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.

Unsupervised Domain Adaptation for Vestibular Schwannoma and Cochlea Segmentation via Semi-supervised Learning and Label Fusion

Automatic methods to segment the vestibular schwannoma (VS) tumors and the cochlea from magnetic resonance imaging (MRI) are critical to VS treatment planning. Although supervised methods have achieved satisfactory performance in VS segmentation, they require full annotations by experts, which is laborious and time-consuming. In this work, we aim to tackle the VS and cochlea segmentation problem in an unsupervised domain adaptation setting. Our proposed method leverages both the image-level domain alignment to minimize the domain divergence and semi-supervised training to further boost the performance. Furthermore, we propose to fuse the labels predicted from multiple models via noisy label correction. In the MICCAI 2021 crossMoDA challenge, our results on the final evaluation leaderboard showed that our proposed method has achieved promising segmentation performance with mean dice score of 79.9% and 82.5% and ASSD of 1.29 mm and 0.18 mm for VS tumor and cochlea, respectively. The cochlea ASSD achieved by our method has outperformed all other competing methods as well as the supervised nnU-Net.

Cross-Modality Domain Adaptation for Vestibular Schwannoma and Cochlea Segmentation

Automatic methods to segment the vestibular schwannoma (VS) tumors and the cochlea from magnetic resonance imaging (MRI) are critical to VS treatment planning. Although supervised methods have achieved satisfactory performance in VS segmentation, they require full annotations by experts, which is laborious and time-consuming. In this work, we aim to tackle the VS and cochlea segmentation problem in an unsupervised domain adaptation setting. Our proposed method leverages both the image-level domain alignment to minimize the domain divergence and semi-supervised training to further boost the performance. Furthermore, we propose to fuse the labels predicted from multiple models via noisy label correction. Our results on the challenge validation leaderboard showed that our unsupervised method has achieved promising VS and cochlea segmentation performance with mean dice score of 0.8261 $\pm$ 0.0416; The mean dice value for the tumor is 0.8302 $\pm$ 0.0772. This is comparable to the weakly-supervised based method.

Atlas-Based Segmentation of Intracochlear Anatomy in Metal Artifact Affected CT Images of the Ear with Co-trained Deep Neural Networks

We propose an atlas-based method to segment the intracochlear anatomy (ICA) in the post-implantation CT (Post-CT) images of cochlear implant (CI) recipients that preserves the point-to-point correspondence between the meshes in the atlas and the segmented volumes. To solve this problem, which is challenging because of the strong artifacts produced by the implant, we use a pair of co-trained deep networks that generate dense deformation fields (DDFs) in opposite directions. One network is tasked with registering an atlas image to the Post-CT images and the other network is tasked with registering the Post-CT images to the atlas image. The networks are trained using loss functions based on voxel-wise labels, image content, fiducial registration error, and cycle-consistency constraint. The segmentation of the ICA in the Post-CT images is subsequently obtained by transferring the predefined segmentation meshes of the ICA in the atlas image to the Post-CT images using the corresponding DDFs generated by the trained registration networks. Our model can learn the underlying geometric features of the ICA even though they are obscured by the metal artifacts. We show that our end-to-end network produces results that are comparable to the current state of the art (SOTA) that relies on a two-steps approach that first uses conditional generative adversarial networks to synthesize artifact-free images from the Post-CT images and then uses an active shape model-based method to segment the ICA in the synthetic images. Our method requires a fraction of the time needed by the SOTA, which is important for end-user acceptance.