Influence of background preprocessing on the performance of deep learning retinal vessel detection

Purpose: Segmentation of the vessel tree from retinal fundus images can be used to track changes in the retina and be an important first step in a diagnosis. Manual segmentation is a time-consuming process that is prone to error; effective and reliable automation can alleviate these problems but one of the difficulties is uneven image background, which may affect segmentation performance. Approach: We present a patch-based deep learning framework, based on a modified U-Net architecture, that automatically segments the retinal blood vessels from fundus images. In particular, we evaluate how various pre-processing techniques, images with either no processing, N4 bias field correction, contrast limited adaptive histogram equalization (CLAHE), or a combination of N4 and CLAHE, can compensate for uneven image background and impact final segmentation performance. Results: We achieved competitive results on three publicly available datasets as a benchmark for our comparisons of pre-processing techniques. In addition, we introduce Bayesian statistical testing, which indicates little practical difference ( $$ ) between pre-processing methods apart from the sensitivity metric. In terms of sensitivity and pre-processing, the combination of N4 correction and CLAHE performs better in comparison to unprocessed and N4 pre-processing ( $$ ); but compared to CLAHE alone, the differences are not significant ( $$ to 0.88). Conclusions: We conclude that deep learning is an effective method for retinal vessel segmentation and that CLAHE pre-processing has the greatest positive impact on segmentation performance, with N4 correction helping only in images with extremely inhomogeneous background illumination.