Int
ern
at
i
onal
Journ
al of Ele
ctrical
an
d
Co
mput
er
En
gin
eeri
ng
(IJ
E
C
E)
Vo
l.
8
, No
.
6
,
Decem
ber
201
8
, p
p.
4545
~
4553
IS
S
N: 20
88
-
8708
,
DOI: 10
.11
591/
ijece
.
v8
i
6
.
pp4545
-
45
53
4545
Journ
al h
om
e
page
:
http:
//
ia
es
core
.c
om/
journa
ls
/i
ndex.
ph
p/IJECE
An Autom
atic ROI
of The Fun
du
s Photo
graphy
Ju
f
ri
ad
if
Na
`am
1
, Johan
H
ar
lan
2
, I
r
awa
di Putr
a
3
,
Romi
Ha
rdi
anto
4
,
Muti
ana Pr
ati
w
i
5
1,4,5
Facul
t
y
of
C
om
pute
r
Scie
n
ce,
Univer
si
ta
s Put
ra
Indone
si
a
YP
TK
Padang, I
nd
onesia
2
Facul
t
y
of
Com
pute
r
Sc
ie
nc
e, U
nive
rsit
as
Gunad
arma
Depok, Ind
onesia
3
Ophthal
m
ologi
st,
Rum
ah
Sakit Stroke
Nasion
al B
ukit
ti
ngg
i, Indon
esia
Art
ic
le
In
f
o
ABSTR
A
CT
Art
ic
le
history:
Re
cei
ved
Ma
y
30
, 201
8
Re
vised
Ju
l
28
,
201
8
Accepte
d
Aug 3
, 2
01
8
The
Regi
on
of
i
nte
rest
(ROI)
of
the
fundus
photogra
ph
y
is
an
important
t
ask
in
m
edi
c
al
imag
e
proc
essing.
It
cont
a
ins
a
lo
t
of
informati
on
r
elate
d
to
th
e
dia
gnosis
of
the
ret
in
al
dise
ase
.
So
the
determ
ina
ti
on
of
thi
s
ROI
is
a
v
e
r
y
i
nflue
nt
ial
first
step
in
fundus
image
proc
essing
l
at
er
.
Thi
s
res
ea
r
ch
proposed
a
thre
shold
m
et
hod
of
segm
ent
at
ion
to
d
et
e
rm
ine
ROI
of
the
fundus
photogra
ph
y
a
utomati
c
al
l
y
.
D
at
a
to
be
el
a
bora
te
d
wer
e
the
fundus
photogra
ph
y
’s
of
13
pat
ie
nts,
c
apt
ure
d
using
N
onm
y
d7
c
amera
of
Kow
a
Com
pan
y
Lt
d
i
n
Dr.
M.
Djamil
Hos
pit
al
,
P
ada
ng.
The
res
ult
s
of
thi
s
proc
essing
could
det
ermine
ROI
aut
om
at
ic
a
lly
.
Th
e
aut
om
atic
cro
ppin
g
succ
essfull
y
om
it
s
as
m
uch
as
po
ss
ibl
e
the
non
-
m
edi
c
al
ar
ea
s
show
n
as
dar
k
bac
kground,
whi
le
sti
ll
m
a
int
a
ining
the
whole
m
edi
c
al
areas,
co
m
prised
the
posteri
or
pol
e
o
f
ret
in
a
ca
ptur
e
d
through
th
e
p
upil
.
Thus,
thi
s
m
et
hod
is
hel
pful
in
fur
th
er
image
proc
essing
of
posteri
o
r
are
as.
W
e
ho
pe
tha
t
thi
s
rese
arc
h
wil
l
b
e useful
for
rese
a
r
che
rs.
Ke
yw
or
d:
Au
t
om
atic
Fundus
Me
dical
i
m
age
Re
gion
of
i
nter
est
(
RO
I)
The p
os
te
rio
r p
ole of
reti
na
Copyright
©
201
8
Instit
ut
e
o
f Ad
vanc
ed
Engi
n
ee
r
ing
and
S
cienc
e
.
Al
l
rights re
serv
ed
.
Corres
pond
in
g
Aut
h
or
:
Ju
f
riadif
N
a
`a
m
,
Faculty
of Com
pu
te
r
Scie
nc
e,
Un
i
ver
sit
as
Pu
t
ra In
donesia
Y
PTK
Pada
ng,
Jl. Ray
a Lub
uk Begalu
ng Pa
da
ng, 252
21
,
Indonesia
.
Em
a
il
:
j
uf
ria
difn
aam
@
gm
ai
l.
com
1.
INTROD
U
CTION
Fundus
photog
raphy
involv
es
act
ivit
ie
s
to
c
aptu
re
f
undus
i
m
ages,
wh
ic
h
sh
ows
the
i
nner
poste
rio
r
par
t
of
the
ey
e,
com
pr
ise
d
of
the
reti
na,
the
op
ti
c
disc,
the
m
acula
as
the
m
ai
n
structur
e
s
in
a
fu
ndu
s
i
m
age.
Fundus
im
age
con
ta
in
s
lots
of
inf
or
m
at
ion
fo
r
op
hth
al
m
olo
gists
co
ncerni
ng
m
any
reti
nal
al
te
rati
on
s
aff
ect
ed
by
ocu
la
r
as
w
el
l
as
extra
-
oc
ular
diseases
or
healt
h
d
ist
ur
ban
ce
s,
su
c
h
a
s
glauc
om
a,
macular
de
ge
nerat
ion
,
pap
il
edem
a,
reti
nal
detach
m
ent,
diabeti
c
reti
nopathy,
diabeti
c
m
aculop
at
hy,
hype
r
te
ns
ive
reti
no
pathy,
et
c
[1
]
-
[
5].
For
m
erly
fu
ndus
photog
raphy
w
ere
sel
do
m
to
be
pe
rfor
m
ed,
as
m
os
t
op
ht
ha
l
m
olo
gists
pref
er
to
hav
e
direct
f
un
du
s
co
py
exam
i
nation,
ho
wev
e
r
in
the
era
of
e
-
healt
h
a
nd
th
e
dev
el
op
m
ent
of
el
ect
r
on
ic
he
al
th
record
s n
owa
da
ys,
there
are
great
er
te
nd
e
nci
es
to k
ee
p
dig
it
al
fun
du
s
im
ag
es
f
or
la
te
r
e
xa
m
inati
on
s
as we
ll
as
m
edical
d
oc
ume
ntati
on
s
.
