Retinal vessel segmentation is crucial for the diagnosis of ophthalmic and cardiovascular diseases. However, retinal vessels are densely and irregularly distributed, with many capillaries blending into the background, and exhibit low contrast. Moreover, the encoder-decoder-based network for retinal vessel segmentation suffers from irreversible loss of detailed features due to multiple encoding and decoding, leading to incorrect segmentation of the vessels. Meanwhile, the single-dimensional attention mechanisms possess limitations, neglecting the importance of multidimensional features. To solve these issues, in this paper, we propose a detail-enhanced attention feature fusion network (DEAF-Net) for retinal vessel segmentation. First, the detail-enhanced residual block (DERB) module is proposed to strengthen the capacity for detailed representation, ensuring that intricate features are efficiently maintained during the segmentation of delicate vessels. Second, the multidimensional collaborative attention encoder (MCAE) module is proposed to optimize the extraction of multidimensional information. Then, the dynamic decoder (DYD) module is introduced to preserve spatial information during the decoding process and reduce the information loss caused by upsampling operations. Finally, the proposed detail-enhanced feature fusion (DEFF) module composed of DERB, MCAE and DYD modules fuses feature maps from both encoding and decoding and achieves effective aggregation of multi-scale contextual information. The experiments conducted on the datasets of DRIVE, CHASEDB1, and STARE, achieving Sen of 0.8305, 0.8784, and 0.8654, and AUC of 0.9886, 0.9913, and 0.9911 on DRIVE, CHASEDB1, and STARE, respectively, demonstrate the performance of our proposed network, particularly in the segmentation of fine retinal vessels.

Accurate segmentation of retinal vessels is of great significance for computer-aided diagnosis and treatment of many diseases. Due to the limited number of retinal vessel samples and the scarcity of labeled samples, and since grey theory excels in handling problems of \"few data, poor information\", this paper proposes a novel grey relational-based method for retinal vessel segmentation. Firstly, a noise-adaptive discrimination filtering algorithm based on grey relational analysis (NADF-GRA) is designed to enhance the image. Secondly, a threshold segmentation model based on grey relational analysis (TS-GRA) is designed to segment the enhanced vessel image. Finally, a post-processing stage involving hole filling and removal of isolated pixels is applied to obtain the final segmentation output. The performance of the proposed method is evaluated using multiple different measurement metrics on publicly available digital retinal DRIVE, STARE and HRF datasets. Experimental analysis showed that the average accuracy and specificity on the DRIVE dataset were 96.03% and 98.51%. The mean accuracy and specificity on the STARE dataset were 95.46% and 97.85%. Precision, F1-score, and Jaccard index on the HRF dataset all demonstrated high-performance levels. The method proposed in this paper is superior to the current mainstream methods.

Retinal vessel segmentation is crucial for diagnosing and monitoring various eye diseases such as diabetic retinopathy, glaucoma, and hypertension. In this study, we examine how sharpness-aware minimization (SAM) can improve RF-UNet\'s generalization performance. RF-UNet is a novel model for retinal vessel segmentation. We focused our experiments on the digital retinal images for vessel extraction (DRIVE) dataset, which is a benchmark for retinal vessel segmentation, and our test results show that adding SAM to the training procedure leads to notable improvements. Compared to the non-SAM model (training loss of 0.45709 and validation loss of 0.40266), the SAM-trained RF-UNet model achieved a significant reduction in both training loss (0.094225) and validation loss (0.08053). Furthermore, compared to the non-SAM model (training accuracy of 0.90169 and validation accuracy of 0.93999), the SAM-trained model demonstrated higher training accuracy (0.96225) and validation accuracy (0.96821). Additionally, the model performed better in terms of sensitivity, specificity, AUC, and F1 score, indicating improved generalization to unseen data. Our results corroborate the notion that SAM facilitates the learning of flatter minima, thereby improving generalization, and are consistent with other research highlighting the advantages of advanced optimization methods. With wider implications for other medical imaging tasks, these results imply that SAM can successfully reduce overfitting and enhance the robustness of retinal vessel segmentation models. Prospective research avenues encompass verifying the model on vaster and more diverse datasets and investigating its practical implementation in real-world clinical situations.

