Deep learning for discrimination of active and inactive lesions in multiple sclerosis using non-contrast FLAIR MRI: A multicenter study.

BACKGROUND: Within the domain of multiple sclerosis (MS), the precise discrimination between active and inactive lesions bears immense significance. Active lesions are enhanced on T1-weighted MRI images after administration of gadolinium-based contrast agents, which brings about associated complexities. This study investigates the potential of deep learning to differentiate between active and inactive lesions in MS using non-contrast FLAIR-type MRI data, presenting a non-invasive alternative to conventional gadolinium-based MRI methods. METHODS: The dataset encompasses 9097 lesion images collected from 130 MS patients across four distinct imaging centers, with post-contrast T1-weighted images as the benchmark reference. We initially identified and labeled the lesions and carefully selected corresponding regions of interest (ROIs). These ROIs were employed as inputs for a convolutional neural network (CNN) to predict lesion status. Also, transfer learning was utilized, incorporating 12 pre-trained CNN models. Subsequently, an ensemble technique was applied to 3 of best models, followed by a systematic comparison of the results. RESULTS: Through a 5-fold cross-validation, our custom designed network exhibited an average accuracy of 85 %, a sensitivity of 95 %, a specificity of 75 %, and an AUC value of 0.90. Among the pre-trained models, ResNet50 emerged as the most effective, achieving a specificity of 58 %, an accuracy of 75 %, a sensitivity of 91 %, and an AUC value of 0.81. Our comprehensive evaluations encompassed the receiver operating characteristic curve, precision-recall curve, and confusion matrix analyses. CONCLUSION: The findings underscore the efficacy of the proposed CNN, trained on FLAIR MRI data ROIs, in accurately discerning active and inactive lesions without reliance on contrast agents. Our multicenter study of 130 patients with diverse imaging devices outperforms the other single-center studies, achieving superior sensitivity and specificity. Unlike studies using multiple modalities, our exclusive use of FLAIR images streamlines the process, and our streamlined approach, excluding conventional pre-processing, demonstrates efficiency. The external validation conducted on diverse datasets, coupled with the analysis of dilated masks, underscores the adaptability and efficacy of our custom CNN model in discerning between active and inactive lesions.

Differentiation between Pancreatic Ductal Adenocarcinoma and Normal Pancreatic Tissue for Treatment Response Assessment using Multi-Scale Texture Analysis of CT Images.

Background: Pancreatic ductal adenocarcinoma (PDAC) is the most prevalent type of pancreas cancer with a high mortality rate and its staging is highly dependent on the extent of involvement between the tumor and surrounding vessels, facilitating treatment response assessment in PDAC. Objective: This study aims at detecting and visualizing the tumor region and the surrounding vessels in PDAC CT scan since, despite the tumors in other abdominal organs, clear detection of PDAC is highly difficult. Material and Methods: This retrospective study consists of three stages: 1) a patch-based algorithm for differentiation between tumor region and healthy tissue using multi-scale texture analysis along with L1-SVM (Support Vector Machine) classifier, 2) a voting-based approach, developed on a standard logistic function, to mitigate false detections, and 3) 3D visualization of the tumor and the surrounding vessels using ITK-SNAP software. Results: The results demonstrate that multi-scale texture analysis strikes a balance between recall and precision in tumor and healthy tissue differentiation with an overall accuracy of 0.78±0.12 and a sensitivity of 0.90±0.09 in PDAC. Conclusion: Multi-scale texture analysis using statistical and wavelet-based features along with L1-SVM can be employed to differentiate between healthy and pancreatic tissues. Besides, 3D visualization of the tumor region and surrounding vessels can facilitate the assessment of treatment response in PDAC. However, the 3D visualization software must be further developed for integrating with clinical applications.

Segmentation of pancreatic ductal adenocarcinoma (PDAC) and surrounding vessels in CT images using deep convolutional neural networks and texture descriptors.

