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Surgical phase recognition (SPR) is crucial for applications in workflow optimization, performance evaluation, and real-time intervention guidance. However, current deep learning models often struggle with fragmented predictions, failing to capture the sequential nature of surgical workflows. We propose the Neural Finite-State Machine (NFSM), a novel approach that enforces temporal coherence by integrating classical state-transition priors with modern neural networks. NFSM leverages learnable global state embeddings as unique phase identifiers and dynamic transition tables to model phase-to-phase progressions. Additionally, a future phase forecasting mechanism employs repeated frame padding to anticipate upcoming transitions. Implemented as a plug-and-play module, NFSM can be integrated into existing SPR pipelines without changing their core architectures. We demonstrate state-of-the-art performance across multiple benchmarks, including a significant improvement on the BernBypass70 dataset - raising video-level accuracy by 0.9 points and phase-level precision, recall, F1-score, and mAP by 3.8, 3.1, 3.3, and 4.1, respectively. Ablation studies confirm each component's effectiveness and the module's adaptability to various architectures. By unifying finite-state principles with deep learning, NFSM offers a robust path toward consistent, long-term surgical video analysis.

Ultrasound (US) image stitching can expand the field-of-view (FOV) by combining multiple US images from varied probe positions. However, registering US images with only partially overlapping anatomical contents is a challenging task. In this work, we introduce SynStitch, a self-supervised framework designed for 2DUS stitching. SynStitch consists of a synthetic stitching pair generation module (SSPGM) and an image stitching module (ISM). SSPGM utilizes a patch-conditioned ControlNet to generate realistic 2DUS stitching pairs with known affine matrix from a single input image. ISM then utilizes this synthetic paired data to learn 2DUS stitching in a supervised manner. Our framework was evaluated against multiple leading methods on a kidney ultrasound dataset, demonstrating superior 2DUS stitching performance through both qualitative and quantitative analyses. The code will be made public upon acceptance of the paper.

Numerous recent approaches to modeling and re-rendering dynamic scenes leverage plane-based explicit representations, addressing slow training times associated with models like neural radiance fields (NeRF) and Gaussian splatting (GS). However, merely decomposing 4D dynamic scenes into multiple 2D plane-based representations is insufficient for high-fidelity re-rendering of scenes with complex motions. In response, we present DaRePlane, a novel direction-aware representation approach that captures scene dynamics from six different directions. This learned representation undergoes an inverse dual-tree complex wavelet transformation (DTCWT) to recover plane-based information. Within NeRF pipelines, DaRePlane computes features for each space-time point by fusing vectors from these recovered planes, then passed to a tiny MLP for color regression. When applied to Gaussian splatting, DaRePlane computes the features of Gaussian points, followed by a tiny multi-head MLP for spatial-time deformation prediction. Notably, to address redundancy introduced by the six real and six imaginary direction-aware wavelet coefficients, we introduce a trainable masking approach, mitigating storage issues without significant performance decline. To demonstrate the generality and efficiency of DaRePlane, we test it on both regular and surgical dynamic scenes, for both NeRF and GS systems. Extensive experiments show that DaRePlane yields state-of-the-art performance in novel view synthesis for various complex dynamic scenes., Comment: arXiv admin note: substantial text overlap with arXiv:2403.02265

Monocular depth estimation is crucial for tracking and reconstruction algorithms, particularly in the context of surgical videos. However, the inherent challenges in directly obtaining ground truth depth maps during surgery render supervised learning approaches impractical. While many self-supervised methods based on Structure from Motion (SfM) have shown promising results, they rely heavily on high-quality camera motion and require optimization on a per-patient basis. These limitations can be mitigated by leveraging the current state-of-the-art foundational model for depth estimation, Depth Anything. However, when directly applied to surgical scenes, Depth Anything struggles with issues such as blurring, bleeding, and reflections, resulting in suboptimal performance. This paper presents a fine-tuning of the Depth Anything model specifically for the surgical domain, aiming to deliver more accurate pixel-wise depth maps tailored to the unique requirements and challenges of surgical environments. Our fine-tuning approach significantly improves the model's performance in surgical scenes, reducing errors related to blurring and reflections, and achieving a more reliable and precise depth estimation.