BACKGROUND: The retinal vasculature, a crucial component of the human body, mirrors various illnesses such as cardiovascular disease, glaucoma, and retinopathy. Accurate segmentation of retinal vessels in funduscopic images is essential for diagnosing and understanding these conditions. However, existing segmentation models often struggle with images from different sources, making accurate segmentation in crossing-source fundus images challenging.
METHODS: To address the crossing-source segmentation issues, this paper proposes a novel Multi-level Adversarial Learning and Pseudo-label Denoising-based Self-training Framework (MLAL&PDSF). Expanding on our previously proposed Multiscale Context Gating with Breakpoint and Spatial Dual Attention Network (MCG&BSA-Net), MLAL&PDSF introduces a multi-level adversarial network that operates at both the feature and image layers to align distributions between the target and source domains. Additionally, it employs a distance comparison technique to refine pseudo-labels generated during the self-training process. By comparing the distance between the pseudo-labels and the network predictions, the framework identifies and corrects inaccuracies, thus enhancing the accuracy of the fine vessel segmentation.
RESULTS: We have conducted extensive validation and comparative experiments on the CHASEDB1, STARE, and HRF datasets to evaluate the efficacy of the MLAL&PDSF. The evaluation metrics included the area under the operating characteristic curve (AUC), sensitivity (SE), specificity (SP), accuracy (ACC), and balanced F-score (F1). The performance results from unsupervised domain adaptive segmentation are remarkable: for DRIVE to CHASEDB1, results are AUC: 0.9806, SE: 0.7400, SP: 0.9737, ACC: 0.9874, and F1: 0.8851; for DRIVE to STARE, results are AUC: 0.9827, SE: 0.7944, SP: 0.9651, ACC: 0.9826, and F1: 0.8326.
CONCLUSIONS: These results demonstrate the effectiveness and robustness of MLAL&PDSF in achieving accurate segmentation results from crossing-domain retinal vessel datasets. The framework lays a solid foundation for further advancements in cross-domain segmentation and enhances the diagnosis and understanding of related diseases.

Accurate segmentation of retinal vessels in fundus images is of great importance for the diagnosis of numerous ocular diseases. However, due to the complex characteristics of fundus images, such as various lesions, image noise and complex background, the pixel features of some vessels have significant differences, which makes it easy for the segmentation networks to misjudge these vessels as noise, thus affecting the accuracy of the overall segmentation. Therefore, accurately segment retinal vessels in complex situations is still a great challenge. To address the problem, a partial class activation mapping guided graph convolution cascaded U-Net for retinal vessel segmentation is proposed. The core idea of the proposed network is first to use the partial class activation mapping guided graph convolutional network to eliminate the differences of local vessels and generate feature maps with global consistency, and subsequently these feature maps are further refined by segmentation network U-Net to achieve better segmentation results. Specifically, a new neural network block, called EdgeConv, is stacked multiple layers to form a graph convolutional network to realize the transfer an update of information from local to global, so as gradually enhance the feature consistency of graph nodes. Simultaneously, in an effort to suppress the noise information that may be transferred in graph convolution and thus reduce adverse effects of noise on segmentation results, the partial class activation mapping is introduced. The partial class activation mapping can guide the information transmission between graph nodes and effectively activate vessel feature through classification labels, thereby improving the accuracy of segmentation. The performance of the proposed method is validated on four different fundus image datasets. Compared with existing state-of-the-art methods, the proposed method can improve the integrity of vessel to a certain extent when the pixel features of local vessels are significantly different, caused by objective factors such as inappropriate illumination and exudates. Moreover, the proposed method shows robustness when segmenting complex retinal vessels.

Retinal vessels play a pivotal role as biomarkers in the detection of retinal diseases, including hypertensive retinopathy. The manual identification of these retinal vessels is both resource-intensive and time-consuming. The fidelity of vessel segmentation in automated methods directly depends on the fundus images\' quality. In instances of sub-optimal image quality, applying deep learning-based methodologies emerges as a more effective approach for precise segmentation. We propose a heterogeneous neural network combining the benefit of local semantic information extraction of convolutional neural network and long-range spatial features mining of transformer network structures. Such cross-attention network structure boosts the model\'s ability to tackle vessel structures in the retinal images. Experiments on four publicly available datasets demonstrate our model\'s superior performance on vessel segmentation and the big potential of hypertensive retinopathy quantification.

