Monocular Microscope to CT Registration using Pose Estimation of the Incus for Augmented Reality Cochlear Implant Surgery

For those experiencing severe-to-profound sensorineural hearing loss, the cochlear implant (CI) is the preferred treatment. Augmented reality (AR) aided surgery can potentially improve CI procedures and hearing outcomes. Typically, AR solutions for image-guided surgery rely on optical tracking systems to register pre-operative planning information to the display so that hidden anatomy or other important information can be overlayed and co-registered with the view of the surgical scene. In this paper, our goal is to develop a method that permits direct 2D-to-3D registration of the microscope video to the pre-operative Computed Tomography (CT) scan without the need for external tracking equipment. Our proposed solution involves using surface mapping of a portion of the incus in surgical recordings and determining the pose of this structure relative to the surgical microscope by performing pose estimation via the perspective-n-point (PnP) algorithm. This registration can then be applied to pre-operative segmentations of other anatomy-of-interest, as well as the planned electrode insertion trajectory to co-register this information for the AR display. Our results demonstrate the accuracy with an average rotation error of less than 25 degrees and a translation error of less than 2 mm, 3 mm, and 0.55% for the x, y, and z axes, respectively. Our proposed method has the potential to be applicable and generalized to other surgical procedures while only needing a monocular microscope during intra-operation.

DaReNeRF: Direction-aware Representation for Dynamic Scenes

Addressing the intricate challenge of modeling and re-rendering dynamic scenes, most recent approaches have sought to simplify these complexities using plane-based explicit representations, overcoming the slow training time issues associated with methods like Neural Radiance Fields (NeRF) and implicit representations. However, the straightforward decomposition of 4D dynamic scenes into multiple 2D plane-based representations proves insufficient for re-rendering high-fidelity scenes with complex motions. In response, we present a novel direction-aware representation (DaRe) approach that captures scene dynamics from six different directions. This learned representation undergoes an inverse dual-tree complex wavelet transformation (DTCWT) to recover plane-based information. DaReNeRF computes features for each space-time point by fusing vectors from these recovered planes. Combining DaReNeRF with a tiny MLP for color regression and leveraging volume rendering in training yield state-of-the-art performance in novel view synthesis for complex dynamic scenes. Notably, to address redundancy introduced by the six real and six imaginary direction-aware wavelet coefficients, we introduce a trainable masking approach, mitigating storage issues without significant performance decline. Moreover, DaReNeRF maintains a 2x reduction in training time compared to prior art while delivering superior performance.

Leveraging sinusoidal representation networks to predict fMRI signals from EEG

In modern neuroscience, functional magnetic resonance imaging (fMRI) has been a crucial and irreplaceable tool that provides a non-invasive window into the dynamics of whole-brain activity. Nevertheless, fMRI is limited by hemodynamic blurring as well as high cost, immobility, and incompatibility with metal implants. Electroencephalography (EEG) is complementary to fMRI and can directly record the cortical electrical activity at high temporal resolution, but has more limited spatial resolution and is unable to recover information about deep subcortical brain structures. The ability to obtain fMRI information from EEG would enable cost-effective, imaging across a wider set of brain regions. Further, beyond augmenting the capabilities of EEG, cross-modality models would facilitate the interpretation of fMRI signals. However, as both EEG and fMRI are high-dimensional and prone to artifacts, it is currently challenging to model fMRI from EEG. To address this challenge, we propose a novel architecture that can predict fMRI signals directly from multi-channel EEG without explicit feature engineering. Our model achieves this by implementing a Sinusoidal Representation Network (SIREN) to learn frequency information in brain dynamics from EEG, which serves as the input to a subsequent encoder-decoder to effectively reconstruct the fMRI signal from a specific brain region. We evaluate our model using a simultaneous EEG-fMRI dataset with 8 subjects and investigate its potential for predicting subcortical fMRI signals. The present results reveal that our model outperforms a recent state-of-the-art model, and indicates the potential of leveraging periodic activation functions in deep neural networks to model functional neuroimaging data.

