The Use of Fourier Phase Symmetry for Thin

Vessel Detection in Retinal Fundus Images

1st Mohammad A. U. Khan
Biometric and Sensor Lab
Effat University
Jeddah 22322, Saudi Arabia
mohammad a khan@yahoo.com
2nd Tariq M. Khan 3rd Kahtan I. Aziz
Electrical and Computer Engineering Dept. College of Engineering and Computing
COMSATS University Al Ghurair University
Islamabad, Pakistan Dubai Academic City, UAE 37374
tariq045@gmail.com kahtan@agu.ac.ae

4th Sayed S. Ahmad 5th Nighat Mir 6th Emhemed Elbakush

College of Engineering and Computing Department of Computer Science College of Engineering and Computing
Al Ghurair University Effat University Al Ghurair University
Dubai Academic City, UAE 37374 Jeddah 22322, Saudi Arabia Dubai Academic City, UAE 37374
sahmed@agu.ac.ae nmir@effatuniversity.edu.sa e.albakush@agu.ac.ae

Abstract—Fundus examination is a non-invasive procedure
of observing changes in retinal vasculature linked with the
identification and progression of certain ocular diseases. Seg-
menting vessels from the rest of the structure is found helpful
in analyzing and later tracking the changes. Manual vessel
segmentation requires clinical expertise, and with large scale
screening certainly puts a burden on already scarce clinical
resources. A computer-aided diagnosis (CAD) recently emerged
to alleviate this burden. A variety of computerized methods have
emerged recently with the primary aim of providing accurate
vessel segmentation. One particularly interesting approach is
multi-scale line filtering. However, its response diminishes in
low-contrast areas of the image causing certain vessels to be
missed. In this paper, we investigate the use of phase symmetry
detector to get help with low-contrast vessel detection. This
specific detector does not make any assumptions about the
luminance profile of the vessel but then has major drawback
of being sensitive to background noise. To reduce the noise
sensitivity, we adopted the multi-scale line filtering with an
improved vessel uniformity function as an input to the phase
symmetry detector. The low-contrast vessel information thus
made available helps in providing an improved accuracy for
automated vessel segmentation algorithms. The quantitative tests
are conducted for two publicly available databases (DRIVE,
STARE) of fundus images that shows promise of improvements
in all three performance categories called accuracy, sensitivity,
and specificity.
Index Terms—segmentation, fundus image, multi-scale line
filtering, color-to-gray conversion, weighted linear square filter
I. I NTRODUCTION
Majority of ocular diseases undergo asymptomatic progres-
sion and the patient become aware only at the last stage
where treatment options become limited in preventing vision
impairment. With regular eye screenings we can detect the
onsight of such diseases and intervention can be devised in
earlier stages. However, an increasing number of eye screening
procedures would put a large burden on the already scarce
clinical resources. Computer-Aided-Diagnosis (CAD) systems
automate the detection process and thus can reduce to a larger
extent the stress on the clinicians. A CAD systems process
retinal fundus images for an earlier warning systems and
can emulate in some way the inspection by ophthalmologists
for the diagnosis of several abnormalities, such as diabetic
retinopathy (DR), retinopathy, and maculopathy [1].
Blood vessel detection is a foremost step in constructing
of a computer-aided diagnostic (CAD) systems for retinal
fundus images as they provide one of the most stable fea-
tures. Furthermore, vessel detection can help in finding other
anatomical landmarks such as the optic nerve head (ONH)
and the macula in the retinal image. The landmark feature
spatial characteristics can be helpful in detection of other
abnormalities. It has been established that blood vessels appear
with Gaussian cross-sectional profile in fundus images and
spread as piecewise linear segments with a look of a tree
structure. Majority of the vasculature is found to converge at
one specific location referred to as optic disc [2], [3].
The blood vessel segmentation with computerized methods
can be challenging for several reasons. Some of the noise
sources are due to the acquisition process, while others are
intrinsic to retinal images. The two most dominating factors
making segmentation hard are the nonuniform intensity for
a vessel across its entire length and the uneven background.
The uneven background intensity is due to the acquisition
conditions, while the unstable contrast is for the reason that
contrast agent injected may not reach to all parts of the retinal
vessels. Generally speaking, arteries have higher contrast than
veins. Thick vessels are found to possess a higher contrast
than most of the thin ones. Additionally, presence of noise,
fovea and optical disk, vessels having width variation, effects
of lesions, and pathological changes are probable concerns to
be addressed. Therefore, development of an automatic blood
vessel detection system that extracts blood vessels of a retina
with adequate accuracy is highly desired.
A vessel extraction algorithm must take advantage of the
geometry of the vessels; in particular, the characteristic cross-

