Multi-task Localization and Segmentation for X-ray Guided Planning in Knee Surgery

X-ray based measurement and guidance are commonly used tools in orthopaedic surgery to facilitate a minimally invasive workflow. Typically, a surgical planning is first performed using knowledge of bone morphology and anatomical landmarks. Information about bone location then serves as a prior for registration during overlay of the planning on intra-operative X-ray images. Performing these steps manually however is prone to intra-rater/inter-rater variability and increases task complexity for the surgeon. To remedy these issues, we propose an automatic framework for planning and subsequent overlay. We evaluate it on the example of femoral drill site planning for medial patellofemoral ligament reconstruction surgery. A deep multi-task stacked hourglass network is trained on 149 conventional lateral X-ray images to jointly localize two femoral landmarks, to predict a region of interest for the posterior femoral cortex tangent line, and to perform semantic segmentation of the femur, patella, tibia, and fibula with adaptive task complexity weighting. On 38 clinical test images the framework achieves a median localization error of 1.50 mm for the femoral drill site and mean IOU scores of 0.99, 0.97, 0.98, and 0.96 for the femur, patella, tibia, and fibula respectively. The demonstrated approach consistently performs surgical planning at expert-level precision without the need for manual correction.

Aerial LaneNet: Lane Marking Semantic Segmentation in Aerial Imagery using Wavelet-Enhanced Cost-sensitive Symmetric Fully Convolutional Neural Networks

The knowledge about the placement and appearance of lane markings is a prerequisite for the creation of maps with high precision, necessary for autonomous driving, infrastructure monitoring, lane-wise traffic management, and urban planning. Lane markings are one of the important components of such maps. Lane markings convey the rules of roads to drivers. While these rules are learned by humans, an autonomous driving vehicle should be taught to learn them to localize itself. Therefore, accurate and reliable lane marking semantic segmentation in the imagery of roads and highways is needed to achieve such goals. We use airborne imagery which can capture a large area in a short period of time by introducing an aerial lane marking dataset. In this work, we propose a Symmetric Fully Convolutional Neural Network enhanced by Wavelet Transform in order to automatically carry out lane marking segmentation in aerial imagery. Due to a heavily unbalanced problem in terms of number of lane marking pixels compared with background pixels, we use a customized loss function as well as a new type of data augmentation step. We achieve a very high accuracy in pixel-wise localization of lane markings without using 3rd-party information. In this work, we introduce the first high-quality dataset used within our experiments which contains a broad range of situations and classes of lane markings representative of current transportation systems. This dataset will be publicly available and hence, it can be used as the benchmark dataset for future algorithms within this domain.

Metric-Driven Learning of Correspondence Weighting for 2-D/3-D Image Registration

Registration of pre-operative 3-D volumes to intra-operative 2-D X-ray images is important in minimally invasive medical procedures. Rigid registration can be performed by estimating a global rigid motion that optimizes the alignment of local correspondences. However, inaccurate correspondences challenge the registration performance. To minimize their influence, we estimate optimal weights for correspondences using PointNet. We train the network directly with the criterion to minimize the registration error. We propose an objective function which includes point-to-plane correspondence-based motion estimation and projection error computation, thereby enabling the learning of a weighting strategy that optimally fits the underlying formulation of the registration task in an end-to-end fashion. For single-vertebra registration, we achieve an accuracy of 0.74$\pm$0.26 mm and highly improved robustness. The success rate is increased from 79.3 % to 94.3 % and the capture range from 3 mm to 13 mm.

Dilated FCN for Multi-Agent 2D/3D Medical Image Registration

2D/3D image registration to align a 3D volume and 2D X-ray images is a challenging problem due to its ill-posed nature and various artifacts presented in 2D X-ray images. In this paper, we propose a multi-agent system with an auto attention mechanism for robust and efficient 2D/3D image registration. Specifically, an individual agent is trained with dilated Fully Convolutional Network (FCN) to perform registration in a Markov Decision Process (MDP) by observing a local region, and the final action is then taken based on the proposals from multiple agents and weighted by their corresponding confidence levels. The contributions of this paper are threefold. First, we formulate 2D/3D registration as a MDP with observations, actions, and rewards properly defined with respect to X-ray imaging systems. Second, to handle various artifacts in 2D X-ray images, multiple local agents are employed efficiently via FCN-based structures, and an auto attention mechanism is proposed to favor the proposals from regions with more reliable visual cues. Third, a dilated FCN-based training mechanism is proposed to significantly reduce the Degree of Freedom in the simulation of registration environment, and drastically improve training efficiency by an order of magnitude compared to standard CNN-based training method. We demonstrate that the proposed method achieves high robustness on both spine cone beam Computed Tomography data with a low signal-to-noise ratio and data from minimally invasive spine surgery where severe image artifacts and occlusions are presented due to metal screws and guide wires, outperforming other state-of-the-art methods (single agent-based and optimization-based) by a large margin.