Anatomy Might Be All You Need: Forecasting What to Do During Surgery

Surgical guidance can be delivered in various ways. In neurosurgery, spatial guidance and orientation are predominantly achieved through neuronavigation systems that reference pre-operative MRI scans. Recently, there has been growing interest in providing live guidance by analyzing video feeds from tools such as endoscopes. Existing approaches, including anatomy detection, orientation feedback, phase recognition, and visual question-answering, primarily focus on aiding surgeons in assessing the current surgical scene. This work aims to provide guidance on a finer scale, aiming to provide guidance by forecasting the trajectory of the surgical instrument, essentially addressing the question of what to do next. To address this task, we propose a model that not only leverages the historical locations of surgical instruments but also integrates anatomical features. Importantly, our work does not rely on explicit ground truth labels for instrument trajectories. Instead, the ground truth is generated by a detection model trained to detect both anatomical structures and instruments within surgical videos of a comprehensive dataset containing pituitary surgery videos. By analyzing the interaction between anatomy and instrument movements in these videos and forecasting future instrument movements, we show that anatomical features are a valuable asset in addressing this challenging task. To the best of our knowledge, this work is the first attempt to address this task for manually operated surgeries.

CityLoc: 6 DoF Localization of Text Descriptions in Large-Scale Scenes with Gaussian Representation

Localizing text descriptions in large-scale 3D scenes is inherently an ambiguous task. This nonetheless arises while describing general concepts, e.g. all traffic lights in a city. To facilitate reasoning based on such concepts, text localization in the form of distribution is required. In this paper, we generate the distribution of the camera poses conditioned upon the textual description. To facilitate such generation, we propose a diffusion-based architecture that conditionally diffuses the noisy 6DoF camera poses to their plausible locations. The conditional signals are derived from the text descriptions, using the pre-trained text encoders. The connection between text descriptions and pose distribution is established through pretrained Vision-Language-Model, i.e. CLIP. Furthermore, we demonstrate that the candidate poses for the distribution can be further refined by rendering potential poses using 3D Gaussian splatting, guiding incorrectly posed samples towards locations that better align with the textual description, through visual reasoning. We demonstrate the effectiveness of our method by comparing it with both standard retrieval methods and learning-based approaches. Our proposed method consistently outperforms these baselines across all five large-scale datasets. Our source code and dataset will be made publicly available.

Explicit and data-Efficient Encoding via Gradient Flow

The autoencoder model typically uses an encoder to map data to a lower dimensional latent space and a decoder to reconstruct it. However, relying on an encoder for inversion can lead to suboptimal representations, particularly limiting in physical sciences where precision is key. We introduce a decoder-only method using gradient flow to directly encode data into the latent space, defined by ordinary differential equations (ODEs). This approach eliminates the need for approximate encoder inversion. We train the decoder via the adjoint method and show that costly integrals can be avoided with minimal accuracy loss. Additionally, we propose a $2^{nd}$ order ODE variant, approximating Nesterov's accelerated gradient descent for faster convergence. To handle stiff ODEs, we use an adaptive solver that prioritizes loss minimization, improving robustness. Compared to traditional autoencoders, our method demonstrates explicit encoding and superior data efficiency, which is crucial for data-scarce scenarios in the physical sciences. Furthermore, this work paves the way for integrating machine learning into scientific workflows, where precise and efficient encoding is critical. \footnote{The code for this work is available at \url{https://github.com/k-flouris/gfe}.}

Energy-Based Prior Latent Space Diffusion model for Reconstruction of Lumbar Vertebrae from Thick Slice MRI

Lumbar spine problems are ubiquitous, motivating research into targeted imaging for treatment planning and guided interventions. While high resolution and high contrast CT has been the modality of choice, MRI can capture both bone and soft tissue without the ionizing radiation of CT albeit longer acquisition time. The critical trade-off between contrast quality and acquisition time has motivated 'thick slice MRI', which prioritises faster imaging with high in-plane resolution but variable contrast and low through-plane resolution. We investigate a recently developed post-acquisition pipeline which segments vertebrae from thick-slice acquisitions and uses a variational autoencoder to enhance quality after an initial 3D reconstruction. We instead propose a latent space diffusion energy-based prior to leverage diffusion models, which exhibit high-quality image generation. Crucially, we mitigate their high computational cost and low sample efficiency by learning an energy-based latent representation to perform the diffusion processes. Our resulting method outperforms existing approaches across metrics including Dice and VS scores, and more faithfully captures 3D features.