(a) (b)
Fig. 1. Multiscale Line filtering limitation: Image on the left depicts Image
30 of DRIVE database having vasculature (thick and thin vessels) marked
as yellow color; while image on the right displays Multi-scale line filtering
output superimposed as green color with undetected thin vessels appearing as
yellow.
vessel profile is Gaussian in nature together with constant
intensity along the flow direction. A large majority of vessel
enhancement filters reported earlier make use of eigen-value
analysis of the second-order spatial derivatives matrix (Hessian
matrix ) of the image intensity in neighborhood of a pixel in
order to detect elongated linear structures. One most popular
example is the Frangi’s filter [4]. The second most popular
approach in this genre is the employment of a specially-
designed linear filter. It is more like an oriented line, which is
used to scan the neighborhood with rotation through a number
of angles while convolving with the image at the same time,
called multi-scale line filtering [5], which was later improved
in [6] resulting in acceptable accuracy scores. The simulation
tests revealed that line filtering technique is not adequate, as
it responds more strongly to bright distracters than to those
of actual vessels. This happens due to the method’s direct
proportionality of the magnitude of the eigenvalues. However,
in reality vessels carry eigenvalue heterogeneity and variation
in eigenvalue magnitude across background, this proportion-
ality dependence results in nonuniform enhancement. In [7],
authors suggested a modification to mitigate the vessel contrast
variation and provide filters that depends on eigenvalue ratio
rather than magnitude. This results in a regularised filter to
show robustness to small changes in magnitude due to back-
ground noise. The modified vessel enhancement filter detects
large percentage of the vasculature. however, certain thin low-
contrast vessels still remains illusive as they are not raised to
adequate level due to the structural limitations of the vessel
enhancement filters. Certain fundus images are quite noisy
and it happens so that fine vessels ranging down to sub-pixel
level shows their presence with low contrast and therefore
hard to be identified even by a human eye. Segmenting these
very fine vessels is the focus of the research presented here.
The paper proposes the use of contrast- and illumination-
invariant phase-symmetry detector to recover many of the
thin low-contrast vessels. There has been a renewed interest
recently in employing phase congruency characteristics such
as phase symmetry detector for the purpose of line and blob
identification in diverse applications. A relevant application
is to develop a reliable and robust detector for extracting
the lake outlines of glacial masses in high-temporal reso-
lution SAR imagery [8]. A different application is its use
for discriminating lung disease in chest radiograph [9]. The
use of the phase congruency for image and video sharpness
improvement and blur reduction is discussed in [10]. The
phase congruency concept is also been tested for subsurface
structures delineation within migrated seismic volumes [11].
A strong impediment in its use is its high sensitivity to
pick background noise. We proposed a variant of fourier
phase characteristic known as phase symmetry. At points of
symmetry in natural images we find readily identifiable phase
patterns. The bilateral symmetry identification is found helpful
in detecting low-contrast thin vessels. Measures are discussed
to reduce the sensitivity of the phase-symmetry detector for
noise such as instead of applying directly on acquired images,
it works on output of the multi-scale line filtering rather
than directly on acquired images. A specialized vessel linking
algorithm is then enacted to provide response to breakage
in low-contrast vessel network. The processing flow of the
proposed vessel segmentation method is as shown in Fig. 1.
The rest of the paper is organized as follows. The details of the
proposed method are described in Section 2. The experimental
results and performance evaluation are provided in Section 3.
Final Section 4 presents conclusions.
II. P ROPOSED M ETHODOLOGY
Our proposed methodology for retinal blood vessel seg-
mentation comprises of four consecutive stages: 1) Weighted-
Least-Square Filtering with SUACE algorithm for background
homogenization and the removal of non-uniform illumination;
2) vessel enhancement using multi-scale line filter and its
improvement for uniformity of vessels; 3) Morphological
Vessel Enhancement with Phase Congruency detector; and
4) Hysteresis threshold operation with post-processing for
removing artifacts. For the illustration of the flow process, Fig.
1 displays the original color image 12 of the DRIVE database
and its ground-truth image.
A. Grayscale Conversion
Fundus image is an RGB color image, which consists of
three channels (red, green and blue). It has been observed
that the green channel provides the highest vessel/background
contrast; whereas the red shows vasculature with saturation,
whereas blue channels is largely noisy [12]. Therefore, the
blue channel is avoided altogether, while the green and red
channels are linearly combined to provide a grayscale image,
according to the relationship as described below:
I = k · Ig + (k − 1) · Ir , (1)
where Ig and Ir represent the green and red color components
of a retinal image. Parameter k is the weight and is set at 0.75
here. The purpose of assigning more weight to Ig is to keep
the image variation across the background suppressed and get
better contrast for the retinal vessels which are usually much
stronger in Ig as compared to in Ir .
 Fig. 2. Block diagram showing the flow from an input color fundus image to the final binary vessel image.

