3D Perception based Imitation Learning under Limited Demonstration for Laparoscope Control in Robotic Surgery

Automatic laparoscope motion control is fundamentally important for surgeons to efficiently perform operations. However, its traditional control methods based on tool tracking without considering information hidden in surgical scenes are not intelligent enough, while the latest supervised imitation learning (IL)-based methods require expensive sensor data and suffer from distribution mismatch issues caused by limited demonstrations. In this paper, we propose a novel Imitation Learning framework for Laparoscope Control (ILLC) with reinforcement learning (RL), which can efficiently learn the control policy from limited surgical video clips. Specially, we first extract surgical laparoscope trajectories from unlabeled videos as the demonstrations and reconstruct the corresponding surgical scenes. To fully learn from limited motion trajectory demonstrations, we propose Shape Preserving Trajectory Augmentation (SPTA) to augment these data, and build a simulation environment that supports parallel RGB-D rendering to reinforce the RL policy for interacting with the environment efficiently. With adversarial training for IL, we obtain the laparoscope control policy based on the generated rollouts and surgical demonstrations. Extensive experiments are conducted in unseen reconstructed surgical scenes, and our method outperforms the previous IL methods, which proves the feasibility of our unified learning-based framework for laparoscope control.

Transformer-empowered Multi-scale Contextual Matching and Aggregation for Multi-contrast MRI Super-resolution

Magnetic resonance imaging (MRI) can present multi-contrast images of the same anatomical structures, enabling multi-contrast super-resolution (SR) techniques. Compared with SR reconstruction using a single-contrast, multi-contrast SR reconstruction is promising to yield SR images with higher quality by leveraging diverse yet complementary information embedded in different imaging modalities. However, existing methods still have two shortcomings: (1) they neglect that the multi-contrast features at different scales contain different anatomical details and hence lack effective mechanisms to match and fuse these features for better reconstruction; and (2) they are still deficient in capturing long-range dependencies, which are essential for the regions with complicated anatomical structures. We propose a novel network to comprehensively address these problems by developing a set of innovative Transformer-empowered multi-scale contextual matching and aggregation techniques; we call it McMRSR. Firstly, we tame transformers to model long-range dependencies in both reference and target images. Then, a new multi-scale contextual matching method is proposed to capture corresponding contexts from reference features at different scales. Furthermore, we introduce a multi-scale aggregation mechanism to gradually and interactively aggregate multi-scale matched features for reconstructing the target SR MR image. Extensive experiments demonstrate that our network outperforms state-of-the-art approaches and has great potential to be applied in clinical practice. Codes are available at https://github.com/XAIMI-Lab/McMRSR.

Towards Robust Part-aware Instance Segmentation for Industrial Bin Picking

Industrial bin picking is a challenging task that requires accurate and robust segmentation of individual object instances. Particularly, industrial objects can have irregular shapes, that is, thin and concave, whereas in bin-picking scenarios, objects are often closely packed with strong occlusion. To address these challenges, we formulate a novel part-aware instance segmentation pipeline. The key idea is to decompose industrial objects into correlated approximate convex parts and enhance the object-level segmentation with part-level segmentation. We design a part-aware network to predict part masks and part-to-part offsets, followed by a part aggregation module to assemble the recognized parts into instances. To guide the network learning, we also propose an automatic label decoupling scheme to generate ground-truth part-level labels from instance-level labels. Finally, we contribute the first instance segmentation dataset, which contains a variety of industrial objects that are thin and have non-trivial shapes. Extensive experimental results on various industrial objects demonstrate that our method can achieve the best segmentation results compared with the state-of-the-art approaches.

PEg TRAnsfer Workflow recognition challenge report: Does multi-modal data improve recognition?