Fully automated and volumetric segmentation of critical tumors may play a crucial role in diagnosis and surgical planning. One of the most challenging tumor segmentation tasks is localization of pancreatic ductal adenocarcinoma (PDAC). Exclusive application of conventional methods does not appear promising. Deep learning approaches has achieved great success in the computer aided diagnosis, especially in biomedical image segmentation. This paper introduces a framework based on convolutional neural network (CNN) for segmentation of PDAC mass and surrounding vessels in CT images by incorporating powerful classic features, as well. First, a 3D-CNN architecture is used to localize the pancreas region from the whole CT volume using 3D Local Binary Pattern (LBP) map of the original image. Segmentation of PDAC mass is subsequently performed using 2D attention U-Net and Texture Attention U-Net (TAU-Net). TAU-Net is introduced by fusion of dense Scale-Invariant Feature Transform (SIFT) and LBP descriptors into the attention U-Net. An ensemble model is then used to cumulate the advantages of both networks using a 3D-CNN. In addition, to reduce the effects of imbalanced data, a multi-objective loss function is proposed as a weighted combination of three classic losses including Generalized Dice Loss (GDL), Weighted Pixel-Wise Cross Entropy loss (WPCE) and boundary loss. Due to insufficient sample size for vessel segmentation, we used the above-mentioned pre-trained networks and fine-tuned them. Experimental results show that the proposed method improves the Dice score for PDAC mass segmentation in portal-venous phase by 7.52% compared to state-of-the-art methods in term of DSC. Besides, three dimensional visualization of the tumor and surrounding vessels can facilitate the evaluation of PDAC treatment response.

Evaluation of Asymmetry in Right and Left Eyes of Normal Individuals Using Extracted Features from Optical Coherence Tomography and Fundus Images.

BACKGROUND: Asymmetry analysis of retinal layers in right and left eyes can be a valuable tool for early diagnoses of retinal diseases. To determine the limits of the normal interocular asymmetry in retinal layers around macula, thickness measurements are obtained with optical coherence tomography (OCT). METHODS: For this purpose, after segmentation of intraretinal layer in threedimensional OCT data and calculating the midmacular point, the TM of each layer is obtained in 9 sectors in concentric circles around the macula. To compare corresponding sectors in the right and left eyes, the TMs of the left and right images are registered by alignment of retinal raphe (i.e. diskfovea axes). Since the retinal raphe of macular OCTs is not calculable due to limited region size, the TMs are registered by first aligning corresponding retinal raphe of fundus images and then registration of the OCTs to aligned fundus images. To analyze the asymmetry in each retinal layer, the mean and standard deviation of thickness in 9 sectors of 11 layers are calculated in 50 normal individuals. RESULTS: The results demonstrate that some sectors of retinal layers have signifcant asymmetry with P < 0.05 in normal population. In this base, the tolerance limits for normal individuals are calculated. CONCLUSION: This article shows that normal population does not have identical retinal information in both eyes, and without considering this reality, normal asymmetry in information gathered from both eyes might be interpreted as retinal disorders.

Optical Coherence Tomography in Neuromyelitis Optica spectrum disorder and Multiple Sclerosis: A population-based study.

BACKGROUND: The aim of this study was to identify and compare the characteristics of retinal nerve layers using spectral domain-optical coherence tomography (SD-OCT) in neuromyelitis optica spectrum disorder (NMOSD), relapsing-remitting multiple sclerosis (RRMS) and healthy controls (HCs). METHODS: It is a cross-sectional population-based study in Isfahan, Iran. We enrolled 98 participants including 45 NMOSD patients (90 eyes), 35 RRMS patients (70 eyes) and 18 HCs (36 eyes). Evaluation criteria were thickness of different sectors in peripapillary retinal nerve fiber layer (pRNFL) and intra-retinal layers around the macula. History of previous optic neuritis (ON) was obtained through chart review and medical record. RESULTS: Without considering ON, total macular, ganglion cell layer (GCL) and pRNFL were significantly thinner in both groups of patients compared to HCs. On macular examination, GCL and total macular thickness were significantly thinner than HCs in all NMOSD and RRMS eyes with and without history of ON. While there was no significant difference between MS-ON and MS without a history of ON in the macular measures, the reduction in total macular and GCL thickness was significantly greater in NMOSD-ON compared to NMOSD without a history of ON. Also in NMOSD-ON eyes, the RNFL, GCL, IPL and GCIPL layers were significantly thinner than that of MS-ON. On the other hand, the pRNFL study showed significant thinning of all quadrants in the RRMS and NMOSD groups relative to HCs. While the decrease of pRNFL thickness in the eyes of NMOSD-ON and MS with and without a previous history of ON was significantly greater than that of HCs, no difference was observed between NMOSD without ON and HCs. In addition, in NMOSD patients, pRNFL was significantly thinner in eyes with history of ON compared to non ON-eyes. Furthermore, in patients with a history of ON, reduction in all sectors of pRNFl (except in T) was significantly greater in NMOSD compared to MS patients. CONCLUSION: Our findings showed that although macular and retinal damage occurred in both NMOSD and RRMS patients without significant differences, the severity of injury in eyes with history of ON was significantly higher in NMOSD compared to MS patients, that could be considered as a marker to distinguish them. In addition, our results confirmed the absence of subclinical optic nerve involvement in NMOSD unlike MS patients.