B. SUACE algorithm value of each pixel to be a linear combination of its neighbors

The retinal background shows considerable intensity vari- N (i). The non-linear weights wij provides the edge-preserving
ation, and the contrast of the thin vessels quite low. If properties for the smooth image,
and are
P set as follows:
background is left untreated will produce artifacts, especially wij ∝ exp α||g(i) − g(j)||2 , where j∈N (i) wij = 1,
around light objects such as exudates, reflection artifacts and α is a parameter to emphasize the edge-preserving power.
the optic nerve head. Recently, a Speeded-Up Adaptive Con- The smooth image approach has three parameters: choice
trast Enhancement (SUACE) has been proposed in [14], which of neighborhood N (i), λ to trade off smoothing and edge-
provides background homogenization. The SUACE algorithm preservation, and α for computing weights.
uses a fixed distance for enhancing the contrast of the image. We seek a new image u, which, on the one hand, is as close
However, the distance is moved up or down based on the as possible to g, and, while on the other hand, is as smooth as
calculated illumination map corresponding to local intensity possible everywhere, except across some significant gradients
mean, i.e. the two boundary values of the range are varied in g, which happens to be at the vessels boundaries [15] in
from point to point. The two boundary values are calculated our case.
as follows: The enhanced image can be obtained by using the condi-
d tional relation as described below:
a(x, y) = g(x, y) − , 
2 (2) 0,
 I(x, y) < a(x, y)
d Ienh (x, y) = 1, I(x, y) ≥ b(x, y) (4)
b(x, y) = g(x, y) + ,
2  I(x,y)−a

d × k, otherwise
where a(x, y) and b(x, y) are the lower and upper endpoints
of the fixed distance d for the scaling, respectively. where Ienh (x, y) is the contrast enhanced image and k is the
The image g(x, y) is e low-frequency response of the image new dynamic range.
which was obtained by filtering the original image with the
Gaussian kernel. However, in our application, vessels are C. Multi-scale Line Filtering
involved, that are regarded as linear features, so a better Though the SUACE algorithm provided background homog-
alternative is to preserve the edges of the vessels, while enized image, the vessel contrast has to be enhanced with
smoothing the rest of the image. For this purpose, an edge- background noise suppressed. For this purpose, Nguyen et al.
preserving smoothing is utilized which provides a compromise [5] proposed a multi-scale line detector, which uses a range
between two possibly contradictory goals: smoothness and of lengths assigned to lines aligned to the underlying linear
edge-preservation. Given an input image g with n pixels,the features. The generalized multi-scale line detector is defined
image u is an edge-preserving smooth result, which minimizes as follows:
the following energy expression: L L L
RW = Imax − Iavg , (5)
 
n L
X X where, 1 ≤ L ≤ W , and Iavg is the average intensity of
λ||u(i) − g(i)||2 + ||u(i) − wij u(j)||2  , (3) all pixels lying along the line of length L. By changing L,
i=0 j∈N (i)
a multi-scale line detector is constructed. The rationale for
where i denotes the index of the pixel. The data term combining a range of various length filters is understood
||u(i)−g(i)||2 guarantees that the smooth image approximates by observing individual line filter responses. The line filter
the original image, while the smoothing term constraints the having longer length lines can successfully recognize central