WS-SfMLearner: Self-supervised Monocular Depth and Ego-motion Estimation on Surgical Videos with Unknown Camera Parameters

Depth estimation in surgical video plays a crucial role in many image-guided surgery procedures. However, it is difficult and time consuming to create depth map ground truth datasets in surgical videos due in part to inconsistent brightness and noise in the surgical scene. Therefore, building an accurate and robust self-supervised depth and camera ego-motion estimation system is gaining more attention from the computer vision community. Although several self-supervision methods alleviate the need for ground truth depth maps and poses, they still need known camera intrinsic parameters, which are often missing or not recorded. Moreover, the camera intrinsic prediction methods in existing works depend heavily on the quality of datasets. In this work, we aimed to build a self-supervised depth and ego-motion estimation system which can predict not only accurate depth maps and camera pose, but also camera intrinsic parameters. We proposed a cost-volume-based supervision manner to give the system auxiliary supervision for camera parameters prediction. The experimental results showed that the proposed method improved the accuracy of estimated camera parameters, ego-motion, and depth estimation.

SAMSNeRF: Segment Anything Model (SAM) Guides Dynamic Surgical Scene Reconstruction by Neural Radiance Field (NeRF)

The accurate reconstruction of surgical scenes from surgical videos is critical for various applications, including intraoperative navigation and image-guided robotic surgery automation. However, previous approaches, mainly relying on depth estimation, have limited effectiveness in reconstructing surgical scenes with moving surgical tools. To address this limitation and provide accurate 3D position prediction for surgical tools in all frames, we propose a novel approach called SAMSNeRF that combines Segment Anything Model (SAM) and Neural Radiance Field (NeRF) techniques. Our approach generates accurate segmentation masks of surgical tools using SAM, which guides the refinement of the dynamic surgical scene reconstruction by NeRF. Our experimental results on public endoscopy surgical videos demonstrate that our approach successfully reconstructs high-fidelity dynamic surgical scenes and accurately reflects the spatial information of surgical tools. Our proposed approach can significantly enhance surgical navigation and automation by providing surgeons with accurate 3D position information of surgical tools during surgery.The source code will be released soon.

False Negative/Positive Control for SAM on Noisy Medical Images

The Segment Anything Model (SAM) is a recently developed all-range foundation model for image segmentation. It can use sparse manual prompts such as bounding boxes to generate pixel-level segmentation in natural images but struggles in medical images such as low-contrast, noisy ultrasound images. We propose a refined test-phase prompt augmentation technique designed to improve SAM's performance in medical image segmentation. The method couples multi-box prompt augmentation and an aleatoric uncertainty-based false-negative (FN) and false-positive (FP) correction (FNPC) strategy. We evaluate the method on two ultrasound datasets and show improvement in SAM's performance and robustness to inaccurate prompts, without the necessity for further training or tuning. Moreover, we present the Single-Slice-to-Volume (SS2V) method, enabling 3D pixel-level segmentation using only the bounding box annotation from a single 2D slice. Our results allow efficient use of SAM in even noisy, low-contrast medical images. The source code will be released soon.

Surgical tool classification and localization: results and methods from the MICCAI 2022 SurgToolLoc challenge

The ability to automatically detect and track surgical instruments in endoscopic videos can enable transformational interventions. Assessing surgical performance and efficiency, identifying skilled tool use and choreography, and planning operational and logistical aspects of OR resources are just a few of the applications that could benefit. Unfortunately, obtaining the annotations needed to train machine learning models to identify and localize surgical tools is a difficult task. Annotating bounding boxes frame-by-frame is tedious and time-consuming, yet large amounts of data with a wide variety of surgical tools and surgeries must be captured for robust training. Moreover, ongoing annotator training is needed to stay up to date with surgical instrument innovation. In robotic-assisted surgery, however, potentially informative data like timestamps of instrument installation and removal can be programmatically harvested. The ability to rely on tool installation data alone would significantly reduce the workload to train robust tool-tracking models. With this motivation in mind we invited the surgical data science community to participate in the challenge, SurgToolLoc 2022. The goal was to leverage tool presence data as weak labels for machine learning models trained to detect tools and localize them in video frames with bounding boxes. We present the results of this challenge along with many of the team's efforts. We conclude by discussing these results in the broader context of machine learning and surgical data science. The training data used for this challenge consisting of 24,695 video clips with tool presence labels is also being released publicly and can be accessed at https://console.cloud.google.com/storage/browser/isi-surgtoolloc-2022.