Functional magnetic resonance imaging (fMRI) is an indispensable tool in modern neuroscience, providing a non-invasive window into whole-brain dynamics at millimeter-scale spatial resolution. However, fMRI is constrained by issues such as high operation costs and immobility. With the rapid advancements in cross-modality synthesis and brain decoding, the use of deep neural networks has emerged as a promising solution for inferring whole-brain, high-resolution fMRI features directly from electroencephalography (EEG), a more widely accessible and portable neuroimaging modality. Nonetheless, the complex projection from neural activity to fMRI hemodynamic responses and the spatial ambiguity of EEG pose substantial challenges both in modeling and interpretability. Relatively few studies to date have developed approaches for EEG-fMRI translation, and although they have made significant strides, the inference of fMRI signals in a given study has been limited to a small set of brain areas and to a single condition (i.e., either resting-state or a specific task). The capability to predict fMRI signals in other brain areas, as well as to generalize across conditions, remain critical gaps in the field. To tackle these challenges, we introduce a novel and generalizable framework: NeuroBOLT, i.e., Neuro-to-BOLD Transformer, which leverages multi-dimensional representation learning from temporal, spatial, and spectral domains to translate raw EEG data to the corresponding fMRI activity signals across the brain. Our experiments demonstrate that NeuroBOLT effectively reconstructs unseen resting-state fMRI signals from primary sensory, high-level cognitive areas, and deep subcortical brain regions, achieving state-of-the-art accuracy with the potential to generalize across varying conditions and sites, which significantly advances the integration of these two modalities., Comment: This preprint has been accepted to NeurIPS 2024

The Segment Anything Model 2 (SAM 2) is the latest generation foundation model for image and video segmentation. Trained on the expansive Segment Anything Video (SA-V) dataset, which comprises 35.5 million masks across 50.9K videos, SAM 2 advances its predecessor's capabilities by supporting zero-shot segmentation through various prompts (e.g., points, boxes, and masks). Its robust zero-shot performance and efficient memory usage make SAM 2 particularly appealing for surgical tool segmentation in videos, especially given the scarcity of labeled data and the diversity of surgical procedures. In this study, we evaluate the zero-shot video segmentation performance of the SAM 2 model across different types of surgeries, including endoscopy and microscopy. We also assess its performance on videos featuring single and multiple tools of varying lengths to demonstrate SAM 2's applicability and effectiveness in the surgical domain. We found that: 1) SAM 2 demonstrates a strong capability for segmenting various surgical videos; 2) When new tools enter the scene, additional prompts are necessary to maintain segmentation accuracy; and 3) Specific challenges inherent to surgical videos can impact the robustness of SAM 2., Comment: The first work evaluates the performance of SAM 2 in surgical videos

Cochlear Implant (CI) procedures require the insertion of an electrode array into the cochlea within the inner ear. To achieve this, mastoidectomy, a surgical procedure involving the removal of part of the mastoid region of the temporal bone using a high-speed drill provides safe access to the cochlea through the middle and inner ear. In this paper, we propose a novel Mamba-based method to synthesize the mastoidectomy volume using only preoperative Computed Tomography (CT) scans, where the mastoid remains intact. Our approach introduces a self-supervised learning framework designed to predict the mastoidectomy shape and reconstruct a 3D post-mastoidectomy surface directly from preoperative CT scans. This reconstruction aligns with intraoperative microscope views, enabling various downstream surgical applications. For training, we leverage postoperative CT scans to bypass manual data cleaning and labeling, even when the region removed during mastoidectomy is affected by challenges such as metal artifacts, low signal-to-noise ratio, or electrode wiring. Our method achieves a mean Dice score of 0.70 in estimating mastoidectomy regions, demonstrating its effectiveness for accurate and efficient surgical preoperative planning.