(a) (b) (c) (d)
(e) (f) (g) (h)
Fig. 3. Various Stages of the Proposed Method: (a) GrayScale Image,
(b) SUACE algorithm output displaying background homogenization, (c)
the Multi-scale Line filtering Output, (d) High-contrast vessels detected by
hysteresis threshold, (e) Phase Symmetry detector output for low-contrast
vessels, (f) combined low and high-contrast vessel network, (g) morphological
cleaning and vessel linking output as green segments, (h) final vasculature
detected superimposed on the original color image showing high-contrast
vessels with yellow shade and low-contrast vessels with red shade.
reflex pixels as vessel pixels, because the candidate line
includes only a small number of central reflex pixels; hence
the average intensity of pixels in the candidate line is not
much affected, and the central reflex pixels have a high
vessel-ness measure. The shorter-length line filters detect close
vessels more effectively, but introduce background noise. The
variances of line responses decrease with an increase in length
from smaller scalers to large ones, which demonstrates that
the smaller length filters produce higher noise responses. In
order to remove biasses for large-length filters and eliminate
the drawback of each individual line detector, line responses at
all scales are linearly combined with their respective weights
to produce the segmentation for each retinal image. The overall
response at each image pixel is defined as:
! using hysteresis threshold as shown in Fig. 3 (e). We observe
1 1 X L that many fine vessels are identified in the process.
Rcombined = L × RW + Ive , (6)
nL + 1 nL
L
L E. Hysteresis Thresholding
where nL is the number of scales used, RW is the response
of the line filter at scale L, and Ive is the enhanced image.
D. Phase Congruency Detection
The use of fourier phase patterns for marking features
has significant advantages over gradient-based methods. Since
phase is a dimensionless quantity invariant to changes in
image brightness or contrast, it can be used more effectively
for bringing out hidden edges and lines. The research work
presented here takes a look at an aspect of phase patterns
known as phase symmetry for linear feature detection. It has
been observed that the axis of symmetry corresponds to the
linear feature central points (like central-line of the vessel )
where all the frequency components are at either the minimum
or maximum points in their respective periodicity cycles [17].
Using two quadrature filters allows us to calculate the phase
of the signal for a particular scale at a given spatial location.
The input image is convolved with each of the quadrature pairs
of wavelets. If we let I denote the image and Mne and Mno
denote the even-symmetric and odd-symmetric wavelet at scale
n, respectively. This results in vectors en (x) = I(x) ∗ Mne and
on (x) = I(x) ∗ Mno , referred to as real and imaginary parts of
complex valued frequency component. The phase is given by:
φn (x) = atan2(en (x), on (x)).
It has been observed that at a point of symmetry the absolute
value of the even-symmetric filter outputs is large and the ab-
solute value of the odd-symmetric filter outputs is small. Thus,
to emphasize symmetry a natural way is to take the absolute
value of the even-symmetric filter output and subtract from it
the absolute value of the odd-symmetric filter output. Then to
aggregate responses from filter responses over multiple scales
a weighted average is formed. For this purpose, difference of
the absolute values of the even and odd filter responses at each
scale is weighted by the corresponding magnitude of the filter
response vector at each scale. The quantity is then normalized
by summing the magnitude filter response over all scales. This
produces the following phase symmetry detection equation:
P
bAn (x)[| cos(φn (x))| − | sin(φn (x))|] − T c
Sym(x) = n P .
n An (x) + 
(7)
The term  is a small numerical quantity to prevent division by
zero. The factor T is a noise compensation term representing
the maximum response that could be generated from noise
alone in the image, and the symbols bc represent the enclosed
quantity to be equal to itself iff its value is positive, and zero
otherwise. For the purpose simulations conducted in this paper,
the local frequency information is obtained via a bank of log
Gabor wavelets tuned to different spatial frequencies, and the
phase symmetry of vessel detection image is then segmented
The retinal vessel structure is like a tree with branches,
and does form a large connected component. However, some
parts of the tree are not high enough in terms of magnitude to
be picked as vessel part. We resort to Hysteresis threshold for
restoring the connectivity of the vessel tree during binarization
process. Hysteresis is kind of inertia (lagging of an effect).
This threshold process involves two threshold values- TL
(a low threshold) and TH (a high threshold). Pixels below
TL constitute to background and pixels above TH form the
vessel part. The pixels between low and high threshold are
then checked for connectivity with the already designated
vessel part. If found connected, then they are also declared
vessels, otherwise background. Because of its effectiveness,
we adopted the hysteresis threshold approach for both the
high- and low-contrast vessel parts in the research reported
here..
F. Vessel Linking and Morphological Cleaning
The low-contrast vessel map shows gaps at some places. To
