Beruflich Dokumente
Kultur Dokumente
www.elsevier.com/locate/media
Department of Information Engineering, University of Padova, Via Gradenigo 6/a, 35131 Padova, Italy
Received 5 September 2003; received in revised form 24 June 2004; accepted 21 July 2004
Available online 15 September 2004
Abstract
Retinal images are routinely acquired and assessed to provide diagnostic evidence for many important diseases, e.g. diabetes or
hypertension. Because of the acquisition process, very often these images are non-uniformly illuminated and exhibit local luminosity
and contrast variability. This problem may seriously affect the diagnostic process and its outcome, especially if an automatic com-
puter-based procedure is used to derive diagnostic parameters. We propose here a new method to normalize luminosity and contrast
in retinal images, both intra- and inter-image. The method is based on the estimation of the luminosity and contrast variability in the
background part of the image and the subsequent compensation of this variability in the whole image. The application of this
method on 33 fundus images showed an average 19% (max. 45%) reduction of luminosity variability and an average 34% (max.
85%) increment of image contrast, with a remarkable improvement, e.g., over low-pass correction. The proposed image normaliza-
tion technique will definitely improve automatic fundus images analysis but will also be very useful to eye specialists in their visual
examination of retinal images.
2004 Elsevier B.V. All rights reserved.
1361-8415/$ - see front matter 2004 Elsevier B.V. All rights reserved.
doi:10.1016/j.media.2004.07.001
180 M. Foracchia et al. / Medical Image Analysis 9 (2005) 179–190
made regarding I of is that the set of pixels not covered by since by definition I of ¼ 0 in B. Using the statistical
vascular structures, optic disc or lesions, called the back- model of I ob (2) and its further simplification, the statis-
ground set B, is not empty. tical description of background pixels is
On the other hand, I ob can be statistically modelled as Iðx; yÞ NðLðx; yÞ; Cðx; yÞÞ; ðx; yÞ 2 B: ð7Þ
I ob ðx; yÞ Nðlb ; rb Þ; ð2Þ ^
In summary, the proposed method derives estimates L
i.e., as a white (independence between pixels is assumed) ^ from the background component of the observed
and C
random field with mean value lb, representing the ide- image ðIðx; yÞ; ðx; yÞ 2 BÞ by estimating mean and stand-
ally uniform luminosity value, and standard deviation ard deviation of (7), and uses them to recover an esti-
o
rb, representing the natural variability of retinal fundus mate ^I of the observed image Io by applying (4).
pigmentation. This model can be further simplified by
imposing lb = 0 and rb = 1; this latter assumption is 2.2. Extraction of background pixels
acceptable as any bias or amplification can be arbitrarily
lumped into the luminosity and contrast drifts intro- The estimation of C and L requires the preliminary
duced by the acquisition function. extraction of the background set B. To achieve this
The acquisition model f(Æ) describes the contrast and goal, the following assumptions have been made: for
luminosity distortions introduced by the image observa- any pixel of the image, in a neighborhood N of appro-
tion process. Non-uniform contrast and luminosity priate size s:
within an image can be described as
Iðx; yÞ ¼ f ðI o ðx; yÞÞ ¼ Cðx; yÞI o ðx; yÞ þ Lðx; yÞ; ð3Þ (1) both L and C are constant;
(2) at least 50% of the pixels are background pixels;
where C(x, y) is the contrast drift factor and L(x, y) is the (3) all background pixels have intensity values signifi-
luminosity drift term. Both contrast and luminosity cantly different from those of foreground pixels.
drifts are space-dependent scalar functions and can
therefore be considered as images themselves. The first assumption comes directly from the model
o
The recovery of an estimate ^I of original image Io is hypothesis that the spectral content of L and C is con-
based on the estimation of C and L ðC ^ and LÞ,
^ and the
centrated in the low frequencies, whereas the second
compensation of the observed image I as one indicates that a sufficient portion of background
^ area must be present in each N. The third assumption al-
^I o ðx; yÞ ¼ Iðx; yÞ Lðx; yÞ : ð4Þ lows to determine whether pixels belong to background
^
Cðx; yÞ
or not simply by examining their intensity, i.e., any two
Note that the acquisition model just described does not pixels in N having the same intensity both belong either
take into account any blurring or additive noise. The to background or to foreground.