This paper presents the design and results of the "PEg TRAnsfert Workflow recognition" (PETRAW) challenge whose objective was to develop surgical workflow recognition methods based on one or several modalities, among video, kinematic, and segmentation data, in order to study their added value. The PETRAW challenge provided a data set of 150 peg transfer sequences performed on a virtual simulator. This data set was composed of videos, kinematics, semantic segmentation, and workflow annotations which described the sequences at three different granularity levels: phase, step, and activity. Five tasks were proposed to the participants: three of them were related to the recognition of all granularities with one of the available modalities, while the others addressed the recognition with a combination of modalities. Average application-dependent balanced accuracy (AD-Accuracy) was used as evaluation metric to take unbalanced classes into account and because it is more clinically relevant than a frame-by-frame score. Seven teams participated in at least one task and four of them in all tasks. Best results are obtained with the use of the video and the kinematics data with an AD-Accuracy between 93% and 90% for the four teams who participated in all tasks. The improvement between video/kinematic-based methods and the uni-modality ones was significant for all of the teams. However, the difference in testing execution time between the video/kinematic-based and the kinematic-based methods has to be taken into consideration. Is it relevant to spend 20 to 200 times more computing time for less than 3% of improvement? The PETRAW data set is publicly available at www.synapse.org/PETRAW to encourage further research in surgical workflow recognition.

HarmoFL: Harmonizing Local and Global Drifts in Federated Learning on Heterogeneous Medical Images

Multiple medical institutions collaboratively training a model using federated learning (FL) has become a promising solution for maximizing the potential of data-driven models, yet the non-independent and identically distributed (non-iid) data in medical images is still an outstanding challenge in real-world practice. The feature heterogeneity caused by diverse scanners or protocols introduces a drift in the learning process, in both local (client) and global (server) optimizations, which harms the convergence as well as model performance. Many previous works have attempted to address the non-iid issue by tackling the drift locally or globally, but how to jointly solve the two essentially coupled drifts is still unclear. In this work, we concentrate on handling both local and global drifts and introduce a new harmonizing framework called HarmoFL. First, we propose to mitigate the local update drift by normalizing amplitudes of images transformed into the frequency domain to mimic a unified imaging setting, in order to generate a harmonized feature space across local clients. Second, based on harmonized features, we design a client weight perturbation guiding each local model to reach a flat optimum, where a neighborhood area of the local optimal solution has a uniformly low loss. Without any extra communication cost, the perturbation assists the global model to optimize towards a converged optimal solution by aggregating several local flat optima. We have theoretically analyzed the proposed method and empirically conducted extensive experiments on three medical image classification and segmentation tasks, showing that HarmoFL outperforms a set of recent state-of-the-art methods with promising convergence behavior. Code is available at https://github.com/med-air/HarmoFL.

Integrating Artificial Intelligence and Augmented Reality in Robotic Surgery: An Initial dVRK Study Using a Surgical Education Scenario

The demand of competent robot assisted surgeons is progressively expanding, because robot-assisted surgery has become progressively more popular due to its clinical advantages. To meet this demand and provide a better surgical education for surgeon, we develop a novel robotic surgery education system by integrating artificial intelligence surgical module and augmented reality visualization. The artificial intelligence incorporates reinforcement leaning to learn from expert demonstration and then generate 3D guidance trajectory, providing surgical context awareness of the complete surgical procedure. The trajectory information is further visualized in stereo viewer in the dVRK along with other information such as text hint, where the user can perceive the 3D guidance and learn the procedure. The proposed system is evaluated through a preliminary experiment on surgical education task peg-transfer, which proves its feasibility and potential as the next generation of robot-assisted surgery education solution.

