Optical techniques for 3D surface reconstruction in computer-assisted laparoscopic surgery

One of the main challenges for computer-assisted surgery (CAS) is to determine the intra-opera- tive morphology and motion of soft-tissues. This information is prerequisite to the registration of multi-modal patient-specific data for enhancing the surgeon’s navigation capabilites by observ- ing beyond exposed tissue surfaces and for providing intelligent control of robotic-assisted in- struments. In minimally invasive surgery (MIS), optical techniques are an increasingly attractive approach for in vivo 3D reconstruction of the soft-tissue surface geometry. This paper reviews the state-of-the-art methods for optical intra-operative 3D reconstruction in laparoscopic surgery and discusses the technical challenges and future perspectives towards clinical translation. With the recent paradigm shift of surgical practice towards MIS and new developments in 3D opti- cal imaging, this is a timely discussion about technologies that could facilitate complex CAS procedures in dynamic and deformable anatomical regions

Intraoperative Extraction of Airways Anatomy in VideoBronchoscopy

A main bottleneck in bronchoscopic biopsy sampling is to efficiently reach the lesion navigating across bronchial levels. Any guidance system should be able to localize the scope position during the intervention with minimal costs and alteration of clinical protocols. With the final goal of an affordable image-based guidance, this work presents a novel strategy to extract and codify the anatomical structure of bronchi, as well as, the scope navigation path from videobronchoscopy. Experiments using interventional data show that our method accurately identifies the bronchial structure. Meanwhile, experiments using simulated data verify that the extracted navigation path matches the 3D route

Tracking and Mapping in Medical Computer Vision: A Review

As computer vision algorithms are becoming more capable, their applications in clinical systems will become more pervasive. These applications include diagnostics such as colonoscopy and bronchoscopy, guiding biopsies and minimally invasive interventions and surgery, automating instrument motion and providing image guidance using pre-operative scans. Many of these applications depend on the specific visual nature of medical scenes and require designing and applying algorithms to perform in this environment. In this review, we provide an update to the field of camera-based tracking and scene mapping in surgery and diagnostics in medical computer vision. We begin with describing our review process, which results in a final list of 515 papers that we cover. We then give a high-level summary of the state of the art and provide relevant background for those who need tracking and mapping for their clinical applications. We then review datasets provided in the field and the clinical needs therein. Then, we delve in depth into the algorithmic side, and summarize recent developments, which should be especially useful for algorithm designers and to those looking to understand the capability of off-the-shelf methods. We focus on algorithms for deformable environments while also reviewing the essential building blocks in rigid tracking and mapping since there is a large amount of crossover in methods. Finally, we discuss the current state of the tracking and mapping methods along with needs for future algorithms, needs for quantification, and the viability of clinical applications in the field. We conclude that new methods need to be designed or combined to support clinical applications in deformable environments, and more focus needs to be put into collecting datasets for training and evaluation.Comment: 31 pages, 17 figure

Generative localisation with uncertainty estimation through video-CT data for bronchoscopic biopsy

Robot-assisted endobronchial intervention requires accurate localisation based on both intra- and pre-operative data. Most existing methods achieve this by registering 2D videos with 3D CT models according to a defined similarity metric with local features. Instead, we formulate the bronchoscopic localisation as a learning-based global localisation using deep neural networks. The proposed network consists of two generative architectures and one auxiliary learning component. The cycle generative architecture bridges the domain variance between the real bronchoscopic videos and virtual views derived from pre-operative CT data so that the proposed approach can be trained through a large number of generated virtual images but deployed through real images. The auxiliary learning architecture leverages complementary relative pose regression to constrain the search space, ensuring consistent global pose predictions. Most importantly, the uncertainty of each global pose is obtained through variational inference by sampling within the learned underlying probability distribution. Detailed validation results demonstrate the localisation accuracy with reasonable uncertainty achieved and its potential clinical value

Towards Robot Autonomy in Medical Procedures Via Visual Localization and Motion Planning