goal of our system is not, in fact, the restoration of For each pixel (x, y) in the image, mean lN(x, y) and
the image; therefore we implicitly assume that blurring standard deviation rN(x, y) of the statistical distribution
and noise are already present in the original image Io of intensities in N are estimated. As estimator l ^N for
we are trying to recover. The resulting normalized image lN(x, y) we used the sample mean; r ^N , estimator for
can then be processed by any restoration algorithm. rN(x, y), was the sample standard deviation. Pixel (x, y)
C(x, y) is assumed to be positive. Both C(x, y) and is considered to belong to the background set B if its
L(x, y) are assumed to have a spectral content concen- intensity is close to the mean intensity in N. This is
trated in the low frequencies, which means that illumina- mathematically expressed by saying that (x, y) belongs
tion irregularities do not to present rapid changes. This to B if its Mahalanobis distance from l ^N , dM, defined as
is reasonable for regular fundus imaging techniques that
Iðx; yÞ l
^N
adopt diffused light. d M ¼ ð8Þ
Estimation of drift images can be achieved by consid- r
^ N
ering their effects on the background component of ob- is lower than a given threshold t.
served image. By combining (3) with (1) we obtain The procedure for background pixel extraction could
be implemented by means of two filters, evaluating
Iðx; yÞ ¼ Cðx; yÞI o ðx; yÞ þ Lðx; yÞ ^N ðx; yÞ and r
l ^N ðx; yÞ, respectively, for each pixel (x, y).
¼ Cðx; yÞ I ob ðx; yÞ þ I of ðx; yÞ þ Lðx; yÞ The resulting images could then be combined to evaluate
the Mahalanobis distance image, which could be seg-
¼ Cðx; yÞI ob ðx; yÞ þ Cðx; yÞI of ðx; yÞ þ Lðx; yÞ: ð5Þ
mented with threshold t to identify the background
If we restrict our analysis to background set B, this pixels.
expression simplifies to In order to reduce the computational burden, a differ-
ent implementation has been chosen. The image was
Iðx; yÞ ¼ Cðx; yÞI ob ðx; yÞ þ Lðx; yÞ; ðx; yÞ 2 B; ð6Þ partitioned into a tessellation of squares Si of side s.
182 M. Foracchia et al. / Medical Image Analysis 9 (2005) 179–190
0 0 0 0 0
0 0.5 1 0 0.5 1 0 0.5 1 0 0.5 1 0 0.5 1
0 0 0 0 0
0 0.5 1 0 0.5 1 0 0.5 1 0 0.5 1 0 0.5 1
0.15 0.15 0.15 0.15 0.15
0 0 0 0 0
0 0.5 1 0 0.5 1 0 0.5 1 0 0.5 1 0 0.5 1
0.15 0.15 0.15 0.15 0.15
0 0 0 0 0
0 0.5 1 0 0.5 1 0 0.5 1 0 0.5 1 0 0.5 1
0.15 0.15 0.15 0.15 0.15
0 0 0 0 0
0 0.5 1 0 0.5 1 0 0.5 1 0 0.5 1 0 0.5 1
0 0 0 0 0
0 0.5 1 0 0.5 1 0 0.5 1 0 0.5 1 0 0.5 1
0 0 0 0 0
0 0.5 1 0 0.5 1 0 0.5 1 0 0.5 1 0 0.5 1
0.15 0.15 0.15 0.15 0.15
0 0 0 0 0
0 0.5 1 0 0.5 1 0 0.5 1 0 0.5 1 0 0.5 1
0.15 0.15 0.15 0.15 0.15
0 0 0 0 0
0 0.5 1 0 0.5 1 0 0.5 1 0 0.5 1 0 0.5 1
0.15 0.15 0.15 0.15 0.15
0 0 0 0 0
0 0.5 1 0 0.5 1 0 0.5 1 0 0.5 1 0 0.5 1
Fig. 3. Histograms of luminosity values in the 25 image blocks for the observed (a) and normalized (b) version of the same image.
sffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffi
ffi
1 2 1 3.2. Global indexes
2
ra[b ¼ r þ r2b þ ðla lb Þ : ð13Þ
2 a 2
The following indexes were defined for the whole
Reducing the difference (la lb) clearly increases the image:
sum of the local contrasts, r2a and r2b , if ra[b is kept qffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffiffi
P ffi P
constant. rl ¼ N1 i ðli ll Þ2 , where ll ¼ N1 i li ,
M. Foracchia et al. / Medical Image Analysis 9 (2005) 179–190 185
0.16 0.16
µaUb=0.495 µaUb=µa=µb=0.495
0.14 0.14
σ =0.095 σaUb=σa=σb=0.095
aUb
0.12 0.12
0.1 0.1
µa=0.430
0.08 0.08
σa=0.031
0.06 0.06
µb=0.559
0.04 σb=0.094 0.04
0.02 0.02
0 0
0 0.2 0.4 0.6 0.8 1 0 0.2 0.4 0.6 0.8 1
Table 1
Indexes for local luminosity and contrast for observed ðrl ; lr ; lc Þ and normalized ðrNl ; lNr ; lNc Þ images, and their percent differences
rl rNl % difference lr lNr % difference lc lNc % difference
1 0.037 0.041 12 0.035 0.034 5 0.085 0.079 6
2 0.058 0.062 6 0.042 0.039 6 0.105 0.098 6
3 0.025 0.019 21 0.033 0.034 4 0.085 0.087 2
4 0.051 0.031 38 0.059 0.074 24 0.135 0.160 19
5 0.038 0.038 1 0.036 0.043 17 0.095 0.110 16
6 0.058 0.043 25 0.054 0.069 28 0.126 0.158 25
7 0.077 0.068 11 0.039 0.057 45 0.094 0.134 42
8 0.074 0.060 20 0.037 0.066 81 0.089 0.161 80
9 0.082 0.071 14 0.042 0.060 45 0.103 0.149 45
10 0.182 0.197 8 0.070 0.125 80 0.176 0.314 78
11 0.029 0.026 11 0.032 0.035 10 0.080 0.087 9
12 0.032 0.023 28 0.030 0.034 13 0.077 0.086 12
13 0.043 0.031 28 0.036 0.045 26 0.089 0.112 25
14 0.042 0.024 43 0.035 0.043 22 0.092 0.111 21
15 0.041 0.035 14 0.035 0.046 33 0.089 0.116 31
16 0.036 0.028 21 0.034 0.039 15 0.088 0.100 14
17 0.040 0.029 28 0.034 0.045 32 0.087 0.114 31
18 0.056 0.041 28 0.043 0.056 32 0.108 0.141 31
19 0.096 0.053 45 0.051 0.094 85 0.127 0.229 80
20 0.108 0.072 34 0.055 0.094 70 0.134 0.219 64
21 0.089 0.067 25 0.053 0.072 35 0.129 0.168 30
22 0.089 0.091 2 0.051 0.089 73 0.108 0.183 70
23 0.061 0.036 41 0.052 0.075 44 0.118 0.165 40
24 0.078 0.058 27 0.050 0.070 40 0.112 0.151 34
25 0.062 0.057 9 0.045 0.057 26 0.095 0.112 18
26 0.090 0.091 1 0.034 0.048 42 0.080 0.111 40
27 0.066 0.048 27 0.060 0.071 19 0.130 0.156 20
28 0.090 0.059 34 0.065 0.094 44 0.148 0.202 37
29 0.066 0.052 20 0.061 0.079 30 0.139 0.175 26
30 0.061 0.050 17 0.042 0.050 20 0.088 0.103 17
31 0.087 0.060 31 0.059 0.089 51 0.139 0.203 46
32 0.082 0.066 20 0.036 0.056 53 0.086 0.128 48
33 0.072 0.071 2 0.041 0.041 2 0.091 0.088 3
Average 19 34 31
P
lr ¼ N1 i ri , where N = 25 is the number of blocks in the image.