Forming Optimal Projection Images from Intra-Retinal Layers Using Curvelet-Based Image Fusion Method.

BACKGROUND: Image fusion is the process of combining the information of several input images into one image. Projection images obtained from three-dimensional (3D) optical coherence tomography (OCT) can show inlier retinal pathology and abnormalities that are not visible in conventional fundus images. In recent years, the projection image is often made by an average on all retina that causes to lose many intraretinal details. METHODS: In this study, we focus on the formation of optimum projection images from retinal layers using Curvelet-based image fusion. The latter consists of three main steps. In the earlier studies, macular spectral 3D data using diffusion map-based OCT were segmented into 12 different boundaries identifying 11 retinal layers in three dimensions. In the second step, projection images are attained using conducting some statistical methods on the space between each pair of boundaries. In the next step, retinal layers are merged using Curvelet transform to make the final projection images. RESULTS: These images contain integrated retinal depth information as well as an ideal opportunity to better extract retinal features such as vessels and the macula region. Finally, qualitative and quantitative evaluations show the superiority of this method to the average-based and wavelet-based fusion methods. Overall, our method obtains the best results for image fusion in all terms such as entropy (6.7744) and AG (9.5491). CONCLUSION: Creating an image with more and detailed information made by the Curvelet-based image fusion has significantly higher contrast. There are also many thin veins in Curvelet-based fused image, which are absent in average-based and wavelet-based fused images.

An Exact and Fast CBCT Reconstruction via Pseudo-Polar Fourier Transform based Discrete Grangeat's Formula.

The recent application of Fourier Based Iterative Reconstruction Method (FIRM) has made it possible to achieve high-quality 2D images from a fan beam Computed Tomography (CT) scan with a limited number of projections in a fast manner. The proposed methodology in this article is designed to provide 3D Radon space in linogram fashion to facilitate the use of FIRM with cone beam projections (CBP) for the reconstruction of 3D images in a sparse view angles Cone Beam CT (CBCT). For this reason, in the first phase, the 3D Radon space is generated using CBP data after discretization and optimization of the famous Grangeat's formula. The method used in this process involves fast Pseudo Polar Fourier transform (PPFT) based on 2D and 3D Discrete Radon Transformation (DRT) algorithms with no wraparound effects. In the second phase, we describe reconstruction of the objects with available Radon values, using direct inverse of 3D PPFT. The method presented in this section eliminates noises caused by interpolation from polar to Cartesian space and exhibits no thorn, V-shaped and wrinkle artifacts. This method reduces the complexity to for images of size n × n × n The Cone to Radon conversion (Cone2Radon) Toolbox in the first phase and MATLAB/ Python toolbox in the second phase were tested on three digital phantoms and experiments demonstrate fast and accurate cone beam image reconstruction due to proposed.

NF-RCNN: Heart localization and right ventricle wall motion abnormality detection in cardiac MRI.

Convolutional neural networks (CNNs) are extensively used in cardiac image analysis. However, heart localization has become a prerequisite to these networks since it decreases the size of input images. Accordingly, recent CNNs benefit from deeper architectures in gaining abstract semantic information. In the present study, a deep learning-based method was developed for heart localization in cardiac MR images. Further, Network in Network (NIN) was used as the region proposal network (RPN) of the faster R-CNN, and then NIN Faster-RCNN (NF-RCNN) was proposed. NIN architecture is formed based on "MLPCONV" layer, a combination of convolutional network and multilayer perceptron (MLP). Therefore, it could deal with the complicated structures of MR images. Furthermore, two sets of cardiac MRI dataset were used to evaluate the network, and all the evaluation metrics indicated an absolute superiority of the proposed network over all related networks. In addition, FROC curve, precision-recall (PR) analysis, and mean localization error were employed to evaluate the proposed network. In brief, the results included an AUC value of 0.98 for FROC curve, a mean average precision of 0.96 for precision-recall curve, and a mean localization error of 6.17 mm. Moreover, a deep learning-based approach for the right ventricle wall motion analysis (WMA) was performed on the first dataset and the effect of the heart localization on this algorithm was studied. The results revealed that NF-RCNN increased the speed and decreased the required memory significantly.

