Deep morphological recognition of kidney stones using intra-operative endoscopic digital videos

The collection and the analysis of kidney stone morphological criteria are essential for an aetiological diagnosis of stone disease. However, in-situ LASER-based fragmentation of urinary stones, which is now the most established chirurgical intervention, may destroy the morphology of the targeted stone. In the current study, we assess the performance and added value of processing complete digital endoscopic video sequences for the automatic recognition of stone morphological features during a standard-of-care intra-operative session. To this end, a computer-aided video classifier was developed to predict in-situ the morphology of stone using an intra-operative digital endoscopic video acquired in a clinical setting. The proposed technique was evaluated on pure (i.e. include one morphology) and mixed (i.e. include at least two morphologies) stones involving "Ia/Calcium Oxalate Monohydrate (COM)", "IIb/ Calcium Oxalate Dihydrate (COD)" and "IIIb/Uric Acid (UA)" morphologies. 71 digital endoscopic videos (50 exhibited only one morphological type and 21 displayed two) were analyzed using the proposed video classifier (56840 frames processed in total). Using the proposed approach, diagnostic performances (averaged over both pure and mixed stone types) were as follows: balanced accuracy=88%, sensitivity=80%, specificity=95%, precision=78% and F1-score=78%. The obtained results demonstrate that AI applied on digital endoscopic video sequences is a promising tool for collecting morphological information during the time-course of the stone fragmentation process without resorting to any human intervention for stone delineation or selection of good quality steady frames. To this end, irrelevant image information must be removed from the prediction process at both frame and pixel levels, which is now feasible thanks to the use of AI-dedicated networks.

Deep correction of breathing-related artifacts in MR-thermometry

Real-time MR-imaging has been clinically adapted for monitoring thermal therapies since it can provide on-the-fly temperature maps simultaneously with anatomical information. However, proton resonance frequency based thermometry of moving targets remains challenging since temperature artifacts are induced by the respiratory as well as physiological motion. If left uncorrected, these artifacts lead to severe errors in temperature estimates and impair therapy guidance. In this study, we evaluated deep learning for on-line correction of motion related errors in abdominal MR-thermometry. For this, a convolutional neural network (CNN) was designed to learn the apparent temperature perturbation from images acquired during a preparative learning stage prior to hyperthermia. The input of the designed CNN is the most recent magnitude image and no surrogate of motion is needed. During the subsequent hyperthermia procedure, the recent magnitude image is used as an input for the CNN-model in order to generate an on-line correction for the current temperature map. The method's artifact suppression performance was evaluated on 12 free breathing volunteers and was found robust and artifact-free in all examined cases. Furthermore, thermometric precision and accuracy was assessed for in vivo ablation using high intensity focused ultrasound. All calculations involved at the different stages of the proposed workflow were designed to be compatible with the clinical time constraints of a therapeutic procedure.