fill it we adopted the following algorithm. First,we compute
the endpoints of vessel segments, then label the segments and
get a list of all the points in the segment. Then a list of the
distances is created from each endpoint to all other endpoints
that are not in the same segment, and pick the endpoint with
the smallest distance. The smallest distance is compared with
some specified allowable distance (in our case it is 15 pixels),
a line is erected into the binary image connecting those two
endpoints. We need to repeat for every endpoint. We also
added additional criteria that the angle of the ends needs to be
about the same angle as the two endpoints. After the linking
process, we implemented the morphological cleaning process,
which removes all small unconnected components less than a
specified area.
III. E XPERIMENTAL R ESULTS
A. Evaluation Criterion
Vessel segmentation algorithms are binary classifiers that
should distinguish between vessels and non-vessels. Their
performance is evaluated by comparing their results with the
“ground truth”. The ground truth is a set of images that are
annotated manually by human observers. The following four
parameters can be extracted by comparing the algorithm output
with the ground truth:
1) True Positive (TP): when vessels are rightfully predicted
to be vessels
2) False Negative (FN): when vessels are predicted to be
non-vessels
3) True Negative (TN): When non-vessels are correctly
identified as non-vessels &
4) False Positive (FP): When non-vessels are denoted to be
vessels
These parameters can be used to evaluate the quality of
the segmentation algorithm for the pixels inside the FOV as
follows above:
Se = T PT+F
P
N,
TN
Sp = T N +F P ,
Acc = T P +FT N
P +T N
+T N +F P ,
Here, Se is the sensitivity, indicating to what extent the
classifier can identify original vessel pixels. The Sp is the
specificity, which represents classifier discrimination power to
mark non-vessel pixels. The Acc is the overall accuracy score
of the segmentation algorithm, reflecting the ratio between all
correctly classified pixels (vessels or non-vessels) to all the
pixels present in an image.
B. Comparison of performance measures with other algo-
rithms
Different approaches are selected for comparison, both
supervised and unsupervised. The results on the two datasets
are shown in Table I. On DRIVE datebase, proposed method’s
sensitivity is 0.761 while on STARE its sensitivity is 0.757.
(a) (b) (c) (d)
(e) (f) (g) (h)
Fig. 4. Comparison of proposed method with Nguyen et al. [ [5]] and
Modified Frangi. First column show input image, second shows the output
of Nguyen et al. [ [5]], third shows the output of modified Frangi and the last
one shows the output of the proposed method.
The sensitivity of the proposed method is higher than both
Zhao et al. [ [18]] and Mendonca et al. [ [19]] on DRIVE
dataset. It is to be noted that the proposed method’s sensitivity
on STARE database is greater than all existing state-of the art
methods. Specificity(Sp)of the proposed method is at par with
to the state-of-art methods on these two datasets. On STARE
dataset, proposed method’s specificity is higher than other
existing methods while on DRIVE database it is slightly lower
then some of the state-of-the-art methods, showing promise of
improvement for better noise suppression in DRIVE images.
Accuracy (AC) is the mean measurement more closer to the
interpreted standards. The accuracy of the proposed method is
found comparable to the state-of-art methods on two datasets.
On STARE dataset, proposed method’s accuracy is higher than
other methods while on STARE dataset it is slightly lower then
that of Zhao et al.(IPACHI Method) [ [18]].
IV. C ONCLUSION
In this paper, we investigate the use of phase symmetry de-
tector to detect low-contrast thin vessels. The detector does not
make any assumptions regarding vessel’s luminance profile.
We have used the multi-scale filtering to suppress non-linear
objects and then enhanced features of vessel as an input to the
phase symmetry detector stage. This led to a better sensitivity
of automated vessel segmentation algorithms, especially for
thin vessel data. Two public databases (DRIVE, STARE) of
fundus images are used to quantify proposed algorithm in all
three dimensions called accuracy, sensitivity and specificity.
The proposed method’s sensitivity and accuracy is promising
in comparison to the existing state-of-the-art methods.
ACKNOWLEDGMENT
The authors would like to thank Effat University in Jeddah,
Saudi Arabia, for funding the research reported in this paper
through the Research and Consultancy Institute.
 TABLE I
P ERFORMANCE A NALYSIS OF S EGMENTATION M ODEL

DRIV E ST ARE
Methods Se Sp AC Se Sp AC
Supervised Methods
Steal et al. [ [20]] - - 0.946 - - 0.951
Soares et al. [ [21]] - - 0.946 - - 0.948
Lupascu et al. [ [22]] 0.720 - 0.959 - - -
Orlando et al. [ [23]] 0.785 0.967 - - - 0.951
Liskowski [ [24]] - - 0.949 - - 0.949
Unsupervised Methods
Palomera-Perez et al. [ [25]] 0.66 0.961 0.922 0.779 0.940 0.924
Nguyen et al. [ [5]] - - 0.940 - - 0.932
Xiaoxia Yin et al. [ [26]] - - 0.947 - - -
Zhao et al. (IPACHI Method) [ [18]] 0.742 0.982 0.954 0.780 0.978 0.956
Soomro et al. [ [27]] 0.713 0.968 0.941 0.711 0.965 0.942
Khan et al. [ [28]] 0.734 0.967 0.951 0.736 0.971 0.95
Proposed Method 0.757 0.966 0.923 0.761 0.972 0.9537

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