Cooperative vs. Teleoperation Control of the Steady Hand Eye Robot with Adaptive Sclera Force Control: A Comparative Study

A surgeon's physiological hand tremor can significantly impact the outcome of delicate and precise retinal surgery, such as retinal vein cannulation (RVC) and epiretinal membrane peeling. Robot-assisted eye surgery technology provides ophthalmologists with advanced capabilities such as hand tremor cancellation, hand motion scaling, and safety constraints that enable them to perform these otherwise challenging and high-risk surgeries with high precision and safety. Steady-Hand Eye Robot (SHER) with cooperative control mode can filter out surgeon's hand tremor, yet another important safety feature, that is, minimizing the contact force between the surgical instrument and sclera surface for avoiding tissue damage cannot be met in this control mode. Also, other capabilities, such as hand motion scaling and haptic feedback, require a teleoperation control framework. In this work, for the first time, we implemented a teleoperation control mode incorporated with an adaptive sclera force control algorithm using a PHANTOM Omni haptic device and a force-sensing surgical instrument equipped with Fiber Bragg Grating (FBG) sensors attached to the SHER 2.1 end-effector. This adaptive sclera force control algorithm allows the robot to dynamically minimize the tool-sclera contact force. Moreover, for the first time, we compared the performance of the proposed adaptive teleoperation mode with the cooperative mode by conducting a vessel-following experiment inside an eye phantom under a microscope.

HiFi-Syn: Hierarchical Granularity Discrimination for High-Fidelity Synthesis of MR Images with Structure Preservation

Synthesizing medical images while preserving their structural information is crucial in medical research. In such scenarios, the preservation of anatomical content becomes especially important. Although recent advances have been made by incorporating instance-level information to guide translation, these methods overlook the spatial coherence of structural-level representation and the anatomical invariance of content during translation. To address these issues, we introduce hierarchical granularity discrimination, which exploits various levels of semantic information present in medical images. Our strategy utilizes three levels of discrimination granularity: pixel-level discrimination using a Brain Memory Bank, structure-level discrimination on each brain structure with a re-weighting strategy to focus on hard samples, and global-level discrimination to ensure anatomical consistency during translation. The image translation performance of our strategy has been evaluated on three independent datasets (UK Biobank, IXI, and BraTS 2018), and it has outperformed state-of-the-art algorithms. Particularly, our model excels not only in synthesizing normal structures but also in handling abnormal (pathological) structures, such as brain tumors, despite the variations in contrast observed across different imaging modalities due to their pathological characteristics. The diagnostic value of synthesized MR images containing brain tumors has been evaluated by radiologists. This indicates that our model may offer an alternative solution in scenarios where specific MR modalities of patients are unavailable. Extensive experiments further demonstrate the versatility of our method, providing unique insights into medical image translation.

Human-Robot Interaction in Retinal Surgery: A Comparative Study of Serial and Parallel Cooperative Robots

Cooperative robots for intraocular surgery allow surgeons to perform vitreoretinal surgery with high precision and stability. Several robot structural designs have shown capabilities to perform these surgeries. This research investigates the comparative performance of a serial and parallel cooperative-controlled robot in completing a retinal vessel-following task, with a focus on human-robot interaction performance and user experience. Our results indicate that despite differences in robot structure and interaction forces and torques, the two robots exhibited similar levels of performance in terms of general robot-to-patient interaction and average operating time. These findings have implications for the development and implementation of surgical robotics, suggesting that both serial and parallel cooperative-controlled robots can be effective for vitreoretinal surgery tasks.

Denoising of 3D MR images using a voxel-wise hybrid residual MLP-CNN model to improve small lesion diagnostic confidence

Small lesions in magnetic resonance imaging (MRI) images are crucial for clinical diagnosis of many kinds of diseases. However, the MRI quality can be easily degraded by various noise, which can greatly affect the accuracy of diagnosis of small lesion. Although some methods for denoising MR images have been proposed, task-specific denoising methods for improving the diagnosis confidence of small lesions are lacking. In this work, we propose a voxel-wise hybrid residual MLP-CNN model to denoise three-dimensional (3D) MR images with small lesions. We combine basic deep learning architecture, MLP and CNN, to obtain an appropriate inherent bias for the image denoising and integrate each output layers in MLP and CNN by adding residual connections to leverage long-range information. We evaluate the proposed method on 720 T2-FLAIR brain images with small lesions at different noise levels. The results show the superiority of our method in both quantitative and visual evaluations on testing dataset compared to state-of-the-art methods. Moreover, two experienced radiologists agreed that at moderate and high noise levels, our method outperforms other methods in terms of recovery of small lesions and overall image denoising quality. The implementation of our method is available at https://github.com/laowangbobo/Residual_MLP_CNN_Mixer.

nnSpeech: Speaker-Guided Conditional Variational Autoencoder for Zero-shot Multi-speaker Text-to-Speech

Multi-speaker text-to-speech (TTS) using a few adaption data is a challenge in practical applications. To address that, we propose a zero-shot multi-speaker TTS, named nnSpeech, that could synthesis a new speaker voice without fine-tuning and using only one adaption utterance. Compared with using a speaker representation module to extract the characteristics of new speakers, our method bases on a speaker-guided conditional variational autoencoder and can generate a variable Z, which contains both speaker characteristics and content information. The latent variable Z distribution is approximated by another variable conditioned on reference mel-spectrogram and phoneme. Experiments on the English corpus, Mandarin corpus, and cross-dataset proves that our model could generate natural and similar speech with only one adaption speech.