OCT Image Denoising Based on Asymmetric Normal Laplace Mixture Model.

Optical Coherence Tomography (OCT) is one of the well-known imaging systems in ophthalmology that provides images with high resolution from retinal tissue. However, like other coherent imaging systems, OCT images suffer from speckle noise which decreases the image quality. Denoising can be considered as an estimation problem in a Bayesian framework. So, finding a suitable distribution for noiseless data is an important issue. We propose a statistical model for OCT data, namely Asymmetric Normal Laplace Mixture Model (ANLMM), and then convert its distribution to normal by Gaussianization Transform (GT). Finally, by applying the Spatially Constrained Gaussian Mixture Model (SC-GMM), a new OCT denoising algorithm is introduced, which significantly outperforms the other methods in terms of Contrast-to-Noise Ratio (CNR).

A hybrid graph-based approach for right ventricle segmentation in cardiac MRI by long axis information transition.

Right ventricle segmentation is a challenging task in cardiac image analysis due to its complex anatomy and huge shape variations. In this paper, we proposed a semi-automatic approach by incorporating the right ventricle region and shape information into livewire framework and using one slice segmentation result for the segmentation of adjacent slices. The region term is created using our previously proposed region growing algorithm combined with the SUSAN edge detector while the shape prior is obtained by forming a signed distance function (SDF) from a set of binary masks of the right ventricle and applying PCA on them. Short axis slices are divided into two groups: primary and secondary slices. A primary slice is segmented by the proposed modified livewire and the livewire seeds are transited to a pre-processed version of upper and lower slices (secondary) to find new seed positions in these slices. The shortest path algorithm is applied on each pair of seeds for segmentation. This method is applied on 48 MR patients (from MICCAI'12 Right Ventricle Segmentation Challenge) and yielded an average Dice Metric of 0.937 ±â€¯0.58 and the Hausdorff Distance of 5.16 ±â€¯2.88 mm for endocardium segmentation. The correlation with the ground truth contours were measured as 0.99, 0.98, and 0.93 for EDV, ESV and EF respectively. The qualitative and quantitative results declare that the proposed method outperforms the state-of-the-art methods that uses the same dataset and the cardiac global functional parameters are calculated robustly by the proposed method.

Statistical modeling of Optical Coherence Tomography images by asymmetric Normal Laplace mixture model.

Optical Coherence Tomography (OCT) is known as a non-invasive and high resolution imaging modality in ophthalmology. Effecting noise on the OCT images as well as other reasons cause a random behavior in these images. In this study, we introduce a new statistical model for retinal layers in healthy OCT images. This model, namely asymmetric Normal Laplace (NL), fits well the advent of asymmetry and heavy-tailed in intensity distribution of each layer. Due to the layered structure of retina, a mixture model is addressed. It is proposed to evaluate the fitness criteria called Kull-back Leibler Divergence (KLD) and chi-square test along visual results. The results express the well performance of proposed model in fitness of data except for 6th and 7th layers. Using a complicated model, e.g. a mixture model with two component, seems to be appropriate for these layers. The mentioned process for train images can then be devised for a test image by employing the Expectation Maximization (EM) algorithm to estimate the values of parameters in mixture model.

A Comprehensive Study of Retinal Vessel Classification Methods in Fundus Images.

Nowadays, it is obvious that there is a relationship between changes in the retinal vessel structure and diseases such as diabetic, hypertension, stroke, and the other cardiovascular diseases in adults as well as retinopathy of prematurity in infants. Retinal fundus images provide non-invasive visualization of the retinal vessel structure. Applying image processing techniques in the study of digital color fundus photographs and analyzing their vasculature is a reliable approach for early diagnosis of the aforementioned diseases. Reduction in the arteriolar-venular ratio of retina is one of the primary signs of hypertension, diabetic, and cardiovascular diseases which can be calculated by analyzing the fundus images. To achieve a precise measuring of this parameter and meaningful diagnostic results, accurate classification of arteries and veins is necessary. Classification of vessels in fundus images faces with some challenges that make it difficult. In this paper, a comprehensive study of the proposed methods for classification of arteries and veins in fundus images is presented. Considering that these methods are evaluated on different datasets and use different evaluation criteria, it is not possible to conduct a fair comparison of their performance. Therefore, we evaluate the classification methods from modeling perspective. This analysis reveals that most of the proposed approaches have focused on statistics, and geometric models in spatial domain and transform domain models have received less attention. This could suggest the possibility of using transform models, especially data adaptive ones, for modeling of the fundus images in future classification approaches.

