Image Quality Assessment Guided Collaborative Learning of Image Enhancement and Classification for Diabetic Retinopathy Grading

Diabetic retinopathy (DR) is one of the most serious complications of diabetes and is a prominent cause of permanent blindness. However, the low-quality fundus images increase the uncertainty of clinical diagnosis, resulting in a significant decrease on the grading performance of the fundus images. Therefore, enhancing the image quality is essential for predicting the grade level in DR diagnosis. In essence, we are faced with three challenges: (I) How to appropriately evaluate the quality of fundus images; (II) How to effectively enhance low-quality fundus images for providing reliable fundus images to ophthalmologists or automated analysis systems; (III) How to jointly train the quality assessment and enhancement for improving the DR grading performance. Considering the importance of image quality assessment and enhancement for DR grading, we propose a collaborative learning framework to jointly train the subnetworks of the image quality assessment as well as enhancement, and DR disease grading in a unified framework. The key contribution of the proposed framework lies in modelling the potential correlation of these tasks and the joint training of these subnetworks, which significantly improves the fundus image quality and DR grading performance. Our framework is a general learning model, which may be useful in other medical images with low-quality data. Extensive experimental results have shown that our method outperforms state-of-the-art DR grading methods by a considerable 73.6% ACC/71.2% Kappa and 88.5% ACC/86.3% Kappa on Messidor and EyeQ benchmark datasets, respectively. In addition, our method significantly enhances the low-quality fundus images while preserving fundus structure features and lesion information. To make the framework more general, we also evaluate the enhancement results in more downstream tasks, such as vessel segmentation.