View
of
the
poste
rio
r
pole
of
reti
na
is
obt
ai
ned
by
passi
ng
li
ght
rays
thr
ough
dilat
ed
pupil,
an
d
fun
du
s
im
age
i
s
then
capt
ur
e
d
by
us
ing
fun
dus
cam
era,
an
app
a
ratus
desi
gn
e
d
ba
sed
upon
the
form
er
con
ce
pt
of
ordina
ry
dir
ect
ophth
al
m
os
co
pe.
F
undus
i
m
age
to
be
obta
i
ned
is
ci
rc
ular
in
s
hap
e
,
bu
t
us
ually
la
id
upon
dark
rectan
gula
r
bac
kgrou
nd
as
sh
own
in
Figure
1.
Wh
e
n
analy
zi
ng
obj
ect
s
in
an
im
a
ge,
it
is
necessary
to
disti
nguish
the
obj
ect
s
of
inte
rest
from
the
back
gr
ound
[6
]
,
[7
]
.
The
da
r
k
backg
rou
nd
is
no
t
nece
ssary
f
or
t
he
ophth
al
m
olo
gi
sts,
w
hose
Re
gi
on
of
I
ntere
st
(ROI)
only
inc
lud
e
t
he
ci
rc
ul
ar
f
undus
im
a
ge.
The
ob
j
ect
ive
of
this
stud
y
is
to
design
dig
it
al
i
m
age
pr
ocess
to
ob
ta
in
the
ROI
of
ci
rcu
la
r
fun
du
s
im
age
autom
atical
l
y.
The
backg
rou
nd
a
r
ea
can
ei
the
r
be
rem
o
ved
or
f
il
le
d
with
pr
e
fe
rr
e
d
c
olour
of
the
ophth
al
m
olo
gist.
We
e
xpe
ct
that
the
res
ults
will
m
ake
it
easi
er
for
the
op
hth
a
l
m
olo
gist
to
a
na
ly
ze
and
im
pr
ov
e
the
acc
ur
a
cy
of
a
naly
zi
ng
th
e
obj
ect
s
i
n
the
processe
d
fun
dus
im
age.
I
n
t
he
fiel
d
of
m
edical
i
m
aging,
ra
dio
lo
gists
a
re
m
or
e
intere
ste
d
in
Evaluation Warning : The document was created with Spire.PDF for Python.
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S
N
:
2088
-
8708
In
t J
Elec
&
C
om
p
En
g,
V
ol.
8
, N
o.
6
,
Dece
m
ber
2
01
8
:
4545
-
45
53
4546
ROI
t
han
the
entire
im
age
area,
beca
us
e
it
is
pa
rt
of
t
he
i
m
age
that
c
onta
ins
im
po
rta
nt
in
form
at
io
n
as
a
n
obj
ect
of
a
naly
sis
[9
]
.
I
n
a
dd
it
io
n,
t
he
ROI
m
easur
e
c
an
af
fect
the
sensiti
vity
and
sp
eci
fici
ty
of
th
e
cl
assifi
cat
ion
i
n
the
accu
racy
of the a
naly
sis
[10].
Figure
1. N
orm
al
f
undus im
age str
uctu
re
[
8]
Her
e
is
s
om
e
stud
y
that
pe
rfor
m
s
i
m
age
pr
ocessin
g
on
th
e
sel
ect
ion
of
RO
I
on
m
edical
i
m
ages.
Ar
i
bi
et
al
co
nducted
a
st
udy
of
aut
om
atic
ROI
on
t
he
ki
dn
ey
s
on
the
i
m
age
sci
ntigra
ph
ic
im
ages
us
in
g
HOG
3D
de
scr
iptor
[
11]
.
S
ha
n
et
al
us
e
d
th
e
ROI
se
gm
entat
ion
m
ask
m
et
hod
on
the
li
ver
in
the
im
age
of
Com
pu
te
rized
Tom
og
ra
ph
y
Scan
(CT
-
Sca
n)
a
nd
the
brai
n
in
Ma
gn
et
ic
Re
so
na
nce
Im
aging
(MRI
)
[
12
]
.
Gaidel
determ
ines
the
RO
I
of
the
lu
ng
autom
at
ic
al
l
y
on
CT
-
Sca
n
i
m
ages
usi
ng
a
he
ur
ist
ic
im
age
segm
entat
ion
al
gorithm
[1
3]
.
S
har
m
a
condu
ct
e
d
a
st
udy
to
ch
oose
t
he
c
orrect
si
ze
of
recta
ngul
ar
RO
I
m
anu
al
ly
to
diff
e
ren
ti
at
e
between
fat
an
d
de
ns
e
ti
ssu
e
in
br
east
im
age
[
10
]
.
Sim
i
la
rly
,
Santony
et
al
[
14
]
a
nd
sever
al
st
ud
ie
s
of
Na'
a
m
et
al
sel
ect
ively
selected
ROI
area
s
for
m
edical
i
m
ages
of
t
he
s
qu
a
re
[
15]
.
Wu
et
al
cond
ucted
a
st
ud
y t
o
sel
ect
R
OI
ar
ea a
uto
m
at
ic
al
ly
u
sing
t
he
se
gm
entat
ion
m
et
ho
d
i
n
a
br
ai
n
im
age [
16
].
The
f
ollow
i
ng
resea
rch
is
t
he
us
e
of
R
OI
i
n
fun
du
s
im
age
proce
ssin
g
t
o
a
naly
ze
va
ri
ou
s
diseases.
Ma
ny
stud
ie
s
that
def
i
ne
ROI
based
on
pr
oc
essing
needs
by
cro
ppin
g
[
17
-
2
4
]
.