Robots performing medical procedures with autonomous capabilities have the potential to positively effect patient care and healthcare system efficiency. These benefits can be realized by autonomous robots facilitating novel procedures, increasing operative efficiency, standardizing intra- and inter-physician performance, democratizing specialized care, and focusing the physician’s time on subtasks that best leverage their expertise. However, enabling medical robots to act autonomously in a procedural environment is extremely challenging. The deforming and unstructured nature of the environment, the lack of features in the anatomy, and sensor size constraints coupled with the millimeter level accuracy required for safe medical procedures introduce a host of challenges not faced by robots operating in structured environments such as factories or warehouses. Robot motion planning and localization are two fundamental abilities for enabling robot autonomy. Motion planning methods compute a sequence of safe and feasible motions for a robot to accomplish a specified task, where safe and feasible are defined by constraints with respect to the robot and its environment. Localization methods estimate the position and orientation of a robot in its environment. Developing such methods for medical robots that overcome the unique challenges in procedural environments is critical for enabling medical robot autonomy. In this dissertation, I developed and evaluated motion planning and localization algorithms towards robot autonomy in medical procedures. A majority of my work was done in the context of an autonomous medical robot built for enhanced lung nodule biopsy. First, I developed a dataset of medical environments spanning various organs and procedures to foster future research into medical robots and automation. I used this data in my own work described throughout this dissertation. Next, I used motion planning to characterize the capabilities of the lung nodule biopsy robot compared to existing clinical tools and I highlighted trade-offs in robot design considerations. Then, I conducted a study to experimentally demonstrate the benefits of the autonomous lung robot in accessing otherwise hard-to-reach lung nodules. I showed that the robot enables access to lung regions beyond the reach of existing clinical tools with millimeter-level accuracy sufficient for accessing the smallest clinically operable nodules. Next, I developed a localization method to estimate the bronchoscope’s position and orientation in the airways with respect to a preoperatively planned needle insertion pose. The method can be used by robotic bronchoscopy systems and by traditional manually navigated bronchoscopes. The method is designed to overcome challenges with tissue motion and visual homogeneity in the airways. I demonstrated the success of this method in simulated lungs undergoing respiratory motion and showed the method’s ability to generalize across patients.Doctor of Philosoph

Appearance Modelling and Reconstruction for Navigation in Minimally Invasive Surgery

Minimally invasive surgery is playing an increasingly important role for patient care. Whilst its direct patient benefit in terms of reduced trauma, improved recovery and shortened hospitalisation has been well established, there is a sustained need for improved training of the existing procedures and the development of new smart instruments to tackle the issue of visualisation, ergonomic control, haptic and tactile feedback. For endoscopic intervention, the small field of view in the presence of a complex anatomy can easily introduce disorientation to the operator as the tortuous access pathway is not always easy to predict and control with standard endoscopes. Effective training through simulation devices, based on either virtual reality or mixed-reality simulators, can help to improve the spatial awareness, consistency and safety of these procedures. This thesis examines the use of endoscopic videos for both simulation and navigation purposes. More specifically, it addresses the challenging problem of how to build high-fidelity subject-specific simulation environments for improved training and skills assessment. Issues related to mesh parameterisation and texture blending are investigated. With the maturity of computer vision in terms of both 3D shape reconstruction and localisation and mapping, vision-based techniques have enjoyed significant interest in recent years for surgical navigation. The thesis also tackles the problem of how to use vision-based techniques for providing a detailed 3D map and dynamically expanded field of view to improve spatial awareness and avoid operator disorientation. The key advantage of this approach is that it does not require additional hardware, and thus introduces minimal interference to the existing surgical workflow. The derived 3D map can be effectively integrated with pre-operative data, allowing both global and local 3D navigation by taking into account tissue structural and appearance changes. Both simulation and laboratory-based experiments are conducted throughout this research to assess the practical value of the method proposed

Re-localisation of microscopic lesions in their macroscopic context for surgical instrument guidance

Optical biopsies interrogate microscopic structure in vivo with a 2mm diameter miniprobe placed in contact with the tissue for detection of lesions and assessment of disease progression. After detection, instruments are guided to the lesion location for a new optical interrogation, or for treatment, or for tissue excision during the same or a future examination. As the optical measurement can be considered as a point source of information at the surface of the tissue of interest, accurate guidance can be difficult. A method for re-localisation of the sampling point is, therefore, needed. The method presented in this thesis has been developed for biopsy site re-localisation during a surveillance examination of Barrett’s Oesophagus. The biopsy site, invisible macroscopically during conventional endoscopy, is re-localised in the target endoscopic image using epipolar lines derived from its locations given by the tip of the miniprobe visible in a series of reference endoscopic images. A confidence region can be drawn around the relocalised biopsy site from its uncertainty that is derived analytically. This thesis also presents a method to improve the accuracy of the epipolar lines derived for the biopsy site relocalisation using an electromagnetic tracking system. Simulations and tests on patient data identified the cases when the analytical uncertainty is a good approximation of the confidence region and showed that biopsy sites can be re-localised with accuracies better than 1mm. Studies on phantom and on porcine excised tissue demonstrated that an electromagnetic tracking system contributes to more accurate epipolar lines and re-localised biopsy sites for an endoscope displacement greater than 5mm. The re-localisation method can be applied to images acquired during different endoscopic examinations. It may also be useful for pulmonary applications. Finally, it can be combined with a Magnetic Resonance scanner which can steer cells to the biopsy site for tissue treatment