CaraNet: Context Axial Reverse Attention Network for Segmentation of Small Medical Objects

Segmenting medical images accurately and reliably is important for disease diagnosis and treatment. It is a challenging task because of the wide variety of objects' sizes, shapes, and scanning modalities. Recently, many convolutional neural networks (CNN) have been designed for segmentation tasks and achieved great success. Few studies, however, have fully considered the sizes of objects, and thus most demonstrate poor performance for small objects segmentation. This can have a significant impact on the early detection of diseases. This paper proposes a Context Axial Reverse Attention Network (CaraNet) to improve the segmentation performance on small objects compared with several recent state-of-the-art models. CaraNet applies axial reserve attention (ARA) and channel-wise feature pyramid (CFP) module to dig feature information of small medical object. And we evaluate our model by six different measurement metrics. We test our CaraNet on brain tumor (BraTS 2018) and polyp (Kvasir-SEG, CVC-ColonDB, CVC-ClinicDB, CVC-300, and ETIS-LaribPolypDB) segmentation datasets. Our CaraNet achieves the top-rank mean Dice segmentation accuracy, and results show a distinct advantage of CaraNet in the segmentation of small medical objects.

Self-Supervised Surgical Instrument 3D Reconstruction from a Single Camera Image

Surgical instrument tracking is an active research area that can provide surgeons feedback about the location of their tools relative to anatomy. Recent tracking methods are mainly divided into two parts: segmentation and object detection. However, both can only predict 2D information, which is limiting for application to real-world surgery. An accurate 3D surgical instrument model is a prerequisite for precise predictions of the pose and depth of the instrument. Recent single-view 3D reconstruction methods are only used in natural object reconstruction and do not achieve satisfying reconstruction accuracy without 3D attribute-level supervision. Further, those methods are not suitable for the surgical instruments because of their elongated shapes. In this paper, we firstly propose an end-to-end surgical instrument reconstruction system -- Self-supervised Surgical Instrument Reconstruction (SSIR). With SSIR, we propose a multi-cycle-consistency strategy to help capture the texture information from a slim instrument while only requiring a binary instrument label map. Experiments demonstrate that our approach improves the reconstruction quality of surgical instruments compared to other self-supervised methods and achieves promising results.

Min-Max Similarity: A Contrastive Learning Based Semi-Supervised Learning Network for Surgical Tools Segmentation

Segmentation of images is a popular topic in medical AI. This is mainly due to the difficulty to obtain a significant number of pixel-level annotated data to train a neural network. To address this issue, we proposed a semi-supervised segmentation network based on contrastive learning. In contrast to the previous state-of-the-art, we introduce a contrastive learning form of dual-view training by employing classifiers and projectors to build all-negative, and positive and negative feature pairs respectively to formulate the learning problem as solving min-max similarity problem. The all-negative pairs are used to supervise the networks learning from different views and make sure to capture general features, and the consistency of unlabeled predictions is measured by pixel-wise contrastive loss between positive and negative pairs. To quantitative and qualitative evaluate our proposed method, we test it on two public endoscopy surgical tool segmentation datasets and one cochlear implant surgery dataset which we manually annotate the cochlear implant in surgical videos. The segmentation performance (dice coefficients) indicates that our proposed method outperforms state-of-the-art semi-supervised and fully supervised segmentation algorithms consistently. The code is publicly available at: https://github.com/AngeLouCN/Min_Max_Similarity