We introduce a novel bottom-up approach for human body mesh reconstruction, specifically designed to address the challenges posed by partial visibility and occlusion in input images. Traditional top-down methods, relying on whole-body parametric models like SMPL, falter when only a small part of the human is visible, as they require visibility of most of the human body for accurate mesh reconstruction. To overcome this limitation, our method employs a "Divide and Fuse (D&F)" strategy, reconstructing human body parts independently before fusing them, thereby ensuring robustness against occlusions. We design Human Part Parametric Models (HPPM) that independently reconstruct the mesh from a few shape and global-location parameters, without inter-part dependency. A specially designed fusion module then seamlessly integrates the reconstructed parts, even when only a few are visible. We harness a large volume of ground-truth SMPL data to train our parametric mesh models. To facilitate the training and evaluation of our method, we have established benchmark datasets featuring images of partially visible humans with HPPM annotations. Our experiments, conducted on these benchmark datasets, demonstrate the effectiveness of our D&F method, particularly in scenarios with substantial invisibility, where traditional approaches struggle to maintain reconstruction quality., Comment: Accepted by ECCV2024

For those experiencing severe-to-profound sensorineural hearing loss, the cochlear implant (CI) is the preferred treatment. Augmented reality (AR) aided surgery can potentially improve CI procedures and hearing outcomes. Typically, AR solutions for image-guided surgery rely on optical tracking systems to register pre-operative planning information to the display so that hidden anatomy or other important information can be overlayed and co-registered with the view of the surgical scene. In this paper, our goal is to develop a method that permits direct 2D-to-3D registration of the microscope video to the pre-operative Computed Tomography (CT) scan without the need for external tracking equipment. Our proposed solution involves using surface mapping of a portion of the incus in surgical recordings and determining the pose of this structure relative to the surgical microscope by performing pose estimation via the perspective-n-point (PnP) algorithm. This registration can then be applied to pre-operative segmentations of other anatomy-of-interest, as well as the planned electrode insertion trajectory to co-register this information for the AR display. Our results demonstrate the accuracy with an average rotation error of less than 25 degrees and a translation error of less than 2 mm, 3 mm, and 0.55% for the x, y, and z axes, respectively. Our proposed method has the potential to be applicable and generalized to other surgical procedures while only needing a monocular microscope during intra-operation.

Addressing the intricate challenge of modeling and re-rendering dynamic scenes, most recent approaches have sought to simplify these complexities using plane-based explicit representations, overcoming the slow training time issues associated with methods like Neural Radiance Fields (NeRF) and implicit representations. However, the straightforward decomposition of 4D dynamic scenes into multiple 2D plane-based representations proves insufficient for re-rendering high-fidelity scenes with complex motions. In response, we present a novel direction-aware representation (DaRe) approach that captures scene dynamics from six different directions. This learned representation undergoes an inverse dual-tree complex wavelet transformation (DTCWT) to recover plane-based information. DaReNeRF computes features for each space-time point by fusing vectors from these recovered planes. Combining DaReNeRF with a tiny MLP for color regression and leveraging volume rendering in training yield state-of-the-art performance in novel view synthesis for complex dynamic scenes. Notably, to address redundancy introduced by the six real and six imaginary direction-aware wavelet coefficients, we introduce a trainable masking approach, mitigating storage issues without significant performance decline. Moreover, DaReNeRF maintains a 2x reduction in training time compared to prior art while delivering superior performance., Comment: Accepted at CVPR 2024. Paper + supplementary material

In modern neuroscience, functional magnetic resonance imaging (fMRI) has been a crucial and irreplaceable tool that provides a non-invasive window into the dynamics of whole-brain activity. Nevertheless, fMRI is limited by hemodynamic blurring as well as high cost, immobility, and incompatibility with metal implants. Electroencephalography (EEG) is complementary to fMRI and can directly record the cortical electrical activity at high temporal resolution, but has more limited spatial resolution and is unable to recover information about deep subcortical brain structures. The ability to obtain fMRI information from EEG would enable cost-effective, imaging across a wider set of brain regions. Further, beyond augmenting the capabilities of EEG, cross-modality models would facilitate the interpretation of fMRI signals. However, as both EEG and fMRI are high-dimensional and prone to artifacts, it is currently challenging to model fMRI from EEG. To address this challenge, we propose a novel architecture that can predict fMRI signals directly from multi-channel EEG without explicit feature engineering. Our model achieves this by implementing a Sinusoidal Representation Network (SIREN) to learn frequency information in brain dynamics from EEG, which serves as the input to a subsequent encoder-decoder to effectively reconstruct the fMRI signal from a specific brain region. We evaluate our model using a simultaneous EEG-fMRI dataset with 8 subjects and investigate its potential for predicting subcortical fMRI signals. The present results reveal that our model outperforms a recent state-of-the-art model, and indicates the potential of leveraging periodic activation functions in deep neural networks to model functional neuroimaging data.