Zah
oor
et
al
con
duct
ed
a
stud
y
of
opti
cal
disc
sp
ace
RO
I
ta
king
with
Po
l
ar
T
ran
s
f
or
m
m
et
ho
d
[
25
]
.
Haleem
et
al
cond
ucted
a
st
ud
y
of
op
ti
cal
disc
s
pa
ce
ROI
ta
ki
ng
with
Re
gi
on
Cl
assifi
cat
ion
Mod
el
(RCM
)
[
26
]
.
Ka
rusul
u
cond
ucted
a
r
esearch
to
detect
op
ti
cal
disk
area
auto
m
at
ic
ally
us
in
g
Mult
i
-
le
vel
Thr
es
holdi
ng
m
et
ho
d
[
27
]
.
Mukher
j
ee
et
a
l
cond
ucted
a
re
search
t
o
local
iz
e
the
op
ti
c
dis
k
re
gion
base
d
on
a
pa
ram
et
e
rized
m
e
m
ber
sh
ip
f
unct
ion
de
fine
d
on
the
cl
us
te
r
re
gions
a
nd
the
pr
e
dicte
d
c
onve
rg
e
nce
po
int
of
the
reti
nal
va
sc
ulatu
r
e
[
28
]
.
From
so
m
e
researc
h
a
bove
,
he
nce
re
qu
i
r
ed
a
m
et
ho
d
a
uto
m
at
ic
ally
t
o
determ
ine
ROI
in
fun
dus
i
m
age.
T
he
goal
is
to
furthe
r
im
pr
ove the
obj
ect
ivit
y and acc
uracy
of the
an
al
ysi
s
in
the
fu
ndus
i
m
age.
2.
RESEA
R
CH MET
HO
D
Ma
ny
diseases
that
can
be
analy
zed
in
the
fundus
im
age
so
that
accura
cy
in
i
m
age
pr
ocessin
g
is
i
m
po
rtant.
On
e
of
the
in
dicat
ors
to
im
pr
ov
e
t
he
accu
racy
of
the
i
m
age
proc
essing
is
to
li
m
it
the
i
m
age
area
to
the
require
d
pa
rt
on
ly
,
w
hich
is
the
Re
gio
n
of
In
t
e
rest
(ROI).
The
re
su
lt
of
this
stud
y
perf
or
m
s
the
automa
ti
c
creati
ng of R
O
I of
t
he fu
ndus
i
m
age.
Evaluation Warning : The document was created with Spire.PDF for Python.
In
t J
Elec
&
C
om
p
En
g
IS
S
N: 20
88
-
8708
An
A
utom
atic
ROI o
f
Th
e
F
undus
Ph
otogr
aphy
(
Jufria
dif
Na`am
)
4547
The
sam
ple
to
be
proce
ssed
consi
sts
of
13
f
undus
im
ages
of
13
pa
ti
en
ts
in
the
Ce
nt
r
al
Gen
e
ral
Ho
s
pital
(RSUP)
D
r.
M.
Dj
a
m
il
Padan
g.
T
he
im
ages
wer
e
captu
re
d
b
y
us
in
g
a
N
onm
yd7
br
a
nd
f
undu
s
ca
m
era
of
K
owa
Com
pan
y
Ltd
in
Jo
int
P
hoto
gr
a
phyi
c
Exp
e
rts
G
rou
p
(
j
pg
)
form
at
.
F
ur
t
her
m
or
e,
th
e
i
m
ages
wer
e
pro
ce
ssed
w
it
h
Ma
tl
ab
R201
7a
s
of
t
war
e
. S
ta
ge
s
of
t
he im
age p
r
ocessi
ng are
sho
w
in
Figure
2.
Figure
2
.
Stage
s of t
he
pr
oces
s
2.1.
Th
resh
old
Th
re
shold
is
t
he
pix
el
gr
ay
sca
le
value
li
m
i
t
t
o
disti
nguish
the
backgro
und
of
the
obj
ect
ob
s
er
ved
i
n
the im
age.
The
equati
ons
us
e
d
in
this st
ud
y
are as
f
ollow
s:
u
i
n
t
(
I
m
)
h
(
I
m
)
m
u
l
t
i
t
h
r
es
T
x
2
5
5
=
(1)
whe
re:
T
: t
hr
es
ho
l
d val
ue
mu
lt
it
hr
es
h
:
f
un
ct
io
n
t
o fin
d m
any g
r
oups o
f gr
ay
Im
:
in
pu
t
i
m
age
255
: m
axim
u
m
v
al
ue
of gra
ysc
al
e
uin
t
:
bit o
f
m
e
m
or
y ea
ch
gra
ysc
al
e v
al
ue
.
2.2.
Bi
n
ariz
at
ion
The
bi
nar
y
pr
ocess
is
perfor
m
ed
to
convert
a
gr
ay
scal
e
i
m
age
pix
el
va
lue
betwee
n
0
to
255
to
a
bin
a
ry
i
m
age
with
a
pi
xel
va
lue
of
0
or
1.
Conver
sio
n
pr
ocess
base
d
on
the
thre
shold
value
s
pecifie
d
above.
The
e
quat
ion i
s as foll
ows:
0,
(
,
)
(
,
)
1,
(
,
)
I
m
T
rc
Ib
rc
I
m
T
rc
(2)
Evaluation Warning : The document was created with Spire.PDF for Python.
IS
S
N
:
2088
-
8708
In
t J
Elec
&
C
om
p
En
g,
V
ol.
8
, N
o.
6
,
Dece
m
ber
2
01
8
:
4545
-
45
53
4548
whe
re:
Ib
:
bin
a
ry im
age
r
:
row
of p
i
xel
c
: colum
n
of
pix
el
2.3.
I
mco
mple
ment
Im
co
m
ple
m
ent
process
is
re
ve
rsing
the
im
a
ge
pi
xel
val
ue.
The
pix
el
value
is
0
bec
ome
s
1
a
nd
th
e
value 1
bec
ome
s 0. T
he
e
qu
at
ion
is
as
fo
ll
ow
s:
I
m
'
Ic
=
(3)
whe
re:
Ic
: i
m
com
ple
m
ent i
m
age
2.4.
