Learning dissection trajectories from expert surgical videos via imitation learning with equivariant diffusion

Endoscopic Submucosal Dissection (ESD) is a well-established technique for removing epithelial lesions. Predicting dissection trajectories in ESD videos offers significant potential for enhancing surgical skill training and simplifying the learning process, yet this area remains underexplored. While imitation learning has shown promise in acquiring skills from expert demonstrations, challenges persist in handling uncertain future movements, learning geometric symmetries, and generalizing to diverse surgical scenarios. To address these, we introduce a novel approach: Implicit Diffusion Policy with Equivariant Representations for Imitation Learning (iDPOE). Our method models expert behavior through a joint state action distribution, capturing the stochastic nature of dissection trajectories and enabling robust visual representation learning across various endoscopic views. By incorporating a diffusion model into policy learning, iDPOE ensures efficient training and sampling, leading to more accurate predictions and better generalization. Additionally, we enhance the model's ability to generalize to geometric symmetries by embedding equivariance into the learning process. To address state mismatches, we develop a forward-process guided action inference strategy for conditional sampling. Using an ESD video dataset of nearly 2000 clips, experimental results show that our approach surpasses state-of-the-art methods, both explicit and implicit, in trajectory prediction. To the best of our knowledge, this is the first application of imitation learning to surgical skill development for dissection trajectory prediction.

Uncertainty Estimation for Safety-critical Scene Segmentation via Fine-grained Reward Maximization

Uncertainty estimation plays an important role for future reliable deployment of deep segmentation models in safety-critical scenarios such as medical applications. However, existing methods for uncertainty estimation have been limited by the lack of explicit guidance for calibrating the prediction risk and model confidence. In this work, we propose a novel fine-grained reward maximization (FGRM) framework, to address uncertainty estimation by directly utilizing an uncertainty metric related reward function with a reinforcement learning based model tuning algorithm. This would benefit the model uncertainty estimation through direct optimization guidance for model calibration. Specifically, our method designs a new uncertainty estimation reward function using the calibration metric, which is maximized to fine-tune an evidential learning pre-trained segmentation model for calibrating prediction risk. Importantly, we innovate an effective fine-grained parameter update scheme, which imposes fine-grained reward-weighting of each network parameter according to the parameter importance quantified by the fisher information matrix. To the best of our knowledge, this is the first work exploring reward optimization for model uncertainty estimation in safety-critical vision tasks. The effectiveness of our method is demonstrated on two large safety-critical surgical scene segmentation datasets under two different uncertainty estimation settings. With real-time one forward pass at inference, our method outperforms state-of-the-art methods by a clear margin on all the calibration metrics of uncertainty estimation, while maintaining a high task accuracy for the segmentation results. Code is available at \url{https://github.com/med-air/FGRM}.