OTRE: Where Optimal Transport Guided Unpaired Image-to-Image Translation Meets Regularization by Enhancing

TL;DR

This paper introduces OTRE, a novel framework that uses optimal transport theory for unpaired image-to-image translation to enhance retinal fundus images, improving quality and downstream diagnostic tasks.

Contribution

It proposes a new OT-guided unpaired image translation method combined with regularization by denoising, enhancing retinal images for clinical and automated analysis.

Findings

Outperforms state-of-the-art unsupervised methods in image quality enhancement.

Improves accuracy in diabetic retinopathy grading and lesion segmentation.

Validated on three public datasets with superior results.

Abstract

Non-mydriatic retinal color fundus photography (CFP) is widely available due to the advantage of not requiring pupillary dilation, however, is prone to poor quality due to operators, systemic imperfections, or patient-related causes. Optimal retinal image quality is mandated for accurate medical diagnoses and automated analyses. Herein, we leveraged the Optimal Transport (OT) theory to propose an unpaired image-to-image translation scheme for mapping low-quality retinal CFPs to high-quality counterparts. Furthermore, to improve the flexibility, robustness, and applicability of our image enhancement pipeline in the clinical practice, we generalized a state-of-the-art model-based image reconstruction method, regularization by denoising, by plugging in priors learned by our OT-guided image-to-image translation network. We named it as regularization by enhancing (RE). We validated the integrated framework, OTRE, on three publicly available retinal image datasets by assessing the quality after enhancement and their performance on various downstream tasks, including diabetic retinopathy grading, vessel segmentation, and diabetic lesion segmentation. The experimental results demonstrated the superiority of our proposed framework over some state-of-the-art unsupervised competitors and a state-of-the-art supervised method.