I
mfil
l
Im
fil
l
process
is
us
e
d
to
eq
ua
li
ze
the
pix
el
va
lue
s
urrou
nd
e
d
by
the
sam
e
value.
T
he
e
quat
ion
is
a
s
fo
ll
ows:
,
(
,
)
=
0
I
c
if
r
c
is
o
n
th
e
b
o
r
d
e
r
(
r
,
c
)
o
f
I
c
o
th
e
r
w
is
e
Il
(4)
whe
re:
Il
: im
fill
i
m
age
2.5. Re
gio
n
pr
op
s
The
process
of
re
gionpro
ps
s
erv
es
to
re
pr
es
ent
the
obje
ct
area
in
the
im
age
int
o
a
squ
are
(
re
gion)
base
d on a set
of p
i
xels of
val
ue 1
(whit
e). T
he
Ma
tl
ab
sta
te
m
ent is fo
ll
ows:
Co
de of regio
npr
o
ps co
m
m
a
nds
Inpu
t:
Il
O
utp
ut:
tBox
Initia
liz
a
tion
reg
reg
=
regio
n
p
rop
s(
Il
);
tBox
=
reg
.Bo
u
n
d
i
n
g
Box;
2.6. Ad
ju
s
t
B
ac
ground
Ba
ckgrou
nd
a
dju
st
is
co
nve
rting
t
he
bac
kgr
ound
pi
xel
value
to
a
val
ue
that
does
not
aff
ect
for
furthe
r
im
age
processi
ng.
Co
m
m
on
ly
,
ty
pe
of
bac
kgr
ound
pix
el
is
us
i
ng
0
for
black
or
255
f
or
w
hite,
bu
t
c
a
n
al
so
us
e
oth
e
r
t
ypes s
uch as
re
d,
blu
e
or
gr
ee
n.
The
equati
on is as
foll
ow
s:
1
()
=
()
()
n,
I
l
r,
c
Ia
r,
c
Il
r,
c
(5)
whe
re:
Ia
: i
m
a
ge result
n
: 0
for blac
k o
r 255
for w
hite
2.7. Cr
op
Crop
is
cutti
ng
the
sq
ua
re
-
sh
a
ped
a
rea
aut
om
at
ic
ally
to
the
i
m
age
adj
ust
ed
bac
kgr
ound
.
The
area
of
crop is acc
omm
od
at
ed
the
re
gionpr
op
s
r
es
ul
t. Th
e
Ma
tl
ab
sta
tem
ent is fo
l
lows
:
Co
de of
crop
co
m
m
a
nds
Inpu
t:
Ia, t
Box
O
utp
ut:
Iro
i
Iro
i
=
i
m
crop
(
Ia,
tB
o
x
);
Evaluation Warning : The document was created with Spire.PDF for Python.
In
t J
Elec
&
C
om
p
En
g
IS
S
N: 20
88
-
8708
An
A
utom
atic
ROI o
f
Th
e
F
undus
Ph
otogr
aphy
(
Jufria
dif
Na`am
)
4549
3.
RESU
LT
S
A
ND AN
ALYSIS
Ther
e
we
re
13
fun
du
s
im
age
s
processe
d
i
n
this
stu
dy
at
D
r.
M.
D
j
am
i
l
Ho
sp
it
al
,
Pa
da
ng.
Howe
ver,
on
ly
one
of
th
e
m
is
pr
esente
d
her
e
.
Sp
eci
fica
ti
on
of
fun
du
s
ca
m
era
and
the
exam
inati
on
is
sh
ow
n
in
Table
1
.
The
f
undus ca
m
era is co
nn
ec
te
d
to a W
i
ndows d
es
ktop w
it
h
instal
le
d
K
owa’s
VK
-
2 dig
it
al
i
m
aging
software
,
al
lowing
a
utom
at
ic
i
m
age
savin
g
for
viewin
g
at
us
er
’s
co
nv
e
nienc
e.
The
V
K
-
2
digi
ta
l
i
m
aging
s
of
t
ware
captu
re
a
nd
sto
res
reti
nal
phot
ogra
ph
s
ta
ke
n
from
Ko
wa
ret
inal
cam
era
as
well
as
im
ages
from
oth
er
s
ources
includi
ng
a
sc
ann
e
r.
T
he
shoo
ts
ca
n
be
do
ne
at
3
inter
na
l
fixati
on
poi
nt
s,
i.e.
tem
po
r
al
,
central,
an
d
nasal
po
i
nt to
e
ns
ur
e
b
et
te
r ret
inal c
ov
e
ra
ge.
Res
ul
t of the s
hoots
is sh
own
i
n
Fi
gure
3
.
Table
1.
Sp
eci
f
ic
at
ion
of
Fun
dus E
xam
inati
on
s
[
29
]
Categ
o
ry
Descripti
o
n
Desig
n
Ref
lectiv
e i
m
ag
in
g
us
in
g
white lig
h
t
Pu
p
il
No
n
m
y
d
riati
c
Field
of
view
40
0
I
m
ag
e s
en
so
r/dis
p
l
ay
12
MP
d
ig
ital ca
m
era
Ad
d
itio
n
al f
eatu
res
Op
tic nerv
e head
c
o
lo
r,
r
ed
-
f
ree
i
m
ag
es, ps
eu
d
o
-
3
D dis
p
lay
(a)
(b)
(c)
Figure
3
.
S
hoot
, (
a)
tem
po
ral,
(b)
ce
ntral,
(
c
)
n
asal
[30]
First the r
et
ina
is
il
lu
m
inate
d
by whit
e li
gh
t and
bein
g
e
xa
m
ined
in full
co
lo
ur. Th
e
n
th
e il
lu
m
inati
on
li
gh
t
is
filt
ered
to
rem
ov
e
re
d
colo
ur
s
,
w
hic
h
ai
m
ed
to
i
m
pro
ve
the
co
nt
rast
of
vessels
and
oth
e
r
str
uc
tures.
Var
i
ou
s
fun
dus
structu
res
ca
n
be
bette
r
vis
ualiz
ed
by
usi
ng
li
m
i
te
d
sp
e
ct
ral
range
of
the
il
lum
inati
on
li
gh
t
.