P Index rl expresses the variability of the local luminos-
lc ¼ N1 i ci , ity throughout the image, and thus the lower this index,
186 M. Foracchia et al. / Medical Image Analysis 9 (2005) 179–190
Table 2
Indexes for local luminosity obtained with the proposed technique ðrNl Þ, the low-pass correction ðrLP W
l Þ, the Wallis filter correction (Wallis, 1976) ðrl Þ,
the correction proposed by H. Wang (Wang et al., 2000) ðrHW l Þ, and the correction proposed by Y. Wang (Wang et al., 2001) ðrYW
l Þ
rNl rLP
l % difference rW
l % difference rHW
l % difference rYW
l % difference
1 0.041 0.049 18 0.046 11 0.036 13 0.040 3
2 0.062 0.067 8 0.064 4 0.058 6 0.049 21
3 0.019 0.037 90 0.040 106 0.025 27 0.029 50
4 0.031 0.061 94 0.044 41 0.048 53 0.047 51
5 0.038 0.054 42 0.047 24 0.038 1 0.038 1
6 0.043 0.069 60 0.058 33 0.057 31 0.045 5
7 0.068 0.068 1 0.065 6 0.079 16 0.047 31
8 0.060 0.071 18 0.077 30 0.077 29 0.052 13
9 0.071 0.068 4 0.059 17 0.085 20 0.056 20
10 0.197 0.106 46 0.144 27 0.196 1 0.102 48
11 0.026 0.043 66 0.033 27 0.028 10 0.032 26
12 0.023 0.041 81 0.037 64 0.032 39 0.028 26
13 0.031 0.055 77 0.042 35 0.043 40 0.045 46
14 0.024 0.054 128 0.046 94 0.042 76 0.037 57
15 0.035 0.055 57 0.052 47 0.041 16 0.043 23
16 0.028 0.047 67 0.044 55 0.036 27 0.033 17
17 0.029 0.053 81 0.050 69 0.041 39 0.037 28
18 0.041 0.063 56 0.047 15 0.056 37 0.048 18
19 0.053 0.094 76 0.096 80 0.097 83 0.087 64
20 0.072 0.094 31 0.102 43 0.110 54 0.079 10
21 0.067 0.084 25 0.074 10 0.081 22 0.103 53
22 0.091 0.083 8 0.081 11 0.091 0 0.075 18
23 0.036 0.066 83 0.056 54 0.060 65 0.046 28
24 0.058 0.073 26 0.062 8 0.074 29 0.069 20
25 0.057 0.069 22 0.065 15 0.061 7 0.049 13
26 0.091 0.087 4 0.089 2 0.089 2 0.065 28
27 0.048 0.063 30 0.059 23 0.062 28 0.059 23
28 0.059 0.069 17 0.063 6 0.087 47 0.065 10
29 0.052 0.066 26 0.067 28 0.065 23 0.062 18
30 0.050 0.060 21 0.049 2 0.058 15 0.045 10
31 0.060 0.079 31 0.059 1 0.078 30 0.067 11
32 0.066 0.084 27 0.065 1 0.082 24 0.064 2
33 0.071 0.076 8 0.076 7 0.070 1 0.074 5
Average 40 26 26 11
ment can also be appreciated by observing the results This behavior of the low-pass correction is also
shown in Fig. 5 for the proposed technique and the responsible for the apparently better results it achieved
low-pass correction. By comparing the two normalized in some images (e.g. no. 10) where it scored significantly
images, one can note that the low-pass corrected image better than the proposed technique as regards luminos-
markedly exhibits a smoothing effect around retinal ity variability and contrast. This image contains many
structures (e.g. vessel or lesion), resulting in a heavily pathological areas, which appear as extended bright or
reduced contrast and ringing effects in these areas. This dark areas (see e.g. observed image no. 10, shown in
can be explained by considering on a row of pixels the Fig. 7, top panel). The low-pass correction considers
drift corrections proposed by the low-pass filter and by the predominant grey-level of these areas as the main
our technique (Fig. 6). The drift estimated by the sim- luminosity value: its correction yields an overall more
ple low-pass filter is greatly influenced by the presence uniform luminosity, but it also saturates towards zero
of retinal structures, since it incorporates them into the background areas surrounded by bright pathological
the drift used for correction. On the contrary, our nor- areas. Moreover, when the corrected image was trans-
malization system is not affected by this portion of the formed with (11) and (12) so as to have an histogram
signal, being based only on the background part of the with the same mean and standard deviation as the ob-
image, and thus its drift correction does not smooth served image, the amplification of the reduced dynamic
vessels or lesions. The effect of this can also be seen range of grey levels translates into an increase of the glo-
in the macula (the darker area on the left-hand side bal index for contrast. These better indexes are however
in Fig. 5, top panel), which is almost invisible in the obtained at the expenses of a notable image distortion.