Diffusion-Based Semantic Segmentation of Lumbar Spine MRI Scans of Lower Back Pain Patients

This study introduces a diffusion-based framework for robust and accurate segmenton of vertebrae, intervertebral discs (IVDs), and spinal canal from Magnetic Resonance Imaging~(MRI) scans of patients with low back pain (LBP), regardless of whether the scans are T1w or T2-weighted. The results showed that SpineSegDiff achieved comparable outperformed non-diffusion state-of-the-art models in the identification of degenerated IVDs. Our findings highlight the potential of diffusion models to improve LBP diagnosis and management through precise spine MRI analysis.

Generalizable Single-Source Cross-modality Medical Image Segmentation via Invariant Causal Mechanisms

Single-source domain generalization (SDG) aims to learn a model from a single source domain that can generalize well on unseen target domains. This is an important task in computer vision, particularly relevant to medical imaging where domain shifts are common. In this work, we consider a challenging yet practical setting: SDG for cross-modality medical image segmentation. We combine causality-inspired theoretical insights on learning domain-invariant representations with recent advancements in diffusion-based augmentation to improve generalization across diverse imaging modalities. Guided by the ``intervention-augmentation equivariant'' principle, we use controlled diffusion models (DMs) to simulate diverse imaging styles while preserving the content, leveraging rich generative priors in large-scale pretrained DMs to comprehensively perturb the multidimensional style variable. Extensive experiments on challenging cross-modality segmentation tasks demonstrate that our approach consistently outperforms state-of-the-art SDG methods across three distinct anatomies and imaging modalities. The source code is available at \href{https://github.com/ratschlab/ICMSeg}{https://github.com/ratschlab/ICMSeg}.

Multimodality Helps Few-Shot 3D Point Cloud Semantic Segmentation

Few-shot 3D point cloud segmentation (FS-PCS) aims at generalizing models to segment novel categories with minimal annotated support samples. While existing FS-PCS methods have shown promise, they primarily focus on unimodal point cloud inputs, overlooking the potential benefits of leveraging multimodal information. In this paper, we address this gap by introducing a cost-free multimodal FS-PCS setup, utilizing textual labels and the potentially available 2D image modality. Under this easy-to-achieve setup, we present the MultiModal Few-Shot SegNet (MM-FSS), a model effectively harnessing complementary information from multiple modalities. MM-FSS employs a shared backbone with two heads to extract intermodal and unimodal visual features, and a pretrained text encoder to generate text embeddings. To fully exploit the multimodal information, we propose a Multimodal Correlation Fusion (MCF) module to generate multimodal correlations, and a Multimodal Semantic Fusion (MSF) module to refine the correlations using text-aware semantic guidance. Additionally, we propose a simple yet effective Test-time Adaptive Cross-modal Calibration (TACC) technique to mitigate training bias, further improving generalization. Experimental results on S3DIS and ScanNet datasets demonstrate significant performance improvements achieved by our method. The efficacy of our approach indicates the benefits of leveraging commonly-ignored free modalities for FS-PCS, providing valuable insights for future research. The code is available at https://github.com/ZhaochongAn/Multimodality-3D-Few-Shot .