Activity profiling for minimally invasive surgery

Imperial Users onl

Scene Reconstruction Beyond Structure-from-Motion and Multi-View Stereo

Image-based 3D reconstruction has become a robust technology for recovering accurate and realistic models of real-world objects and scenes. A common pipeline for 3D reconstruction is to first apply Structure-from-Motion (SfM), which recovers relative poses for the input images and sparse geometry for the scene, and then apply Multi-view Stereo (MVS), which estimates a dense depthmap for each image. While this two-stage process is quite effective in many 3D modeling scenarios, there are limits to what can be reconstructed. This dissertation focuses on three particular scenarios where the SfM+MVS pipeline fails and introduces new approaches to accomplish each reconstruction task. First, I introduce a novel method to recover dense surface reconstructions of endoscopic video. In this setting, SfM can generally provide sparse surface structure, but the lack of surface texture as well as complex, changing illumination often causes MVS to fail. To overcome these difficulties, I introduce a method that utilizes SfM both to guide surface reflectance estimation and to regularize shading-based depth reconstruction. I also introduce models of reflectance and illumination that improve the final result. Second, I introduce an approach for augmenting 3D reconstructions from large-scale Internet photo-collections by recovering the 3D position of transient objects --- specifically, people --- in the input imagery. Since no two images can be assumed to capture the same person in the same location, the typical triangulation constraints enjoyed by SfM and MVS cannot be directly applied. I introduce an alternative method to approximately triangulate people who stood in similar locations, aided by a height distribution prior and visibility constraints provided by SfM. The scale of the scene, gravity direction, and per-person ground-surface normals are also recovered. Finally, I introduce the concept of using crowd-sourced imagery to create living 3D reconstructions --- visualizations of real places that include dynamic representations of transient objects. A key difficulty here is that SfM+MVS pipelines often poorly reconstruct ground surfaces given Internet images. To address this, I introduce a volumetric reconstruction approach that leverages scene scale and person placements. Crowd simulation is then employed to add virtual pedestrians to the space and bring the reconstruction "to life."Doctor of Philosoph

Towards Quantitative Endoscopy with Vision Intelligence

In this thesis, we work on topics related to quantitative endoscopy with vision-based intelligence. Specifically, our works revolve around the topic of video reconstruction in endoscopy, where many challenges exist, such as texture scarceness, illumination variation, multimodality, etc., and these prevent prior works from working effectively and robustly. To this end, we propose to combine the strength of expressivity of deep learning approaches and the rigorousness and accuracy of non-linear optimization algorithms to develop a series of methods to confront such challenges towards quantitative endoscopy. We first propose a retrospective sparse reconstruction method that can estimate a high-accuracy and density point cloud and high-completeness camera trajectory from a monocular endoscopic video with state-of-the-art performance. To enable this, replacing the role of a hand-crafted local descriptor, a deep image feature descriptor is developed to boost the feature matching performance in a typical sparse reconstruction algorithm. A retrospective surface reconstruction pipeline is then proposed to estimate a textured surface model from a monocular endoscopic video, where self-supervised depth and descriptor learning and surface fusion technique is involved. We show that the proposed method performs superior to a popular dense reconstruction method and the estimate reconstructions are in good agreement with the surface models obtained from CT scans. To align video-reconstructed surface models with pre-operative imaging such as CT, we introduce a global point cloud registration algorithm that is robust to resolution mismatch that often happens in such multi-modal scenarios. Specifically, a geometric feature descriptor is developed where a novel network normalization technique is used to help a 3D network produce more consistent and distinctive geometric features for samples with different resolutions. The proposed geometric descriptor achieves state-of-the-art performance, based on our evaluation. Last but not least, a real-time SLAM system that estimates a surface geometry and camera trajectory from a monocular endoscopic video is developed, where deep representations for geometry and appearance and non-linear factor graph optimization are used. We show that the proposed SLAM system performs favorably compared with a state-of-the-art feature-based SLAM system