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Purpose: Registration of Laparoscopic Ultrasound (LUS) to a pre-operative scan such as Computed Tomography (CT) using blood vessel information has been proposed as a method to enable image-guidance for laparoscopic liver resection. Currently, there are solutions for this problem that can potentially enable clinical translation by bypassing the need for a manual initialisation and tracking information. However, no reliable framework for the segmentation of vessels in 2D untracked LUS images has been presented. Methods: We propose the use of 2D UNet for the segmentation of liver vessels in 2D LUS images. We integrate these results in a previously developed registration method, and show the feasibility of a fully automatic initialisation to the LUS to CT registration problem without a tracking device. Results: We validate our segmentation using LUS data from 6 patients. We test multiple models by placing patient datasets into different combinations of training, testing and hold-out, and obtain mean Dice scores ranging from 0.543 to 0.706. Using these segmentations, we obtain registration accuracies between 6.3 and 16.6 mm in 50% of cases. Conclusions: We demonstrate the first instance of deep learning (DL) for the segmentation of liver vessels in LUS. Our results show the feasibility of UNet in detecting multiple vessel instances in 2D LUS images, and potentially automating a LUS to CT registration pipeline.

Endoscopic ultrasound (EUS) is a challenging procedure that requires skill, both in endoscopy and ultrasound image interpretation. Classification of key anatomical landmarks visible on EUS images can assist the gastroenterologist during navigation. Current applications of deep learning have shown the ability to automatically classify ultrasound images with high accuracy. However, these techniques require a large amount of labelled data which is time consuming to obtain, and in the case of EUS, is also a difficult task to perform retrospectively due to the lack of 3D context. In this paper, we propose the use of an image-to-image translation method to create synthetic EUS (sEUS) images from CT data, that can be used as a data augmentation strategy when EUS data is scarce. We train a cycle-consistent adversarial network with unpaired EUS images and CT slices extracted in a manner such that they mimic plausible EUS views, to generate sEUS images from the pancreas, aorta and liver. We quantitatively evaluate the use of sEUS images in a classification sub-task and assess the Frechet Inception Distance. We show that synthetic data, obtained from CT data, imposes only a minor classification accuracy penalty and may help generalization to new unseen patients. The code and a dataset containing generated sEUS images are available at: https://ebonmati.github.io.

DeepReg (https://github.com/DeepRegNet/DeepReg) is a community-supported open-source toolkit for research and education in medical image registration using deep learning., Comment: Accepted in The Journal of Open Source Software (JOSS)