Auto-segmentation of Retinal Blood Vessels Using

Image Processing

Malak T. Bantan
Computer Science Department
Computer and Information System College
Umm Al Qura University
Makkah, Saudi Arabia

m.bantan@hotmail.com

AbstractAutomatic segmentation of the normal features II. RELATED WORK

such the blood vessels may help to develop the future of medicine.
It can give an earlier diagnosis of such eye diseases as diabetic
retinopathy and glaucoma; it can support the specialists in their
decision as well. In this paper, a method of retinal blood vessel
segmentation is proposed. The database used is HRF of a total of
45 fundus images. The fundus images go through a MATLAB
code in preprocessing steps of image acquisition, grayscale
conversion and contrast enhancement, intensity adjustment,
complement and adaptive histogram equalization. Then, the
blood vessel segmentation process includes mathematical
morphological opening, binarization and noise extraction. The
proposed method shows a specificity of 97%, a sensitivity of 69%
and an Accuracy of 94%.
KeywordsSegmentation; Retinal Blood Vessels; Image
Processing; HRF database
I. INTRODUCTION
The eye is an organ of vision. The human eye is considered
as the most complex organ in the body as it has many parts
comparing to its small size [9]. Examples of ocular diseases
are glaucoma and Diabetic retinopathy. They affect the human
eye and cause vision loss or blindness. There are certain
features to be considered in order to diagnose these diseases
such as optic nerve, optic disc [1] [6], blood vessels network
[2].
Blood vessels extraction is very important as many eye
diseases are recognized by inspecting the blood vessels. Since
the eye is the only organ in the body that you can visualize the
blood vessels which reflects the health status of blood vessels
in other body organs, we consider this organ in this work. The
objective of this paper is to segment the blood vessels in fundus
images in order to help specialists to diagnose or support their
decision.
The rest of the paper is organized as follows: Section II is
about other existing related work in the same field, Section III
explains the materials of this paper and methodology followed;
Section IV shows the results and discussion; Section V is the
conclusion and finally, the references.
Ravishankar et al. [1] extracted features in order to detect
lesions of Diabetic retinopathy in its early stages. Blood vessel
extraction was done as the first step. Resizing the input image
to 768 576 pixels was followed by the green channel is
extracted. Morphological Closing was applied on the image
using two different sizes of a structuring element (disk shape).
Both closed images were subtracted using two different scales.
The scales (S1, S2) are chosen depending on the target vessels
to be extracted. To extract the entire blood vessel network, the
radius of the large disk (S2) is fixed at 6 pixels and (S1) is
selected At least 4 pixels below (S2). Then thresholding (90%
of the max intensity), median filtering and thinning were
performed on the image. Lastly, a 22 median filter is used to
remove the noise.
On the other hand, Sri et al. [2] developed an algorithm to
identify the different stages of Diabetic Retinopathy. This was
done by extracting the blood vessels then calculating the area
and the perimeter. Vessel extraction was done using edge
detection (non-linear Sobel operator), then followed by shade
correction, Top hat transformation extracted fine vessels. The
image is then converted to binary. After that, Morphological
opening was applied to remove the isolated pixels. Dilation
was done to fill the space between the edges. Finally, the
image is masked to eliminate the fundus edge.
Like [1] and [2], Phyo et al. [6] concerned about Diabetic
retinopathy. In [1] and [6], both optic disc and vessel were
detected. IN [6] used closing, filling, morphological
reconstruction and Otsu algorithm to detect them. Blood
vessel extraction started with Image Acquisition. Then, RGB
image was converted to gray. Filters such as median,
Averaging and Wiener filters were used. To enhance the
image, histogram, and adaptive histogram equalization was
applied. The morphological closing was applied followed by
filling. The last step was thresholding.