Retinal vessel segmentation plays a crucial role in medical image analysis, aiding ophthalmologists in disease diagnosis, monitoring, and treatment guidance. However, due to the complex boundary structure and rich texture features in retinal blood vessel images, existing methods have challenges in the accurate segmentation of blood vessel boundaries. In this study, we propose the texture-driven Swin-UNet with enhanced boundary-wise perception. Firstly, we designed a Cross-level Texture Complementary Module (CTCM) to fuse feature maps at different scales during the encoding stage, thereby recovering detailed features lost in the downsampling process. Additionally, we introduced a Pixel-wise Texture Swin Block (PT Swin Block) to improve the model\'s ability to localize vessel boundary and contour information. Finally, we introduced an improved Hausdorff distance loss function to further enhance the accuracy of vessel boundary segmentation. The proposed method was evaluated on the DRIVE and CHASEDB1 datasets, and the experimental results demonstrate that our model obtained superior performance in terms of Accuracy (ACC), Sensitivity (SE), Specificity (SP), and F1 score (F1), and the accuracy of vessel boundary segmentation was significantly improved.

Many major diseases of the retina often show symptoms of lesions in the fundus of the eye. The extraction of blood vessels from retinal fundus images is essential to assist doctors. Some of the existing methods do not fully extract the detailed features of retinal images or lose some information, making it difficult to accurately segment capillaries located at the edges of the images. In this paper, we propose a multi-scale retinal vessel segmentation network (SCIE_Net) based on skip connection information enhancement. Firstly, the network processes retinal images at multiple scales to achieve network capture of features at different scales. Secondly, the feature aggregation module is proposed to aggregate the rich information of the shallow network. Further, the skip connection information enhancement module is proposed to take into account the detailed features of the shallow layer and the advanced features of the deeper network to avoid the problem of incomplete information interaction between the layers of the network. Finally, SCIE_Net achieves better vessel segmentation performance and results on the publicly available retinal image standard datasets DRIVE, CHASE_DB1, and STARE.

Blood vessel segmentation is a crucial stage in extracting morphological characteristics of vessels for the clinical diagnosis of fundus and coronary artery disease. However, traditional convolutional neural networks (CNNs) are confined to learning local vessel features, making it challenging to capture the graph structural information and fail to perceive the global context of vessels. Therefore, we propose a novel graph neural network-guided vision transformer enhanced network (G2ViT) for vessel segmentation. G2ViT skillfully orchestrates the Convolutional Neural Network, Graph Neural Network, and Vision Transformer to enhance comprehension of the entire graphical structure of blood vessels. To achieve deeper insights into the global graph structure and higher-level global context cognizance, we investigate a graph neural network-guided vision transformer module. This module constructs graph-structured representation in an unprecedented manner using the high-level features extracted by CNNs for graph reasoning. To increase the receptive field while ensuring minimal loss of edge information, G2ViT introduces a multi-scale edge feature attention module (MEFA), leveraging dilated convolutions with different dilation rates and the Sobel edge detection algorithm to obtain multi-scale edge information of vessels. To avoid critical information loss during upsampling and downsampling, we design a multi-level feature fusion module (MLF2) to fuse complementary information between coarse and fine features. Experiments on retinal vessel datasets (DRIVE, STARE, CHASE_DB1, and HRF) and coronary angiography datasets (DCA1 and CHUAC) indicate that the G2ViT excels in robustness, generality, and applicability. Furthermore, it has acceptable inference time and computational complexity and presents a new solution for blood vessel segmentation.

Retinal vessel segmentation based on deep learning is an important auxiliary method for assisting clinical doctors in diagnosing retinal diseases. However, existing methods often produce mis-segmentation when dealing with low contrast images and thin blood vessels, which affects the continuity and integrity of the vessel skeleton. In addition, existing deep learning methods tend to lose a lot of detailed information during training, which affects the accuracy of segmentation. To address these issues, we propose a novel dual-decoder based Cross-patch Feature Interactive Net with Edge Refinement (CFI-Net) for end-to-end retinal vessel segmentation. In the encoder part, a joint refinement down-sampling method (JRDM) is proposed to compress feature information in the process of reducing image size, so as to reduce the loss of thin vessels and vessel edge information during the encoding process. In the decoder part, we adopt a dual-path model based on edge detection, and propose a Cross-patch Interactive Attention Mechanism (CIAM) in the main path to enhancing multi-scale spatial channel features and transferring cross-spatial information. Consequently, it improve the network\'s ability to segment complete and continuous vessel skeletons, reducing vessel segmentation fractures. Finally, the Adaptive Spatial Context Guide Method (ASCGM) is proposed to fuse the prediction results of the two decoder paths, which enhances segmentation details while removing part of the background noise. We evaluated our model on two retinal image datasets and one coronary angiography dataset, achieving outstanding performance in segmentation comprehensive assessment metrics such as AUC and CAL. The experimental results showed that the proposed CFI-Net has superior segmentation performance compared with other existing methods, especially for thin vessels and vessel edges. The code is available at https://github.com/kita0420/CFI-Net.