Depth estimation in surgical video plays a crucial role in many image-guided surgery procedures. However, it is difficult and time consuming to create depth map ground truth datasets in surgical videos due in part to inconsistent brightness and noise in the surgical scene. Therefore, building an accurate and robust self-supervised depth and camera ego-motion estimation system is gaining more attention from the computer vision community. Although several self-supervision methods alleviate the need for ground truth depth maps and poses, they still need known camera intrinsic parameters, which are often missing or not recorded. Moreover, the camera intrinsic prediction methods in existing works depend heavily on the quality of datasets. In this work, we aimed to build a self-supervised depth and ego-motion estimation system which can predict not only accurate depth maps and camera pose, but also camera intrinsic parameters. We proposed a cost-volume-based supervision manner to give the system auxiliary supervision for camera parameters prediction. The experimental results showed that the proposed method improved the accuracy of estimated camera parameters, ego-motion, and depth estimation., Comment: Accepted by SPIE 2024

The accurate reconstruction of surgical scenes from surgical videos is critical for various applications, including intraoperative navigation and image-guided robotic surgery automation. However, previous approaches, mainly relying on depth estimation, have limited effectiveness in reconstructing surgical scenes with moving surgical tools. To address this limitation and provide accurate 3D position prediction for surgical tools in all frames, we propose a novel approach called SAMSNeRF that combines Segment Anything Model (SAM) and Neural Radiance Field (NeRF) techniques. Our approach generates accurate segmentation masks of surgical tools using SAM, which guides the refinement of the dynamic surgical scene reconstruction by NeRF. Our experimental results on public endoscopy surgical videos demonstrate that our approach successfully reconstructs high-fidelity dynamic surgical scenes and accurately reflects the spatial information of surgical tools. Our proposed approach can significantly enhance surgical navigation and automation by providing surgeons with accurate 3D position information of surgical tools during surgery.The source code will be released soon., Comment: Accepted by SPIE 2024

The Segment Anything Model (SAM) is a recently developed all-range foundation model for image segmentation. It can use sparse manual prompts such as bounding boxes to generate pixel-level segmentation in natural images but struggles in medical images such as low-contrast, noisy ultrasound images. We propose a refined test-phase prompt augmentation technique designed to improve SAM's performance in medical image segmentation. The method couples multi-box prompt augmentation and an aleatoric uncertainty-based false-negative (FN) and false-positive (FP) correction (FNPC) strategy. We evaluate the method on two ultrasound datasets and show improvement in SAM's performance and robustness to inaccurate prompts, without the necessity for further training or tuning. Moreover, we present the Single-Slice-to-Volume (SS2V) method, enabling 3D pixel-level segmentation using only the bounding box annotation from a single 2D slice. Our results allow efficient use of SAM in even noisy, low-contrast medical images. The source code will be released soon.

Robotic assisted (RA) surgery promises to transform surgical intervention. Intuitive Surgical is committed to fostering these changes and the machine learning models and algorithms that will enable them. With these goals in mind we have invited the surgical data science community to participate in a yearly competition hosted through the Medical Imaging Computing and Computer Assisted Interventions (MICCAI) conference. With varying changes from year to year, we have challenged the community to solve difficult machine learning problems in the context of advanced RA applications. Here we document the results of these challenges, focusing on surgical tool localization (SurgToolLoc). The publicly released dataset that accompanies these challenges is detailed in a separate paper arXiv:2501.09209 [1].

