论文标题
几何深度学习以确定视神经头的关键3D结构特征用于青光眼诊断
Geometric Deep Learning to Identify the Critical 3D Structural Features of the Optic Nerve Head for Glaucoma Diagnosis
论文作者
论文摘要
目的:视神经头(ONH)在青光眼发展和进展过程中经历复合物和深3D形态变化。光学相干断层扫描(OCT)是当前可视化和量化这些变化的金标准,但是尚未完全利用产生的3D深部组织信息来诊断和预后。为此,我们的目的是:(1)比较从ONH的一次OCT扫描中诊断青光眼的两种相对较新的几何深度学习技术的性能; (2)确定ONH的3D结构特征,这对于诊断青光眼至关重要。 方法:在这项研究中,我们包括1,725名受试者的总共2,247个非葡萄球瘤和2,259次青光眼扫描。所有受试者的ONH都以Spectralis Oct成像为3D。所有OCT扫描都会使用深度学习自动分割,以识别主要的神经组织和结缔组织。然后,每个ONH被表示为3D点云。我们使用PointNet和动态图卷积神经网络(DGCNN)来诊断从这种3D ONH点云中诊断青光眼,并确定ONH的关键3D结构特征,以示诊断。 结果:DGCNN(AUC:0.97 $ \ pm $ 0.01)和PointNet(AUC:0.95 $ \ pm $ 0.02)都能够准确地从3D ONH点云中检测到青光眼。临界点形成了一个沙漏图案,其中大多数位于ONH的下象限和上象限中。 讨论:两种几何深度学习方法的诊断准确性非常好。此外,我们能够确定ONH的关键3D结构特征用于青光眼诊断,从而极大地提高了我们方法的透明度和解释性。因此,我们的方法可能具有强大的潜力,可以在临床应用中用于诊断和预后多种眼科疾病。
Purpose: The optic nerve head (ONH) undergoes complex and deep 3D morphological changes during the development and progression of glaucoma. Optical coherence tomography (OCT) is the current gold standard to visualize and quantify these changes, however the resulting 3D deep-tissue information has not yet been fully exploited for the diagnosis and prognosis of glaucoma. To this end, we aimed: (1) To compare the performance of two relatively recent geometric deep learning techniques in diagnosing glaucoma from a single OCT scan of the ONH; and (2) To identify the 3D structural features of the ONH that are critical for the diagnosis of glaucoma. Methods: In this study, we included a total of 2,247 non-glaucoma and 2,259 glaucoma scans from 1,725 subjects. All subjects had their ONHs imaged in 3D with Spectralis OCT. All OCT scans were automatically segmented using deep learning to identify major neural and connective tissues. Each ONH was then represented as a 3D point cloud. We used PointNet and dynamic graph convolutional neural network (DGCNN) to diagnose glaucoma from such 3D ONH point clouds and to identify the critical 3D structural features of the ONH for glaucoma diagnosis. Results: Both the DGCNN (AUC: 0.97$\pm$0.01) and PointNet (AUC: 0.95$\pm$0.02) were able to accurately detect glaucoma from 3D ONH point clouds. The critical points formed an hourglass pattern with most of them located in the inferior and superior quadrant of the ONH. Discussion: The diagnostic accuracy of both geometric deep learning approaches was excellent. Moreover, we were able to identify the critical 3D structural features of the ONH for glaucoma diagnosis that tremendously improved the transparency and interpretability of our method. Consequently, our approach may have strong potential to be used in clinical applications for the diagnosis and prognosis of a wide range of ophthalmic disorders.