Three dimensional data-driven multi scale atomic representation of optical coherence tomography.

In this paper, we discuss about applications of different methods for decomposing a signal over elementary waveforms chosen in a family called a dictionary (atomic representations) in optical coherence tomography (OCT). If the representation is learned from the data, a nonparametric dictionary is defined with three fundamental properties of being data-driven, applicability on 3D, and working in multi-scale, which make it appropriate for processing of OCT images. We discuss about application of such representations including complex wavelet based K-SVD, and diffusion wavelets on OCT data. We introduce complex wavelet based K-SVD to take advantage of adaptability in dictionary learning methods to improve the performance of simple dual tree complex wavelets in speckle reduction of OCT datasets in 2D and 3D. The algorithm is evaluated on 144 randomly selected slices from twelve 3D OCTs taken by Topcon 3D OCT-1000 and Cirrus Zeiss Meditec. Improvement of contrast to noise ratio (CNR) (from 0.9 to 11.91 and from 3.09 to 88.9, respectively) is achieved. Furthermore, two approaches are proposed for image segmentation using diffusion. The first method is designing a competition between extended basis functions at each level and the second approach is defining a new distance for each level and clustering based on such distances. A combined algorithm, based on these two methods is then proposed for segmentation of retinal OCTs, which is able to localize 12 boundaries with unsigned border positioning error of 9.22 ±3.05 µm, on a test set of 20 slices selected from 13 3D OCTs.

Thickness mapping of eleven retinal layers segmented using the diffusion maps method in normal eyes.

This study was conducted to determine the thickness map of eleven retinal layers in normal subjects by spectral domain optical coherence tomography (SD-OCT) and evaluate their association with sex and age. Mean regional retinal thickness of 11 retinal layers was obtained by automatic three-dimensional diffusion map based method in 112 normal eyes of 76 Iranian subjects. We applied our previously reported 3D intraretinal fast layer segmentation which does not require edge-based image information but rather relies on regional image texture. The thickness maps are compared among 9 macular sectors within 3 concentric circles as defined by ETDRS. The thickness map of central foveal area in layers 1, 3, and 4 displayed the minimum thickness. Maximum thickness was observed in nasal to the fovea of layer 1 and in a circular pattern in the parafoveal retinal area of layers 2, 3, and 4 and in central foveal area of layer 6. Temporal and inferior quadrants of the total retinal thickness and most of other quadrants of layer 1 were significantly greater in the men than in the women. Surrounding eight sectors of total retinal thickness and a limited number of sectors in layers 1 and 4 significantly correlated with age.

An Automatic Algorithm for Segmentation of the Boundaries of Corneal Layers in Optical Coherence Tomography Images using Gaussian Mixture Model.

Diagnosis of corneal diseases is possible by measuring and evaluation of corneal thickness in different layers. Thus, the need for precise segmentation of corneal layer boundaries is inevitable. Obviously, manual segmentation is time-consuming and imprecise. In this paper, the Gaussian mixture model (GMM) is used for automatic segmentation of three clinically important corneal boundaries on optical coherence tomography (OCT) images. For this purpose, we apply the GMM method in two consequent steps. In the first step, the GMM is applied on the original image to localize the first and the last boundaries. In the next step, gradient response of a contrast enhanced version of the image is fed into another GMM algorithm to obtain a more clear result around the second boundary. Finally, the first boundary is traced toward down to localize the exact location of the second boundary. We tested the performance of the algorithm on images taken from a Heidelberg OCT imaging system. To evaluate our approach, the automatic boundary results are compared with the boundaries that have been segmented manually by two corneal specialists. The quantitative results show that the proposed method segments the desired boundaries with a great accuracy. Unsigned mean errors between the results of the proposed method and the manual segmentation are 0.332, 0.421, and 0.795 for detection of epithelium, Bowman, and endothelium boundaries, respectively. Unsigned mean errors of the inter-observer between two corneal specialists have also a comparable unsigned value of 0.330, 0.398, and 0.534, respectively.

Segmentation of choroidal boundary in enhanced depth imaging OCTs using a multiresolution texture based modeling in graph cuts.