Im
ages to
b
e
generate
d
in
eac
h
ste
p of
t
he pr
ocess
ca
n be
se
en
in
Fig
ure
4
.
Figure
4.
a
s
ho
ws
the
i
nput
i
m
age,
w
hich
t
yp
e
is
true
co
lour,
hav
i
ng
3696
x
24
48
pi
xe
l.
Furthe
r
process
wa
s
to
cal
culat
e
thresh
ol
d
value
.
U
sing
this
thres
ho
l
d
value
,
the
i
m
age
was
con
ve
rted
int
o
a
bin
a
ry
on
e
.
The
bin
a
r
y
i
m
age
was
saved
i
nto
a
ne
w
im
age
with
a
new
file
nam
e.
The
ai
m
of
this
co
nv
e
rsion
was
to
change
the
va
lue
of
the
pi
xe
l
in
the
inter
est
ed
ob
j
ect
to
1
(whit
e)
s
o
that
th
e
inte
rested
obj
ect
can
be
disti
nguish
e
d f
ro
m
it
s b
ack
groun
d.
The
r
es
ul
te
d
i
m
age of
t
his
process is
s
how
n
in
Fig
ure
4
.
b.
The
res
ulted
bin
a
ry
im
age
was
the
n
processe
d
th
r
ough
im
co
m
ple
m
enting.
Im
c
om
ple
m
entin
g
process
re
vers
ed
the
pix
el
va
lue
from
0
to
1
and
f
ro
m
1
to
0.
The
resu
lt
ed
i
m
co
m
ple
m
ent
i
m
age
is
sh
own
i
n
Figure
4.
c
.
T
he
ai
m
was
to
m
ap
the
pix
el
in
inte
rested
ob
j
ect
int
o
th
e
i
m
fi
ll
pr
oces
s.
The
im
fill
pr
oc
ess
ai
m
s
to convert
all
the p
i
xels s
urrounde
d
by
pix
el
s o
f 0
value
i
n t
he
interest
e
d
obj
ect
t
o
0.
S
o
the wh
ole p
i
xel o
f
t
he
interest
ed o
bje
ct
b
ecam
e 0
. T
he result
of thi
s pro
ce
ss ca
n b
e seen
in Fi
gur
e 4
.
d.
(a)
(b)
(c)
(d)
Figure
4. Im
ages in
t
he pr
oce
ss,
(a
)
i
nput im
age, (
b)
bin
a
riz
at
ion
im
age,
(c
)
im
co
m
ple
m
e
nt im
age,
(d)
im
fill
i
m
age
The
ne
xt
proce
ss
is
the
backg
rou
nd
process
of
the
in
put
i
m
age.
All
pi
xels
in
the
sam
e
inp
ut
im
age
po
sit
io
n
as
im
fill
i
m
age
with
pix
el
value
e
qu
al
to
1
were
th
en
c
onver
te
d
t
o
a
c
onsta
nt
va
lue.
T
he
value
of
t
his
const
ant
deter
m
ines
the
c
olour
of
the
backgro
und
par
t
i
n
the
in
pu
t
im
ag
e.
T
he
backg
round
pix
el
s
val
ue
c
a
n
be
co
nv
e
rted
a
ccordin
g
to
th
e
us
er’s
voli
ti
on
.
Wh
it
e
with
the
el
e
m
ent
of
pix
el
value
R
ed
=
25
5,
G
ree
n
=
255,
and
Bl
ue
=
255.
Bl
ack
with
th
e
el
e
m
ent
of
pi
xel
val
ue
Re
d
=
0,
Green
=
0,
an
d
Bl
ue
=
0.
Re
d
with
t
he
el
em
ent
of
Evaluation Warning : The document was created with Spire.PDF for Python.
IS
S
N
:
2088
-
8708
In
t J
Elec
&
C
om
p
En
g,
V
ol.
8
, N
o.
6
,
Dece
m
ber
2
01
8
:
4545
-
45
53
4550
pix
el
value
Re
d
=
25
5,
G
reen
=
0,
an
d
Bl
ue
=
0.
Gr
een
with
th
e
el
e
m
ent
of
pix
el
value
Re
d
=
0,
G
reen
=
25
5,
and
Bl
ue
=
0. Bl
ue wit
h
the
elem
e
nt of
pix
el
valu
e Red
=
0,
Gr
ee
n
=
0, a
nd Bl
ue
=
255.
The
im
fill
i
m
a
ge
wa
s
al
so
p
r
ocesse
d
to o
bta
in
the
RO
I
m
atr
ix.
First,
the
i
m
fi
ll
i
m
age
was
co
nv
e
rtin
g
to
i
m
co
m
ple
m
ent
an
d
ta
ke
n
the
m
at
rix
area
co
ntainin
g
the
obj
ect
of
poste
rio
r
ret
ina
only
by
us
in
g
reg
i
onpro
ps
c
omm
and
.
Furt
her
m
or
e,
t
he
input
im
age
has
bee
n
co
nverte
d
backgroun
d
value
c
rop
i
n
accor
da
nce
wit
h
t
he
re
su
lt
s
of
reg
io
npr
ops
as
the
area
of
the
interest
ed
obj
e
ct
.
The
res
ults of
f
inal
pro
ces
s
can
be
see
n
i
n
Fi
gure
5
.
(a)
(b)
(c)
(d)
(e)
Figure
5. Im
age of
a
n
a
uto
m
a
ti
c ROI
resu
lt
, (a)
w
hite bac
kgr
ound,
(b) bla
ck back
gro
und, (c
) red
b
ac
kgr
o
un
d,
(d) gree
n bac
kgr
ound,
(
e
) blu
e b
ac
kgr
ound
The
final
res
ul
t
i
m
age
in
this
processi
ng
is
the
ROI
ob
j
ect
on
a
square
a
r
ea.
Be
cause
di
gital
i
m
ages
store
d
in
the 2
-
dim
ension
al
m
at
rix
w
hile
the
fun
du
s
is
in
a
c
ircular
s
hap
e
,
s
o
this
di
gital
i
m
age
sti
ll
con
ta
ins
a
m
ini
m
al
back
gro
und
area
that
is
no
t
pa
rt
of
t
he
m
edical
i
m
age.
