Abstract
This paper proposes a conventional approach for pulmonary nodule segmentation, that uses the Sliding Band Filter to estimate the center of the nodule, and consequently the filter's support points, matching the initial border coordinates. This preliminary segmentation is then refined to try to include mainly the nodular area, and no other regions (e.g. vessels and pleural wall). The algorithm was tested on 2653 nodules from the LIDC database and achieved a Dice score of 0.663, yielding similar results to the ground truth reference, and thus being a promising tool to promote early lung cancer screening and improve nodule characterization.

Abstract
Diabetic Retinopathy (DR) is the most common cause of avoidable vision loss, predominantly affecting the working-age population across the globe. Screening for DR, coupled with timely consultation and treatment, is a globally trusted policy to avoid vision loss. However, implementation of DR screening programs is challenging due to the scarcity of medical professionals able to screen a growing global diabetic population at risk for DR. Computer-aided disease diagnosis in retinal image analysis could provide a sustainable approach for such large-scale screening effort. The recent scientific advances in computing capacity and machine learning approaches provide an avenue for biomedical scientists to reach this goal. Aiming to advance the state-of-the-art in automatic DR diagnosis, a grand challenge on "Diabetic Retinopathy - Segmentation and Grading" was organized in conjunction with the IEEE International Symposium on Biomedical Imaging (ISBI-2018). In this paper, we report the set-up and results of this challenge that is primarily based on Indian Diabetic Retinopathy Image Dataset (IDRiD). There were three principal subchallenges: lesion segmentation, disease severity grading, and localization of retinal landmarks and segmentation. These multiple tasks in this challenge allow to test the generalizability of algorithms, and this is what makes it different from existing ones. It received a positive response from the scientific community with 148 submissions from 495 registrations effectively entered in this challenge. This paper outlines the challenge, its organization, the dataset used, evaluation methods and results of top-performing participating solutions. The top-performing approaches utilized a blend of clinical information, data augmentation, and an ensemble of models. These findings have the potential to enable new developments in retinal image analysis and image-based DR screening in particular.

Abstract
Diabetic retinopathy (DR) grading is crucial in determining the adequate treatment and follow up of patient, but the screening process can be tiresome and prone to errors. Deep learning approaches have shown promising performance as computer-aided diagnosis (CAD) systems, but their black-box behaviour hinders clinical application. We propose DR vertical bar GRADUATE, a novel deep learning-based DR grading CAD system that supports its decision by providing a medically interpretable explanation and an estimation of how uncertain that prediction is, allowing the ophthalmologist to measure how much that decision should be trusted. We designed DR vertical bar GRADUATE taking into account the ordinal nature of the DR grading problem. A novel Gaussian-sampling approach built upon a Multiple Instance Learning framework allow DR vertical bar GRADUATE to infer an image grade associated with an explanation map and a prediction uncertainty while being trained only with image-wise labels. DR vertical bar GRADUATE was trained on the Kaggle DR detection training set and evaluated across multiple datasets. In DR grading, a quadratic-weighted Cohen's kappa (kappa) between 0.71 and 0.84 was achieved in five different datasets. We show that high kappa values occur for images with low prediction uncertainty, thus indicating that this uncertainty is a valid measure of the predictions' quality. Further, bad quality images are generally associated with higher uncertainties, showing that images not suitable for diagnosis indeed lead to less trustworthy predictions. Additionally, tests on unfamiliar medical image data types suggest that DR vertical bar GRADUATE allows outlier detection. The attention maps generally highlight regions of interest for diagnosis. These results show the great potential of DR vertical bar GRADUATE as a second-opinion system in DR severity grading.

Abstract
The optic disc (OD) and the fovea are relevant landmarks in fundus images. Their localization and segmentation can facilitate the detection of some retinal lesions and the assessment of their importance to the severity and progression of several eye disorders. Distinct methodologies have been developed for detecting these structures, mainly based on color and vascular information. The methodology herein described combines the entropy of the vessel directions with the image intensities for finding the OD center and uses a sliding band filter for segmenting the OD. The fovea center corresponds to the darkest point inside a region defined from the OD position and radius. Both the Messidor and the IDRiD datasets are used for evaluating the performance of the developed methods. In the first one, a success rate of 99.56% and 100.00% are achieved for OD and fovea localization. Regarding the OD segmentation, the mean Jaccard index and Dice’s coefficient obtained are 0.87 and 0.94, respectively. The proposed methods are also amongst the top-3 performing solutions submitted to the IDRiD online challenge. © Springer Nature Switzerland AG 2020.

Abstract
Diabetic macular edema is a leading cause of visual loss for patients with diabetes. While diagnosis can only be performed by optical coherence tomography, diabetic macular edema risk assessment is often performed in eye fundus images in screening scenarios through the detection of hard exudates. Such screening scenarios are often associated with large amounts of data, high costs and high burden on specialists, motivating then the development of methodologies for automatic diabetic macular edema risk prediction. Nevertheless, significant dataset domain bias, due to different acquisition equipment, protocols and/or different populations can have significantly detrimental impact on the performance of automatic methods when transitioning to a new dataset, center or scenario. As such, in this study, a method based on residual neural networks is proposed for the classification of diabetic macular edema risk. This method is then validated across multiple public datasets, simulating the deployment in a multi-center setting and thereby studying the method’s generalization capability and existing dataset domain bias. Furthermore, the method is tested on a private dataset which more closely represents a realistic screening scenario. An average area under the curve across all public datasets of 0.891 ± 0.013 was obtained with a ResNet50 architecture trained on a limited amount of images from a single public dataset (IDRiD). It is also shown that screening scenarios are significantly more challenging and that training across multiple datasets leads to an improvement of performance (area under the curve of 0.911 ± 0.009). © Springer Nature Switzerland AG 2020.

Abstract
Diabetic retinopathy (DR) is a diabetes complication, which in extreme situations may lead to blindness. Since the first stages are often asymptomatic, regular eye examinations are required for an early diagnosis. As microaneurysms (MAs) are one of the first signs of DR, several automated methods have been proposed for their detection in order to reduce the ophthalmologists' workload. Although local convergence filters (LCFs) have already been applied for feature extraction, their potential as MA enhancement operators was not explored yet. In this work, we propose a sliding band filter for MA enhancement aiming at obtaining a set of initial MA candidates. Then, a combination of the filter responses with color, contrast and shape information is used by an ensemble of classifiers for final candidate classification. Finally, for each eye fundus image, a score is computed from the confidence values assigned to the MAs detected in the image. The performance of the proposed methodology was evaluated in four datasets. At the lesion level, sensitivities of 64% and 81% were achieved for an average of 8 false positives per image (FPIs) in e-ophtha MA and SCREEN-DR, respectively. In the last dataset, an AUC of 0.83 was also obtained for DR detection.