Segmenting medical images accurately and reliably is important for disease diagnosis and treatment. It is a challenging task because of the wide variety of objects' sizes, shapes, and scanning modalities. Recently, many convolutional neural networks (CNN) have been designed for segmentation tasks and achieved great success. Few studies, however, have fully considered the sizes of objects, and thus most demonstrate poor performance for small objects segmentation. This can have a significant impact on the early detection of diseases. This paper proposes a Context Axial Reverse Attention Network (CaraNet) to improve the segmentation performance on small objects compared with several recent state-of-the-art models. CaraNet applies axial reserve attention (ARA) and channel-wise feature pyramid (CFP) module to dig feature information of small medical object. And we evaluate our model by six different measurement metrics. We test our CaraNet on brain tumor (BraTS 2018) and polyp (Kvasir-SEG, CVC-ColonDB, CVC-ClinicDB, CVC-300, and ETIS-LaribPolypDB) segmentation datasets. Our CaraNet achieves the top-rank mean Dice segmentation accuracy, and results show a distinct advantage of CaraNet in the segmentation of small medical objects., Comment: arXiv admin note: text overlap with arXiv:2108.07368

Surgical instrument tracking is an active research area that can provide surgeons feedback about the location of their tools relative to anatomy. Recent tracking methods are mainly divided into two parts: segmentation and object detection. However, both can only predict 2D information, which is limiting for application to real-world surgery. An accurate 3D surgical instrument model is a prerequisite for precise predictions of the pose and depth of the instrument. Recent single-view 3D reconstruction methods are only used in natural object reconstruction and do not achieve satisfying reconstruction accuracy without 3D attribute-level supervision. Further, those methods are not suitable for the surgical instruments because of their elongated shapes. In this paper, we firstly propose an end-to-end surgical instrument reconstruction system -- Self-supervised Surgical Instrument Reconstruction (SSIR). With SSIR, we propose a multi-cycle-consistency strategy to help capture the texture information from a slim instrument while only requiring a binary instrument label map. Experiments demonstrate that our approach improves the reconstruction quality of surgical instruments compared to other self-supervised methods and achieves promising results., Comment: Accepted by SPIE Medical Imaging 2023

A common problem with segmentation of medical images using neural networks is the difficulty to obtain a significant number of pixel-level annotated data for training. To address this issue, we proposed a semi-supervised segmentation network based on contrastive learning. In contrast to the previous state-of-the-art, we introduce Min-Max Similarity (MMS), a contrastive learning form of dual-view training by employing classifiers and projectors to build all-negative, and positive and negative feature pairs, respectively, to formulate the learning as solving a MMS problem. The all-negative pairs are used to supervise the networks learning from different views and to capture general features, and the consistency of unlabeled predictions is measured by pixel-wise contrastive loss between positive and negative pairs. To quantitatively and qualitatively evaluate our proposed method, we test it on four public endoscopy surgical tool segmentation datasets and one cochlear implant surgery dataset, which we manually annotated. Results indicate that our proposed method consistently outperforms state-of-the-art semi-supervised and fully supervised segmentation algorithms. And our semi-supervised segmentation algorithm can successfully recognize unknown surgical tools and provide good predictions. Also, our MMS approach could achieve inference speeds of about 40 frames per second (fps) and is suitable to deal with the real-time video segmentation.

Segmenting medical images accurately and reliably is important for disease diagnosis and treatment. It is a challenging task because of the wide variety of objects' sizes, shapes, and scanning modalities. Recently, many convolutional neural networks (CNN) have been designed for segmentation tasks and achieved great success. Few studies, however, have fully considered the sizes of objects, and thus most demonstrate poor performance for small objects segmentation. This can have a significant impact on the early detection of diseases. This paper proposes a Context Axial Reserve Attention Network (CaraNet) to improve the segmentation performance on small objects compared with several recent state-of-the-art models. We test our CaraNet on brain tumor (BraTS 2018) and polyp (Kvasir-SEG, CVC-ColonDB, CVC-ClinicDB, CVC-300, and ETIS-LaribPolypDB) segmentation datasets. Our CaraNet achieves the top-rank mean Dice segmentation accuracy, and results show a distinct advantage of CaraNet in the segmentation of small medical objects., Comment: Accepted by SPIE Medical Imaging: Image Processing (oral presentation)