The
se
bac
kgr
ound
pix
el
values
are
ad
a
pted
to
the n
e
xt
proces
s so as
no
t
to
a
ff
ect
for next i
m
age pro
ces
sing o
f p
os
te
rio
r ret
ina.
Ther
e
a
re
a
lo
t
of
de
finiti
on
s
for
the
Re
gi
on
of
i
nte
rest
(ROI)
of
m
edical
i
m
age,
whic
h
m
a
inly
dep
e
nd
upon
t
he
inte
ntion
of
th
e
resea
rcher
f
or
f
ur
t
her
stud
y.
A
c
om
m
on
-
pur
pose
def
i
niti
on
of
ROI
of
m
edical
i
m
age
can
be
sta
te
d
as
a
su
bs
et
of
a
m
edical
i
m
age,
identifi
ed
f
or
a
par
ti
cular
pu
rpose.
In
th
e
fun
du
sc
op
y
ex
a
m
inati
on
,
it
c
an
be
done
just
as
pa
rt
of
a
r
outi
ne
ph
ysi
cal
exam
inati
on
.
Howe
ver,
m
os
t
of
t
he
tim
e,
the
ophtha
l
m
olo
gist
m
a
y
hav
e
a
certai
n
purpose
t
o
c
heck
the
fun
dus
i
m
age.
F
undus
im
aging
ca
n
se
rv
e
as
a
crit
ic
al
a
djunct
to
the
diag
nosis,
m
o
nitor
i
ng,
an
d
treat
m
ent
of
nu
m
ero
us
oc
ula
r,
as
well
as
gen
e
ral
diseases
[
3
1
]
.
Scree
ning
of
t
he
reti
na
by
f
undus
phot
ogra
ph
yy
m
ay
dete
ct
ocu
la
r
disea
ses,
s
uch
a
s
m
acular
deg
e
ne
rati
on, th
e fir
st an
d
thi
rd
m
os
t im
po
rt
ant causes o
f
bl
ind
ne
ss in
the
dev
el
op
e
d wor
ld.
It m
ay
also
detect
com
plica
ti
on
s
of
syst
em
ic
dis
eases
w
hich
al
so
af
fect
the
re
ti
na,
inclu
ding
diabeti
c
reti
no
pathy
f
ro
m
diabetes,
the
sec
ond
c
om
m
on
cause
of
blindness
in
t
he
dev
el
oped
world
,
hyper
te
ns
ive
reti
no
pathy
f
ro
m
card
i
ovasc
ular
disease, a
nd m
ulti
ple sc
le
r
os
is [
3
2
].
Figure
6. F
undus
phot
ograph
y from
a n
orm
al
eye
(
le
ft)
a
nd eye
with a
ge
-
relat
ed
m
acular
deg
e
ne
rati
on (r
igh
t)
[33
]
In
gen
e
ral
if
the
opht
halm
ol
og
ist
has
al
rea
dy
known
w
ha
t
he/she
is
lo
ok
i
ng
for,
RO
I
of
fun
dus
photog
raphy
de
pends
upon
the
f
un
ct
i
on
of
the
i
m
age
fo
r
him
/her.
I
n
m
os
t
stu
dies,
ROI
of
m
edical
i
m
age
com
pr
ise
s
just
com
pr
ise
s
a
s
ub
s
et
of
a
m
e
dical
i
m
age.
H
ow
e
ve
r,
in
f
undu
s
ph
otogra
phy
im
age,
the
whole
par
t
of
the
im
a
ge
that
re
garde
d
as
m
ed
ic
al
par
t
is
al
l
can
be
seen
thr
ough
the
pupil.
Act
ually
the
ou
te
r
par
t
of
the
pu
pil
include
s
iris
with
it
s
patte
rn
of
vasc
ularizat
io
n,
neverthele
s
s
stron
g
il
lum
inati
on
only
em
itted
thr
ough
pu
pil,
wh
il
e
ina
de
qu
a
te
il
lu
m
inati
on
to
the
iris
m
akes
it
j
us
t bei
ng d
ar
k
backg
rou
nd,
as
if
it
is
not
an
y
par
t
of a m
edical
i
m
age.
Hu
m
an
pupil
wh
ic
h
will
det
erm
ine
the
ci
rcu
la
r
f
orm
of
the
f
undus
is
no
t
al
ways
perfect
ly
ro
un
d.
Althou
gh
all
of the fund
us
im
ages in
our
sa
m
ple see
m
in
go
od circ
ular fo
rm
, w
e
m
us
t creat
e a p
r
ogram
that i
s
al
so
app
li
ca
ble
to
fu
nd
us
i
m
a
ges
w
hich
are
no
t
pe
rf
ect
ly
ro
un
d.
The
re
ar
e
sever
al
m
e
tho
ds
in
m
edical
i
m
age
processi
ng
tha
t
can
be
us
e
d
to
obta
in
the
ROI.
I
n
t
he
R
el
at
ed
Wo
r
k
s
ect
ion
we
ha
ve
m
entioned
s
ever
al
Evaluation Warning : The document was created with Spire.PDF for Python.
In
t J
Elec
&
C
om
p
En
g
IS
S
N: 20
88
-
8708
An
A
utom
atic
ROI o
f
Th
e
F
undus
Ph
otogr
aphy
(
Jufria
dif
Na`am
)
4551
m
et
ho
ds
of
se
gm
entat
ion
in
i
m
age
p
r
ocessi
ng
t
o
obta
in
R
OI
of
m
edical
i
m
age
[11
-
16]
.
W
e
pro
pose
he
re
a
si
m
ple
m
e
tho
d
of
thres
holdin
g
te
chn
i
qu
e
to
par
ti
on
the
f
undus
ph
otogra
ph
y
into
f
or
e
gro
und
(m
edical
par
t
)
and
bac
kgr
ound
(
non
-
m
edica
l
par
t)
a
nd
c
re
at
e
an
autom
at
ic
cropp
i
ng
of
the
f
undus
im
a
ge.