low-pass corrected image. This is quite evident when one visually examines the
188 M. Foracchia et al. / Medical Image Analysis 9 (2005) 179–190
Table 3
Indexes for contrast obtained with the proposed technique ðlNr Þ, the low-pass correction ðlLP W
r Þ, the Wallis filter correction (Wallis, 1976) ðlr Þ, the
correction proposed by H. Wang (Wang et al., 2000) ðlHWr Þ, and the correction proposed by Y. Wang (Wang et al., 2001) ðlYW
r Þ
lNr lLP
r % difference lW
r % difference lHW
r % difference lYW
r % difference
1 0.034 0.025 26 0.034 1 0.037 8 0.021 39
2 0.039 0.035 10 0.040 3 0.042 8 0.028 29
3 0.034 0.020 40 0.025 25 0.032 4 0.014 57
4 0.074 0.061 17 0.069 6 0.063 15 0.058 22
5 0.043 0.029 32 0.040 6 0.038 11 0.027 36
6 0.069 0.058 16 0.064 7 0.058 17 0.060 14
7 0.057 0.060 6 0.063 12 0.039 30 0.057 0
8 0.066 0.060 10 0.064 3 0.038 42 0.058 13
9 0.060 0.065 8 0.072 20 0.043 28 0.049 19
10 0.125 0.158 26 0.118 6 0.073 42 0.123 2
11 0.035 0.023 35 0.031 11 0.032 7 0.019 47
12 0.034 0.020 42 0.027 22 0.030 12 0.020 42
13 0.045 0.033 28 0.044 3 0.037 18 0.028 37
14 0.043 0.030 30 0.035 18 0.036 16 0.028 34
15 0.046 0.032 31 0.036 22 0.035 24 0.025 45
16 0.039 0.023 40 0.029 26 0.034 14 0.022 44
17 0.045 0.026 42 0.032 29 0.033 26 0.027 40
18 0.056 0.040 29 0.055 3 0.044 21 0.035 37
19 0.094 0.077 18 0.079 16 0.051 46 0.063 33
20 0.094 0.094 1 0.083 11 0.058 38 0.077 17
21 0.072 0.063 12 0.081 12 0.056 22 0.043 41
22 0.089 0.071 21 0.071 20 0.059 34 0.049 45
23 0.075 0.057 23 0.068 10 0.056 26 0.051 32
24 0.070 0.066 5 0.081 17 0.052 25 0.058 17
25 0.057 0.048 16 0.057 2 0.048 15 0.046 18
26 0.048 0.044 9 0.066 38 0.037 24 0.035 27
27 0.071 0.068 4 0.076 6 0.059 17 0.059 17
28 0.094 0.088 6 0.098 4 0.070 26 0.082 13
29 0.079 0.066 17 0.069 14 0.063 20 0.052 35
30 0.050 0.044 12 0.055 9 0.041 18 0.047 7
31 0.089 0.079 11 0.099 11 0.065 27 0.076 15
32 0.056 0.048 14 0.063 14 0.036 36 0.046 18
33 0.041 0.039 5 0.045 9 0.044 6 0.030 27
0.75
0.7
0.65
0.6
0.55
0.5
0.45
0.4
0.35
Original
0.3 Low pass correction
Estimated correction
0.25
200 300 400 500 600 700 800 900 1000 1100 1200
Fig. 6. Intensity profile on a sample row and intensity drift correction estimated by the proposed technique and by a low-pass filter.
M. Foracchia et al. / Medical Image Analysis 9 (2005) 179–190 189
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