978-1-4673-8956-3/16/$31.00 2016 IEEE

 Zana et al. [3] discussed the difficulty of image registration
and presented an algorithm for temporal and multimodal
channel was extracted. Mainly, this paper tracks the vascular
trees. The connected Vessels that have a width less than 15
and locally linear are simplified by applying opening
operation with 15 pixels linear structuring elements. Noise and
nonlinear parts were removed. After that, top hats were used
to enhance the contrast. The author defines the vessels as
correlated cross curvature. So, to calculate this cross
curvature, a Laplacian filter is used. Then, the image is
simplified by applying a sequence of openings and closings
with linear structuring elements of increasing length simple
thresholding is used then. At this stage, the images were
binarized to represent the detected vascular branches.
In Hoover et al. [4], "fuzzy convergence" algorithm is
developed to locate the optic nerve in fundus images. The
segmentation of the vessels was created using two dissimilar
parameter sets in order to detect the convergent points.
"Fuzzy convergence" algorithm worked in the spatial domain
of the image. The input image is a binary segmentation of the
blood vessels. A fuzzy segment modeled all vessels, this
contributed to a cumulative voting image. The output is a
convergence image that is thresholded to find the best
convergence points.
Hoover et al. [8] located the blood vessel by using local
and global vessel features to detect the vessel network.
Probing regions in a matched filter response (MFR) image was
the basic operation of the algorithm. Some criteria were
examined to define the probe threshold and deciding whether
the probed area (termed a piece) was a blood vessel or not.
Another paper concerned about vessel Extraction is found
in Kovcs et al. [5]. Hidden Markov Random Fields (HMRF)
was used to segment the retinal blood vessels. The HMRF
based segmentation means the maximization of the functional.
Basically, the image tangent vector field is considered to
improve the connectivity of the vascular network. To improve
the probability assessment of the Hidden Markov problem, the
Averaged One-Dependence Estimator (AODE) was used. The
images went under morphological operations to trace thick
and thin vessels. Some developed equations were applied to
the green channel image to achieve the objective of vessel
extraction.
Niemeijer et al. [7] evaluated different blood vessel
segmentation methods. Five methods were included in the
comparison. One of them was pixel classification based
method. A feature vector was built for individual pixel and a
classifier was trained. As usual, the green channel was
extracted first. In initial experiments, we compared two types
of features: kNN-classifier was the best among other
classifiers to find the vessel pixels. Finally, thresholding the
probability map helped to obtain a binary segmentation of the
vasculature.
Manjiri et al. [11] extracted blood vessels in the purpose
of detecting Diabetic retinopathy in some unique cases. The
method followed consisted of five stages: preprocessing, mask
registration. The algorithm is applied on retinal images after
they were injected with fluorescein dye, then, the green
extraction, optic disk localization, blood vessel extraction, and
detection of lesions. In blood vessel extraction, the author first
got the green channel. Then, applied histogram equalization
followed by a 2D median filter. After that, a morphological
structuring element and a morphological opening were
performed. Another 2D median filter was used. Finally
thresholding function and intensity transformation function.
Patwari et al. [12] paper, a method was proposed to
calculate retinal blood vessels with respect to six parameters:
Area, Length, thickness, diameter, Mean Diameter and
Tortuosity. The algorithm went through three stages:
preprocessing operations, retinal vessel extraction and
Segmentation to detect the Blood vessels boundaries. Green
channel was extracted as a preprocessing step. For vessel
enhancement, the preprocessed image is complemented. Then,
histogram equalization method was done followed by
morphological structuring element. Finally, the blood vessels
were extracted by the morphological opening, 2D median
filter and a thresholding function.
Rajput et al. [13] proposed a general algorithm that can be
applied on high-resolution fundus images. In this algorithm,
the diameter of the normal blood vessel was defined to be 25
mm; and according to that, the decision was made regarding
the normality and abnormality of blood vessels. To achieve
that, green channel first was extracted; then it was
complemented followed by a histogram equalization method.
After that, both a morphological structuring element and a
morphological opening were applied. A 2D median filter and a
thresholding function were done as final steps. Finally, the
diameter was calculated.
III. MATERIALS AND METHODOLOGY
In this work, HRF High-Resolution Fundus (HRF) Image
Database is used [10]. It contains a total of 45 fundus images.
It also provides 45 manual blood vessel segmentation images
and Field of View (FOV) mask images. The images are a
combination of 15 healthy images, 15 diabetic retinopathy
images, and 15 glaucomatous images. In order to accomplish
this work, we use MATLAB 2015a.
To achieve the objective of this paper, we follow the
methodology shown in Fig. 1.
Preprocessing Stage
A.1. Image Acquisition
A.
The input images are RGB (Red, Green, and Blue) images of
size 2336x3504x3.
Fig. 1. Methodology Block Diagram
 A.2. Converting the image to Gray
The RGB image is converted to gray by extracting the
green channel. Green channel highlights the blood vessel
pixels more than red and blue channels. Fig. 2 shows the
original image and the green channel image.
A.3. Image Enhancement and Adjustment
The contrast of the gray image is enhanced using contrast-
limited adaptive histogram equalization (CLAHE) method. It
is applied to each neighborhood. It also prevents the noise to
be over amplified. The intensity of the image then is
adjusted. This step increases the contrast as well. After that,
the image is complemented. By complementing the image, all
pixels are subtracted from the maximum pixel. The result
gives dark area in bright pixels and vice versa. Another
CLAHE is performed. Fig. 3 shows how the image is
enhanced.
B. Blood Vessels Segmentation
Blood vessels Detection is very important as it is one of
the normal features. To segment them, a morphological
opening is applied first using a structure element of "ball"
[11]. The opening is a combination of dilation and erosion
operations. Where A and B are the input images, is the
opening operation, and are respectively erosion and
dilation operation.
A B = (A B) B (1)
Second, the result is subtracted from the adaptive-
histogram image to get the vessels [11]. After that, the
following steps clarify the vessels and remove the noise. The
Fig. 2. (a) Original fundus image. (b) Green channel extraction
Fig. 3. (a) Contrast Enhancement using CLAHE (b) Intencity
Adjustment (c) Complement (d) Adaptive Histogram Equalization
image is converted to a black and white (binarized) with a
specific thresholding value. Binarization happens according to
the threshold level. All pixels less than the threshold level are
set to 0 and all pixels larger than threshold level are set to 1.
Lastly, opening operation is placed for noise reduction
purposes. The blood vessel segmentation process and result
are shown in Fig. 4. Fig 5. shows the algorithm of segmenting
the retinal blood vessels.
IV. RESULTS AND DISCUSSION
This work mainly aims to segment the blood vessels in
fundus images. MATLAB code is applied on HRF database
[10]. For each image, the code times 36 seconds to segment the
blood vessels and compare the result with the ground truth.
Since HRF database contains images of manual blood vessel
extraction, the results of this experiment are compared to these
images i.e. ground truth images. Mean Squared Error (MSE) is
calculated to find the error between the ground truth image and
the resultant image, see Fig. 6.
 (2)
Where M and N are the numbers of rows and columns of
the input images respectively and I is the input image. Mean
Fig. 4. Steps of Retinal Blood Vessel Segmentation (a) opening. (b)
difference. (c) Binarization. (e ) Noise Removal.
Fig. 5. Proposed algorithm to segment retinal blood vessels
 pixels incorrectly classified as background. TN (True Negative)
is the number of pixels correctly classified as background. FP
(False Positive) is the number of pixels incorrectly classified as
vessels. P is the total number of vessels pixels in the manual
HRF segmentation. N is the total number of background pixels
in the manual HRF segmentation.
Fig. 7 shows the proposed method results of blood vessel
segmentation versus the manual blood vessel extraction images
of HRF dataset. The three cases of Diabetic Retinopathy,
Glaucomatous and Healthy images show different
performance, illustrated in Table II. During the experiment, we
observe that the proposed algorithm works on healthy and can
be seen from Table I that is the MSE of DR images are higher

