A foundation model for generalizable disease detection from retinal images
Author:
Zhou YukunORCID, Chia Mark A., Wagner Siegfried K., Ayhan Murat S.ORCID, Williamson Dominic J.ORCID, Struyven Robbert R.ORCID, Liu TimingORCID, Xu Moucheng, Lozano Mateo G.ORCID, Woodward-Court PeterORCID, Kihara Yuka, Allen Naomi, Gallacher John E. J., Littlejohns Thomas, Aslam Tariq, Bishop Paul, Black Graeme, Sergouniotis Panagiotis, Atan Denize, Dick Andrew D., Williams Cathy, Barman Sarah, Barrett Jenny H., Mackie Sarah, Braithwaite Tasanee, Carare Roxana O., Ennis Sarah, Gibson Jane, Lotery Andrew J., Self Jay, Chakravarthy Usha, Hogg Ruth E., Paterson Euan, Woodside Jayne, Peto Tunde, Mckay Gareth, Mcguinness Bernadette, Foster Paul J., Balaskas Konstantinos, Khawaja Anthony P., Pontikos Nikolas, Rahi Jugnoo S., Lascaratos Gerassimos, Patel Praveen J., Chan Michelle, Chua Sharon Y. L., Day Alexander, Desai Parul, Egan Cathy, Fruttiger Marcus, Garway-Heath David F., Hardcastle Alison, Khaw Sir Peng T., Moore Tony, Sivaprasad Sobha, Strouthidis Nicholas, Thomas Dhanes, Tufail Adnan, Viswanathan Ananth C., Dhillon Bal, Macgillivray Tom, Sudlow Cathie, Vitart Veronique, Doney Alexander, Trucco Emanuele, Guggeinheim Jeremy A., Morgan James E., Hammond Chris J., Williams Katie, Hysi Pirro, Harding Simon P., Zheng Yalin, Luben Robert, Luthert Phil, Sun Zihan, McKibbin Martin, O’Sullivan Eoin, Oram Richard, Weedon Mike, Owen Chris G., Rudnicka Alicja R., Sattar Naveed, Steel David, Stratton Irene, Tapp Robyn, Yates Max M., Petzold Axel, Madhusudhan Savita, Altmann AndreORCID, Lee Aaron Y., Topol Eric J.ORCID, Denniston Alastair K.ORCID, Alexander Daniel C.ORCID, Keane Pearse A.,
Abstract
AbstractMedical artificial intelligence (AI) offers great potential for recognizing signs of health conditions in retinal images and expediting the diagnosis of eye diseases and systemic disorders1. However, the development of AI models requires substantial annotation and models are usually task-specific with limited generalizability to different clinical applications2. Here, we present RETFound, a foundation model for retinal images that learns generalizable representations from unlabelled retinal images and provides a basis for label-efficient model adaptation in several applications. Specifically, RETFound is trained on 1.6 million unlabelled retinal images by means of self-supervised learning and then adapted to disease detection tasks with explicit labels. We show that adapted RETFound consistently outperforms several comparison models in the diagnosis and prognosis of sight-threatening eye diseases, as well as incident prediction of complex systemic disorders such as heart failure and myocardial infarction with fewer labelled data. RETFound provides a generalizable solution to improve model performance and alleviate the annotation workload of experts to enable broad clinical AI applications from retinal imaging.
Publisher
Springer Science and Business Media LLC
Subject
Multidisciplinary
Reference59 articles.
1. Rajpurkar, P., Chen, E., Banerjee, O. & Topol, E. J. AI in health and medicine. Nat. Med. https://doi.org/10.1038/s41591-021-01614-0 (2022). 2. Willemink, M. J. et al. Preparing medical imaging data for machine learning. Radiology 295, 4–15 (2020). 3. Topol, E. J. High-performance medicine: the convergence of human and artificial intelligence. Nat. Med. 25, 44–56 (2019). 4. Yu, K.-H., Beam, A. L. & Kohane, I. S. Artificial intelligence in healthcare. Nat. Biomed. Eng. 2, 719–731 (2018). 5. Liu, X. et al. A comparison of deep learning performance against health-care professionals in detecting diseases from medical imaging: a systematic review and meta-analysis. Lancet Digit. Health 1, e271–e297 (2019).
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