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This paper aims to propose a solution for detecting and grading diabetic retinopathy (DR) in retinal images using a convolutional neural network (CNN)-based approach. It could classify input retinal images into a normal class or an abnormal class, which would be further split into four stages of abnormalities automatically.

The proposed solution is developed based on a newly proposed CNN architecture, namely, DeepRoot. It consists of one main branch, which is connected by two side branches. The main branch is responsible for the primary feature extractor of both high-level and low-level features of retinal images. Then, the side branches further extract more complex and detailed features from the features outputted from the main branch. They are designed to capture details of small traces of DR in retinal images, using modified zoom-in/zoom-out and attention layers.

The proposed method is trained, validated and tested on the Kaggle dataset. The regularization of the trained model is evaluated using unseen data samples, which were self-collected from a real scenario from a hospital. It achieves a promising performance with a sensitivity of 98.18% under the two classes scenario.

The new CNN-based architecture (i.e. DeepRoot) is introduced with the concept of a multi-branch network. It could assist in solving a problem of an unbalanced dataset, especially when there are common characteristics across different classes (i.e. four stages of DR). Different classes could be outputted at different depths of the network.

The cardiomegaly can be determined by the cardiothoracic ratio (CTR) which can be measured in a chest x-ray image. It is calculated based on a relationship between a size of heart and a transverse dimension of chest. The cardiomegaly is identified when the ratio is larger than a cut-off threshold. This paper aims to propose a solution to calculate the ratio for classifying the cardiomegaly in chest x-ray images.

The proposed method begins with constructing lung and heart segmentation models based on U-Net architecture using the publicly available datasets with the groundtruth of heart and lung masks. The ratio is then calculated using the sizes of segmented lung and heart areas. In addition, Progressive Growing of GANs (PGAN) is adopted here for constructing the new dataset containing chest x-ray images of three classes including male normal, female normal and cardiomegaly classes. This dataset is then used for evaluating the proposed solution. Also, the proposed solution is used to evaluate the quality of chest x-ray images generated from PGAN.

In the experiments, the trained models are applied to segment regions of heart and lung in chest x-ray images on the self-collected dataset. The calculated CTR values are compared with the values that are manually measured by human experts. The average error is 3.08%. Then, the models are also applied to segment regions of heart and lung for the CTR calculation, on the dataset computed by PGAN. Then, the cardiomegaly is determined using various attempts of different cut-off threshold values. With the standard cut-off at 0.50, the proposed method achieves 94.61% accuracy, 88.31% sensitivity and 94.20% specificity.

The proposed solution is demonstrated to be robust across unseen datasets for the segmentation, CTR calculation and cardiomegaly classification, including the dataset generated from PGAN. The cut-off value can be adjusted to be lower than 0.50 for increasing the sensitivity. For example, the sensitivity of 97.04% can be achieved at the cut-off of 0.45. However, the specificity is decreased from 94.20% to 79.78%.