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KMID : 0191120180330430239
Journal of Korean Medical Science
2018 Volume.33 No. 43 p.239 ~ p.239
A Novel Fundus Image Reading Tool for Efficient Generation of a Multi-dimensional Categorical Image Database for Machine Learning Algorithm Training
Park Sang-Jun

Shin Joo-Young
Kim Sang-Keun
Son Jae-Min
Jung Kyu-Hwan
Park Kyu-Hyung
Abstract
Background: We described a novel multi-step retinal fundus image reading system for providing high-quality large data for machine learning algorithms, and assessed the grader variability in the large-scale dataset generated with this system.

Methods: A 5-step retinal fundus image reading tool was developed that rates image quality, presence of abnormality, findings with location information, diagnoses, and clinical significance. Each image was evaluated by 3 different graders. Agreements among graders for each decision were evaluated.

Results: The 234,242 readings of 79,458 images were collected from 55 licensed ophthalmologists during 6 months. The 34,364 images were graded as abnormal by at-least one rater. Of these, all three raters agreed in 46.6% in abnormality, while 69.9% of the images were rated as abnormal by two or more raters. Agreement rate of at-least two raters on a certain finding was 26.7%?65.2%, and complete agreement rate of all-three raters was 5.7%?43.3%. As for diagnoses, agreement of at-least two raters was 35.6%?65.6%, and complete agreement rate was 11.0%?40.0%. Agreement of findings and diagnoses were higher when restricted to images with prior complete agreement on abnormality. Retinal/glaucoma specialists showed higher agreements on findings and diagnoses of their corresponding subspecialties.

Conclusion: This novel reading tool for retinal fundus images generated a large-scale dataset with high level of information, which can be utilized in future development of machine learning-based algorithms for automated identification of abnormal conditions and clinical decision supporting system. These results emphasize the importance of addressing grader variability in algorithm developments.
KEYWORD
Retina Fundus Image, Reading Tool, Grader, Machine Learning, Deep Learning
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