,是糖尿病患者视力损害的重要原因。尽管彩色眼底照片(CFPs)结合人工智能(AI)已广泛应用于多种眼病检测,如糖尿病视网膜病变(DR),但其在DMI检测中的应用仍处于空白,部分源于眼科医生对其可行性存疑。本研究提出一种基于图神经网络的多光谱视图学习模型(GNN-MSVL),旨在从CFPs中检测DMI。该模型利用更高光谱分辨率,捕捉因缺血组织导致的视网膜反射微小变化,提升对DMI特征的敏感性。方法首先通过计算多光谱成像(CMI)技术,从CFPs重建24波段多光谱眼底图像;采用ResNeXt101作为主干网络进行多视图特征提取;并设计一种带定制跳跃连接策略的图神经网络(GNN),以强化跨光谱关系,实现高效全面的多光谱学习。研究共纳入592例糖尿病患者的1078张黄斑中心眼底图,其中530张来自300名确诊为DMI的患者。模型在眼级分类上达到84.7%准确率与0.900的受试者工作特征曲线下面积(AUROC,95%置信区间:0.852–0.937),显著优于仅使用CFPs训练的基线模型及人类专家(p值均小于0.01)。结果表明,基于AI的CFP分析具有检测DMI的潜力,有助于实现早期、低成本筛查。
原文摘要 · Abstract (English)
Diabetic macular ischemia (DMI), marked by the loss of retinal capillaries in the macular area, contributes to vision impairment in patients with diabetes. Although color fundus photographs (CFPs), combined with artificial intelligence (AI), have been extensively applied in detecting various eye diseases, including diabetic retinopathy (DR), their applications in detecting DMI remain unexplored, partly due to skepticism among ophthalmologists regarding its feasibility. In this study, we propose a graph neural network-based multispectral view learning (GNN-MSVL) model designed to detect DMI from CFPs. The model leverages higher spectral resolution to capture subtle changes in fundus reflectance caused by ischemic tissue, enhancing sensitivity to DMI-related features. The proposed approach begins with computational multispectral imaging (CMI) to reconstruct 24-wavelength multispectral fundus images from CFPs. ResNeXt101 is employed as the backbone for multi-view learning to extract features from the reconstructed images. Additionally, a GNN with a customized jumper connection strategy is designed to enhance cross-spectral relationships, facilitating comprehensive and efficient multispectral view learning. The study included a total of 1,078 macula-centered CFPs from 1,078 eyes of 592 patients with diabetes, of which 530 CFPs from 530 eyes of 300 patients were diagnosed with DMI. The model achieved an accuracy of 84.7 percent and an area under the receiver operating characteristic curve (AUROC) of 0.900 (95 percent CI: 0.852-0.937) on eye-level, outperforming both the baseline model trained from CFPs and human experts (p-values less than 0.01). These findings suggest that AI-based CFP analysis holds promise for detecting DMI, contributing to its early and low-cost screening.
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