Nev
e
rthele
ss,
in
our
sta
te
-
of
-
t
he
-
art
knowle
dg
e
to
create
autom
atic
cro
ppin
g
in
m
edical
i
m
aging
,
it
will
be
qu
it
e
dif
ficult
if
no
t i
m
po
ssible
to obtai
n
a
circ
ular fo
rm
o
f
R
OI
of m
edical
im
age.
Hira
no
a
nd
T
s
um
oto
(2004
),
us
in
g
discr
et
iz
ed
at
tribu
te
va
lues
we
re
abl
e
to
const
ru
ct
anatom
ic
al
l
y
sh
a
pe
ROI
of
m
edical
i
m
age
captu
red
by
MR
I
or
CT
S
can
ap
pa
ratus.
Yet
the
at
trib
utes
act
ually
sp
li
t
th
e
m
edical
i
m
age
into
3
re
gion
s,
the
po
sit
ive,
the
ne
gative,
and
t
he
bo
unda
ry
ones,
hen
c
e
they
j
ust
cre
at
e
a
rou
gh r
e
pr
ese
nt
at
ion
of R
OI [
3
4
].
4.
CONCL
US
I
O
N
Fr
om
the
resu
l
t
of
this
st
udy
it
is
con
cl
uded
that
the
pr
oce
ss
el
ab
or
at
e
d
c
an
a
uto
m
at
ic
ally
crop
the
interest
ed
obj
e
ct
in
the
i
m
age
ob
ta
ine
d
from
fundus
phot
ography.
We
ha
ve
su
ccess
fu
ll
y
create
a
pro
gr
a
m
to
autom
at
ic
ally
crop
ping
fun
dus
ph
otogra
phy
fo
r
ge
ne
ral
pur
pose
intenti
on.
T
he
cr
opping
res
ult
is
the
reg
i
on
of
i
nterest
(R
O
I)
of
t
he
f
undu
s
i
m
age.
It
m
a
kes
us
easi
er
t
o
cr
op
the
nex
t
i
m
age
with
th
e
aim
to
analy
ze
the
reti
nal
distu
rbances.
So
t
his
researc
h
will
be
us
ef
ul
f
or
re
searche
rs
t
o
pe
rfor
m
fundus
i
m
age
pro
ces
sing
i
n
analy
zi
ng
patie
nt il
lness.
ACKN
OWLE
DGE
MENTS
We
w
ou
l
d
li
ke
to
thank
f
or
D
epar
tm
ent
of
Ra
dio
lo
gy,
M.
Dj
am
il
Ce
nter
Gen
e
ral
Hospit
al
,
Padang,
wh
ic
h has all
owed
the
us
e
of
the d
at
a i
n
t
his
stud
y.
DISCLOS
U
R
E STATE
ME
NT
No potenti
al
c
onflic
t of
inter
est
w
as
re
ported by t
he
a
utho
r
s.
REFERE
NCE
S
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Farooq
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l.
,
“
Im
prove
d
a
utomati
c
lo
ca
l
izati
on
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optic
d
isc
in
Ret
in
al
Fundus
using
im
age
enha
n
ce
m
en
t
te
chn
ique
s
and
SV
M
”
,
IEE
E
In
t
ernati
onal
Conf
ere
nce
on
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trol
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m,
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uti
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ag
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Enha
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ce
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chn
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r
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ase
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u
la
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t
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t
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ETE
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lba
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-
R
a
y
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ta
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vanc
es
i
n
El
e
ct
rica
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and
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omputer
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Gunawan
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e
t
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“
Fuzz
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egi
on
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Us
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Fuzz
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Sim
il
ari
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y
Mea
sur
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on
Im
age
Segm
ent
at
ion
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Inte
rnational
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urnal
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e
ct
ri
c
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Comput
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h
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d
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ero
tree
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”
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al
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n
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ss
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“
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ive
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Inte
rest
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iffe
ren
t
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s
fo
r
Brea
st
Densit
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assific
a
ti
on
,
”
Inte
rnational
Jo
urnal
of
M
edical
Re
search
&
Healt
h
S
ci
en
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et
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“
Autom
at
ic
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nit
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on
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egi
on
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of
Inte
rest
on
Rena
l
Sc
int
igr
ap
hic
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age
s”
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dia
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Shan,
et
al.,
“
Uns
uper
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ea
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e
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ca
l
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Regi
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at
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l
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Method
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om
at
i
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“
Infil
tra
t
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Objec
t
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t
rac
t
ion
in
X
-
ra
y
Im
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by
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g
Math
-
Morpholog
y
Method
an
d
Feat
ure
Reg
ion
Anal
y
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”
Int
ernati
onal
Jour
nal
on
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ci
en
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n
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“
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ola
r
t
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ent
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th
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,
”
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rnationa
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t
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Evaluation Warning : The document was created with Spire.PDF for Python.
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:
2088
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8708
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Elec
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C
om
p
En
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V
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y
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“
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c
ti
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lo
ca
l
iz
a
ti
on
using
flowe
r
poll
in
at
io
n
sea
rch
al
gor
it
h
m
with
pat
te
r
n
sea
rch
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”
Spring
e
r
-
Ve
rlag Berli
n
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def
ects
and
fundus
aut
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s
ce
nc
e
in
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with
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ch
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t
inopa
th
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ane
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om
at
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e
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t
ion
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ret
in
al
ab
norm
al
it
i
es,
”
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I
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Dec
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Dete
c
ti
on
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Pa
pil
le
d
ema
throu
gh
Fundus
Ret
in
al
Im
age
s,
”
Jour
nal
of
Me
d
ic
al
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e
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201
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d,
et
a
l
,
“
Autom
at
ed
S
egmenta
t
ion
an
d
Quanti
ficati
on
of
Drus
en
in
Fundus
and
Op
ti
c
al
Cohere
n
ce
Tomograph
y
Im
age
s for
Detect
i
on
of
ARM
D,”
J
ournal
of
Dig
it
al
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1
-
13,
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[24]
N.
A.
Vija
pur
a
nd
R.
S.
R.