The introduction of enhanced depth imaging optical coherence tomography (EDI-OCT) has provided the advantage of in vivo cross-sectional imaging of the choroid, similar to the retina, with standard commercially available spectral domain (SD) OCT machines. A texture-based algorithm is introduced in this paper for fully automatic segmentation of choroidal images obtained from an EDI system of Heidelberg 3D OCT Spectralis. Dynamic programming is utilized to determine the location of the retinal pigment epithelium (RPE). Bruch's membrane (BM) (the blood-retina barrier which separates the RPE cells of the retina from the choroid) can be segmented by searching for the pixels with the biggest gradient value below the RPE. Furthermore, a novel method is proposed to segment the choroid-sclera interface (CSI), which employs the wavelet based features to construct a Gaussian mixture model (GMM). The model is then used in a graph cut for segmentation of the choroidal boundary. The proposed algorithm is tested on 100 EDI OCTs and is compared with manual segmentation. The results showed an unsigned error of 2.48 ± 0.32 pixels for BM extraction and 9.79 ± 3.29 pixels for choroid detection. It implies significant improvement of the proposed method over other approaches like k-means and graph cut methods.

A review of algorithms for segmentation of optical coherence tomography from retina.

Optical coherence tomography (OCT) is a recently established imaging technique to describe different information about the internal structures of an object and to image various aspects of biological tissues. OCT image segmentation is mostly introduced on retinal OCT to localize the intra-retinal boundaries. Here, we review some of the important image segmentation methods for processing retinal OCT images. We may classify the OCT segmentation approaches into five distinct groups according to the image domain subjected to the segmentation algorithm. Current researches in OCT segmentation are mostly based on improving the accuracy and precision, and on reducing the required processing time. There is no doubt that current 3-D imaging modalities are now moving the research projects toward volume segmentation along with 3-D rendering and visualization. It is also important to develop robust methods capable of dealing with pathologic cases in OCT imaging.

Intra-retinal layer segmentation of 3D optical coherence tomography using coarse grained diffusion map.

Optical coherence tomography (OCT) is a powerful and noninvasive method for retinal imaging. In this paper, we introduce a fast segmentation method based on a new variant of spectral graph theory named diffusion maps. The research is performed on spectral domain (SD) OCT images depicting macular and optic nerve head appearance. The presented approach does not require edge-based image information in localizing most of boundaries and relies on regional image texture. Consequently, the proposed method demonstrates robustness in situations of low image contrast or poor layer-to-layer image gradients. Diffusion mapping applied to 2D and 3D OCT datasets is composed of two steps, one for partitioning the data into important and less important sections, and another one for localization of internal layers. In the first step, the pixels/voxels are grouped in rectangular/cubic sets to form a graph node. The weights of the graph are calculated based on geometric distances between pixels/voxels and differences of their mean intensity. The first diffusion map clusters the data into three parts, the second of which is the area of interest. The other two sections are eliminated from the remaining calculations. In the second step, the remaining area is subjected to another diffusion map assessment and the internal layers are localized based on their textural similarities. The proposed method was tested on 23 datasets from two patient groups (glaucoma and normals). The mean unsigned border positioning errors (mean ± SD) was 8.52 ± 3.13 and 7.56 ± 2.95 µm for the 2D and 3D methods, respectively.

An accurate multimodal 3-D vessel segmentation method based on brightness variations on OCT layers and curvelet domain fundus image analysis.

This paper proposes a multimodal approach for vessel segmentation of macular optical coherence tomography (OCT) slices along with the fundus image. The method is comprised of two separate stages; the first step is 2-D segmentation of blood vessels in curvelet domain, enhanced by taking advantage of vessel information in crossing OCT slices (named feedback procedure), and improved by suppressing the false positives around the optic nerve head. The proposed method for vessel localization of OCT slices is also enhanced utilizing the fact that retinal nerve fiber layer becomes thicker in the presence of the blood vessels. The second stage of this method is axial localization of the vessels in OCT slices and 3-D reconstruction of the blood vessels. Twenty-four macular spectral 3-D OCT scans of 16 normal subjects were acquired using a Heidelberg HRA OCT scanner. Each dataset consisted of a scanning laser ophthalmoscopy (SLO) image and limited number of OCT scans with size of 496 × 512 (namely, for a data with 19 selected OCT slices, the whole data size was 496 × 512 × 19). The method is developed with least complicated algorithms and the results show considerable improvement in accuracy of vessel segmentation over similar methods to produce a local accuracy of 0.9632 in area of SLO, covered with OCT slices, and the overall accuracy of 0.9467 in the whole SLO image. The results are also demonstrative of a direct relation between the overall accuracy and percentage of SLO coverage by OCT slices.