TsmoBN: Interventional Generalization for Unseen Clients in Federated Learning

Generalizing federated learning (FL) models to unseen clients with non-iid data is a crucial topic, yet unsolved so far. In this work, we propose to tackle this problem from a novel causal perspective. Specifically, we form a training structural causal model (SCM) to explain the challenges of model generalization in a distributed learning paradigm. Based on this, we present a simple yet effective method using test-specific and momentum tracked batch normalization (TsmoBN) to generalize FL models to testing clients. We give a causal analysis by formulating another testing SCM and demonstrate that the key factor in TsmoBN is the test-specific statistics (i.e., mean and variance) of features. Such statistics can be seen as a surrogate variable for causal intervention. In addition, by considering generalization bounds in FL, we show that our TsmoBN method can reduce divergence between training and testing feature distributions, which achieves a lower generalization gap than standard model testing. Our extensive experimental evaluations demonstrate significant improvements for unseen client generalization on three datasets with various types of feature distributions and numbers of clients. It is worth noting that our proposed approach can be flexibly applied to different state-of-the-art federated learning algorithms and is orthogonal to existing domain generalization methods.

Stereo Dense Scene Reconstruction and Accurate Laparoscope Localization for Learning-Based Navigation in Robot-Assisted Surgery

The computation of anatomical information and laparoscope position is a fundamental block of robot-assisted surgical navigation in Minimally Invasive Surgery (MIS). Recovering a dense 3D structure of surgical scene using visual cues remains a challenge, and the online laparoscopic tracking mostly relies on external sensors, which increases system complexity. In this paper, we propose a learning-driven framework, in which an image-guided laparoscopic localization with 3D reconstructions of complex anatomical structures is hereby achieved. To reconstruct the 3D structure of the whole surgical environment, we first fine-tune a learning-based stereoscopic depth perception method, which is robust to the texture-less and variant soft tissues, for depth estimation. Then, we develop a dense visual reconstruction algorithm to represent the scene by surfels, estimate the laparoscope pose and fuse the depth data into a unified reference coordinate for tissue reconstruction. To estimate poses of new laparoscope views, we realize a coarse-to-fine localization method, which incorporates our reconstructed 3D model. We evaluate the reconstruction method and the localization module on three datasets, namely, the stereo correspondence and reconstruction of endoscopic data (SCARED), the ex-vivo phantom and tissue data collected with Universal Robot (UR) and Karl Storz Laparoscope, and the in-vivo DaVinci robotic surgery dataset. Extensive experiments have been conducted to prove the superior performance of our method in 3D anatomy reconstruction and laparoscopic localization, which demonstrates its potential implementation to surgical navigation system.

Comparative Validation of Machine Learning Algorithms for Surgical Workflow and Skill Analysis with the HeiChole Benchmark

PURPOSE: Surgical workflow and skill analysis are key technologies for the next generation of cognitive surgical assistance systems. These systems could increase the safety of the operation through context-sensitive warnings and semi-autonomous robotic assistance or improve training of surgeons via data-driven feedback. In surgical workflow analysis up to 91% average precision has been reported for phase recognition on an open data single-center dataset. In this work we investigated the generalizability of phase recognition algorithms in a multi-center setting including more difficult recognition tasks such as surgical action and surgical skill. METHODS: To achieve this goal, a dataset with 33 laparoscopic cholecystectomy videos from three surgical centers with a total operation time of 22 hours was created. Labels included annotation of seven surgical phases with 250 phase transitions, 5514 occurences of four surgical actions, 6980 occurences of 21 surgical instruments from seven instrument categories and 495 skill classifications in five skill dimensions. The dataset was used in the 2019 Endoscopic Vision challenge, sub-challenge for surgical workflow and skill analysis. Here, 12 teams submitted their machine learning algorithms for recognition of phase, action, instrument and/or skill assessment. RESULTS: F1-scores were achieved for phase recognition between 23.9% and 67.7% (n=9 teams), for instrument presence detection between 38.5% and 63.8% (n=8 teams), but for action recognition only between 21.8% and 23.3% (n=5 teams). The average absolute error for skill assessment was 0.78 (n=1 team). CONCLUSION: Surgical workflow and skill analysis are promising technologies to support the surgical team, but are not solved yet, as shown by our comparison of algorithms. This novel benchmark can be used for comparable evaluation and validation of future work.