When SAM2 Meets Video Camouflaged Object Segmentation: A Comprehensive Evaluation and Adaptation

This study investigates the application and performance of the Segment Anything Model 2 (SAM2) in the challenging task of video camouflaged object segmentation (VCOS). VCOS involves detecting objects that blend seamlessly in the surroundings for videos, due to similar colors and textures, poor light conditions, etc. Compared to the objects in normal scenes, camouflaged objects are much more difficult to detect. SAM2, a video foundation model, has shown potential in various tasks. But its effectiveness in dynamic camouflaged scenarios remains under-explored. This study presents a comprehensive study on SAM2's ability in VCOS. First, we assess SAM2's performance on camouflaged video datasets using different models and prompts (click, box, and mask). Second, we explore the integration of SAM2 with existing multimodal large language models (MLLMs) and VCOS methods. Third, we specifically adapt SAM2 by fine-tuning it on the video camouflaged dataset. Our comprehensive experiments demonstrate that SAM2 has excellent zero-shot ability of detecting camouflaged objects in videos. We also show that this ability could be further improved by specifically adjusting SAM2's parameters for VCOS. The code will be available at https://github.com/zhoustan/SAM2-VCOS

Do Vision Foundation Models Enhance Domain Generalization in Medical Image Segmentation?

Neural networks achieve state-of-the-art performance in many supervised learning tasks when the training data distribution matches the test data distribution. However, their performance drops significantly under domain (covariate) shift, a prevalent issue in medical image segmentation due to varying acquisition settings across different scanner models and protocols. Recently, foundational models (FMs) trained on large datasets have gained attention for their ability to be adapted for downstream tasks and achieve state-of-the-art performance with excellent generalization capabilities on natural images. However, their effectiveness in medical image segmentation remains underexplored. In this paper, we investigate the domain generalization performance of various FMs, including DinoV2, SAM, MedSAM, and MAE, when fine-tuned using various parameter-efficient fine-tuning (PEFT) techniques such as Ladder and Rein (+LoRA) and decoder heads. We introduce a novel decode head architecture, HQHSAM, which simply integrates elements from two state-of-the-art decoder heads, HSAM and HQSAM, to enhance segmentation performance. Our extensive experiments on multiple datasets, encompassing various anatomies and modalities, reveal that FMs, particularly with the HQHSAM decode head, improve domain generalization for medical image segmentation. Moreover, we found that the effectiveness of PEFT techniques varies across different FMs. These findings underscore the potential of FMs to enhance the domain generalization performance of neural networks in medical image segmentation across diverse clinical settings, providing a solid foundation for future research. Code and models are available for research purposes at \url{https://github.com/kerem-cekmeceli/Foundation-Models-for-Medical-Imagery}.

Image Segmentation in Foundation Model Era: A Survey

Image segmentation is a long-standing challenge in computer vision, studied continuously over several decades, as evidenced by seminal algorithms such as N-Cut, FCN, and MaskFormer. With the advent of foundation models (FMs), contemporary segmentation methodologies have embarked on a new epoch by either adapting FMs (e.g., CLIP, Stable Diffusion, DINO) for image segmentation or developing dedicated segmentation foundation models (e.g., SAM). These approaches not only deliver superior segmentation performance, but also herald newfound segmentation capabilities previously unseen in deep learning context. However, current research in image segmentation lacks a detailed analysis of distinct characteristics, challenges, and solutions associated with these advancements. This survey seeks to fill this gap by providing a thorough review of cutting-edge research centered around FM-driven image segmentation. We investigate two basic lines of research -- generic image segmentation (i.e., semantic segmentation, instance segmentation, panoptic segmentation), and promptable image segmentation (i.e., interactive segmentation, referring segmentation, few-shot segmentation) -- by delineating their respective task settings, background concepts, and key challenges. Furthermore, we provide insights into the emergence of segmentation knowledge from FMs like CLIP, Stable Diffusion, and DINO. An exhaustive overview of over 300 segmentation approaches is provided to encapsulate the breadth of current research efforts. Subsequently, we engage in a discussion of open issues and potential avenues for future research. We envisage that this fresh, comprehensive, and systematic survey catalyzes the evolution of advanced image segmentation systems.