TABLE I. MSE ON PROPOSED METHOD OF HRF

DATABASE FOR DIFFERENT STATUS OF DR, GLAUCOMA,
AND HEALTHY IMAGES. THE AVERAGE AND STANDARD
DEVIATION ARE CALCULATED

Fig. 6. Mean squared error between the ground truth and the results. The left
column shows the ground truth images. The right column shows the result of Status MSE
vessel extraction. The first row is vessels od Diabetic retinopathy. The second
row shows vessels of glaucoma disease. The third row shows vessels of the DR 7%
healthy eye.
squared error measures the difference between the input images Glaucoma 5%
which is the error, then squares this error and get the average.
Table I. shows the MSE of HFR dataset with different cases. Healthy 5%
Performance measurements include calculating the Average 6%
sensitivity (SE), specificity (SP) and accuracy (ACC) using
equation (3), (4) and (5) respectively. STD 0.00957


(3) TABLE II. PERFORMANCE MEASUREMENTS SE, SP AND
ACC USING PROPOSED METHOD ON HRF DATASET
(4)
Case SE SP ACC
DR 71% 95% 93%
(5)
Glaucoma 66% 97% 95%
Where TP (True Positive) is the number of pixels correctly Healthy 70% 98% 95%
classified as vessels. FN (False Negative) is the number of Average 69% 97% 94%

Fig. 7. From left to right. The fundus image, the manual segmentation, and the proposed method segmentation. Row(a) shows the DR case. Row(b) shows the
Glaucomatous case. Row(c) shows the healthy case
 Fig. 8. Blood vessel segmentation of diabetic retinopathy shows undesired vessels. The arrow points to the soft exudate feature. (a) original fundus image of
DR that shows (b) image adjustment shows the intensity levels of both soft exuadtes and blood vessels. (c) the final result of blood vessel segmentation that
includes the soft exudates as a blood vessel.

than glaucomatous and healthy images. Fig. 8 shows bad blood Error is measured between our results and the ground truth
vessel segmentation result of diabetic retinopathy image. The and found reasonably acceptable. Furthermore, the algorithm
reason behind that is related to the features of DR. Soft exudate will be modified in the future to result in better segmentation
is one feature of Diabetic retinopathy that shows in severing in the case of diabetic retinopathy.
stages of DR. as shown in Fig. 8, soft exudates have almost
similar intensity level to blood vessels. ACKNOWLEDGMENT
In Table III, a comparison between the proposed method I thank Dr. Kalthoum Bantan for her endless help in
and other methods is listed. SE, SP, and ACC are shown for the providing medical information in the field of ophthalmology. I
diabetic retinopathy, glaucomatous and healthy images. In also forward my thanks to Dr. Muhammad Arif for his
terms of sensitivity, our proposed method gives a comparable supervision and help in providing computer knowledge to me.
average sensitivity of 69% although some of other methods
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