Kunte,
“
Sensiti
z
ed
Glauc
om
a
Detec
ti
on
U
sing
a
Unique
Te
m
plate
Based
Corre
lati
o
n
Filt
er
and
Unde
c
imate
d
Isotropic
W
ave
le
t
Tra
nsfo
rm
,
”
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“
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on
in
Re
ti
na
l
Im
ag
es
Us
ing
Polar
Tra
nsform
,
”
Fas
t
Optic
Disc
Segm
ent
at
ion
in
Re
t
ina
l
Im
age
s
Us
ing
Polar
Tra
nsform
.
In:
Val
dés
Hernández
M.
,
Gonz
ále
z
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.
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eds
)
Me
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al
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[26]
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e
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al
,
“
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ve
Defor
m
abl
e
Model
fo
r
Autom
at
ed
Optic
Disc
and
Cu
p
Segm
ent
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ion
to
Aid
Glauc
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a
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”
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n
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isk
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ti
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S
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stem
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Multi
-
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el
Thr
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“
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optic
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r
reg
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n
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[29]
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2005
.
BIOGR
A
PH
I
ES
OF
A
UTH
ORS
Jufriadif
Na`am
was
born
in
Padang,
Indone
s
ia
,
in
1967.
He
is
an
As
soc.
Pro
f.
in
Com
pute
r
Scie
nc
e
Depa
rt
m
ent
,
Univer
sit
a
s
Putra
Indone
sia
YP
TK.
He
re
ce
iv
ed
the
B
ac
h
el
or
Degre
e
in
Mana
gement
Inf
orm
at
ic
s
and
Master
Degre
e
in
Inform
at
ion
Tec
nolog
y
in
1994
and
2006
from
Univer
sita
s
Putr
a
Indone
si
a
YP
TK.
Moreove
r,
he
complet
ed
his
Doctor
a
te
o
f
Inform
at
ion
Te
chno
log
y
as
Medic
a
l
Im
age
expe
rt
ise
from
Gunada
rm
a
Univer
sit
y
in
2017
.
He
is
m
ember
of
IEE
E
(9431333
3)
and
Scopus
id
is
57189371499
(
h
-
inde
x
:
3
)
.
Curre
nt
l
y
,
he
has
been
rese
arc
h
ing
on
Algorit
hm
s a
nd
Medic
a
l
Im
age
s.
E
-
m
ai
l
:
ju
fria
d
if
naa
m
@gm
ai
l.
co
m
Johan
Ha
rl
an
is
a
m
edi
cal
doc
t
or,
profe
ss
or
in
m
edi
ca
l
informa
ti
cs
and
h
ea
d
of
rese
ac
h
ce
n
te
r
of
m
edi
ca
l
infor
m
at
ic
s
of
Gunad
arma
Univer
sit
y
Jaka
rta.
He
obt
ai
ned
his
PhD
i
n
2003
and
has
bee
n
the
lectur
e
r
in
do
ct
or
al
d
e
par
tment
of
info
rm
at
ion
t
ec
hnol
og
y
o
f
Gunad
ar
m
a
Univer
sit
y
since
2004.
He
was
one
of
the
f
ounder
s
of
Indone
sian
Hea
lt
h
In
form
at
ic
s
As
socia
ti
on
in
2005.
Scopus
id
is
561
56931200
(
h
-
inde
x
:
3
)
.
His
are
a
of
expe
rti
se
en
c
om
passes
m
edi
ca
l
stat
ist
ic
s
and
cl
inica
l epi
demi
olog
y
.
E
-
m
ai
l
:
h
arl
an_
joha
n@ho
tmail
.
co
m
Ira
w
a
di
Put
ra
was
born
in
J
ak
art
a
,
Indon
esia,
in
1980.
He
ob
t
ai
ned
his
Ophth
al
m
ologi
st
in
2018
from
Andala
s
Univer
sit
y
P
ada
ng.
In
2010
unti
l
now,
he
is
working
at
Ruma
h
Sakit
Stroke
Nasiona
l
(RSS
N
)
Bukit
ti
nggi
,
In
donesia
.
He
has
expe
rt
ise
in
reti
nal
disea
ses
di
a
gnosis.
E
-
m
ai
l:
ira
wadipu
tra
@g
m
ai
l.
com
Evaluation Warning : The document was created with Spire.PDF for Python.
In
t J
Elec
&
C
om
p
En
g
IS
S
N: 20
88
-
8708
An
A
utom
atic
ROI o
f
Th
e
F
undus
Ph
otogr
aphy
(
Jufria
dif
Na`am
)
4553
Romi
Har
dian
to
was
born
in
Bawa
n,
Indone
sia,
in
1990.
He
is
a
compu
te
r
le
c
ture
r
a
t
Univer
sita
s
Putr
a
Indone
sia
YP
TK.
Obtai
n
ed
hi
s
Bac
hel
or
D
egr
ee
in
Info
rm
at
ics
Engi
nee
r
ing
and
Master
of
Inform
at
ion
Tec
hnolog
y
in
201
3
and
2015
from
Univer
sita
s
Putra
Indone
sia
YP
TK.
E
-
m
ai
l:
r
om
iha
rdia
nto@u
pi
y
p
tk.ac.id
Mutiana
Pr
ati
wi
was
born
in
Padang,
Indone
si
a.
1991.
She
is
a
c
om
pute
r
la
c
ture
r
at
Univer
sit
as
Putra
Indone
sia
YP
TK
Padang.
She
obta
in
ed
bac
e
lor
degr
ee
in
informati
on
t
ec
hnolog
y
and
m
aste
r
of
infor
m
at
ion
technolo
g
y
in
2013
and
2015
from
Univer
sita
s
Putra
I
ndonesia
YP
TK
P
ada
ng.
Curr
ent
l
y
,
she
has
a
rese
arc
her
on
Depa
r
t
m
ent
of
Resea
r
c
h
,
Univer
sit
as
Putra
Indone
si
a
YP
TK
Padang.
E
-
m
ai
l :
m
utiana
pra
ti
wi26@gm
ail.
com
Evaluation Warning : The document was created with Spire.PDF for Python.