Currently, developments of deep learning techniques are providing instrumental to identify, classify, and quantify patterns in medical images. Segmentation is one of the important applications in medical image analysis. In this regard, U-Net is the predominant approach to medical image segmentation tasks. However, we found that those U-Net based models have limitations in several aspects, for example, millions of parameters in the U-Net consuming considerable computation resource and memory, lack of global information, and missing some tough objects. Therefore, we applied two modifications to improve the U-Net model: 1) designed and added the dilated channel-wise CNN module, 2) simplified the U shape network. Based on these two modifications, we proposed a novel light-weight architecture -- Channel-wise Feature Pyramid Network for Medicine (CFPNet-M). To evaluate our method, we selected five datasets with different modalities: thermography, electron microscopy, endoscopy, dermoscopy, and digital retinal images. And we compared its performance with several models having different parameter scales. This paper also involves our previous studies of DC-UNet and some commonly used light-weight neural networks. We applied the Tanimoto similarity instead of the Jaccard index for gray-level image measurements. By comparison, CFPNet-M achieves comparable segmentation results on all five medical datasets with only 0.65 million parameters, which is about 2% of U-Net, and 8.8 MB memory. Meanwhile, the inference speed can reach 80 FPS on a single RTX 2070Ti GPU with the 256 by 192 pixels input size.

Real-time semantic segmentation is playing a more important role in computer vision, due to the growing demand for mobile devices and autonomous driving. Therefore, it is very important to achieve a good trade-off among performance, model size and inference speed. In this paper, we propose a Channel-wise Feature Pyramid (CFP) module to balance those factors. Based on the CFP module, we built CFPNet for real-time semantic segmentation which applied a series of dilated convolution channels to extract effective features. Experiments on Cityscapes and CamVid datasets show that the proposed CFPNet achieves an effective combination of those factors. For the Cityscapes test dataset, CFPNet achieves 70.1% class-wise mIoU with only 0.55 million parameters and 2.5 MB memory. The inference speed can reach 30 FPS on a single RTX 2080Ti GPU with a 1024x2048-pixel image., Comment: Accepted by ICIP 2021

Breast cancer is the second leading cause of death for women in the U.S. Early detection of breast cancer is key to higher survival rates of breast cancer patients. We are investigating infrared (IR) thermography as a noninvasive adjunct to mammography for breast cancer screening. IR imaging is radiation-free, pain-free, and non-contact. Automatic segmentation of the breast area from the acquired full-size breast IR images will help limit the area for tumor search, as well as reduce the time and effort costs of manual segmentation. Autoencoder-like convolutional and deconvolutional neural networks (C-DCNN) had been applied to automatically segment the breast area in IR images in previous studies. In this study, we applied a state-of-the-art deep-learning segmentation model, MultiResUnet, which consists of an encoder part to capture features and a decoder part for precise localization. It was used to segment the breast area by using a set of breast IR images, collected in our pilot study by imaging breast cancer patients and normal volunteers with a thermal infrared camera (N2 Imager). The database we used has 450 images, acquired from 14 patients and 16 volunteers. We used a thresholding method to remove interference in the raw images and remapped them from the original 16-bit to 8-bit, and then cropped and segmented the 8-bit images manually. Experiments using leave-one-out cross-validation (LOOCV) and comparison with the ground-truth images by using Tanimoto similarity show that the average accuracy of MultiResUnet is 91.47%, which is about 2% higher than that of the autoencoder. MultiResUnet offers a better approach to segment breast IR images than our previous model., Comment: 6 pages. Accepted by IEEE AIPR 2019 (Oral)

Recently, deep learning has become much more popular in computer vision area. The Convolution Neural Network (CNN) has brought a breakthrough in images segmentation areas, especially, for medical images. In this regard, U-Net is the predominant approach to medical image segmentation task. The U-Net not only performs well in segmenting multimodal medical images generally, but also in some tough cases of them. However, we found that the classical U-Net architecture has limitation in several aspects. Therefore, we applied modifications: 1) designed efficient CNN architecture to replace encoder and decoder, 2) applied residual module to replace skip connection between encoder and decoder to improve based on the-state-of-the-art U-Net model. Following these modifications, we designed a novel architecture--DC-UNet, as a potential successor to the U-Net architecture. We created a new effective CNN architecture and build the DC-UNet based on this CNN. We have evaluated our model on three datasets with tough cases and have obtained a relative improvement in performance of 2.90%, 1.49% and 11.42% respectively compared with classical U-Net. In addition, we used the Tanimoto similarity to replace the Jaccard similarity for gray-to-gray image comparisons.