Quantitative Screening of Cervical Cancers for Low-Resource Settings: Pilot Study of Smartphone-Based Endoscopic Visual Inspection After Acetic Acid Using Machine Learning Techniques

Background: Approximately 90% of global cervical cancer (CC) is mostly found in low- and middle-income countries. In most cases, CC can be detected early through routine screening programs, including a cytology-based test. However, it is logistically difficult to offer this program in low-resource settings due to limited resources and infrastructure, and few trained experts. A visual inspection following the application of acetic acid (VIA) has been widely promoted and is routinely recommended as a viable form of CC screening in resource-constrained countries. Digital images of the cervix have been acquired during VIA procedure with better quality assurance and visualization, leading to higher diagnostic accuracy and reduction of the variability of detection rate. However, a colposcope is bulky, expensive, electricity-dependent, and needs routine maintenance, and to confirm the grade of abnormality through its images, a specialist must be present. Recently, smartphone-based imaging systems have made a significant impact on the practice of medicine by offering a cost-effective, rapid, and noninvasive method of evaluation. Furthermore, computer-aided analyses, including image processing-based methods and machine learning techniques, have also shown great potential for a high impact on medicinal evaluations

A deep learning framework for quality assessment and restoration in video endoscopy

Endoscopy is a routine imaging technique used for both diagnosis and minimally invasive surgical treatment. Artifacts such as motion blur, bubbles, specular reflections, floating objects and pixel saturation impede the visual interpretation and the automated analysis of endoscopy videos. Given the widespread use of endoscopy in different clinical applications, we contend that the robust and reliable identification of such artifacts and the automated restoration of corrupted video frames is a fundamental medical imaging problem. Existing state-of-the-art methods only deal with the detection and restoration of selected artifacts. However, typically endoscopy videos contain numerous artifacts which motivates to establish a comprehensive solution. We propose a fully automatic framework that can: 1) detect and classify six different primary artifacts, 2) provide a quality score for each frame and 3) restore mildly corrupted frames. To detect different artifacts our framework exploits fast multi-scale, single stage convolutional neural network detector. We introduce a quality metric to assess frame quality and predict image restoration success. Generative adversarial networks with carefully chosen regularization are finally used to restore corrupted frames. Our detector yields the highest mean average precision (mAP at 5% threshold) of 49.0 and the lowest computational time of 88 ms allowing for accurate real-time processing. Our restoration models for blind deblurring, saturation correction and inpainting demonstrate significant improvements over previous methods. On a set of 10 test videos we show that our approach preserves an average of 68.7% which is 25% more frames than that retained from the raw videos.Comment: 14 page

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

Advanced Endoscopic Navigation:Surgical Big Data,Methodology,and Applications

随着科学技术的飞速发展，健康与环境问题日益成为人类面临的最重大问题之一。信息科学、计算机技术、电子工程与生物医学工程等学科的综合应用交叉前沿课题，研究现代工程技术方法，探索肿瘤癌症等疾病早期诊断、治疗和康复手段。本论文综述了计算机辅助微创外科手术导航、多模态医疗大数据、方法论及其临床应用：从引入微创外科手术导航概念出发，介绍了医疗大数据的术前与术中多模态医学成像方法、阐述了先进微创外科手术导航的核心流程包括计算解剖模型、术中实时导航方案、三维可视化方法及交互式软件技术，归纳了各类微创外科手术方法的临床应用。同时，重点讨论了全球各种手术导航技术在临床应用中的优缺点，分析了目前手术导航领域内的最新技术方法。在此基础上，提出了微创外科手术方法正向数字化、个性化、精准化、诊疗一体化、机器人化以及高度智能化的发展趋势。【Abstract】Interventional endoscopy (e.g., bronchoscopy, colonoscopy, laparoscopy, cystoscopy) is a widely performed procedure that involves either diagnosis of suspicious lesions or guidance for minimally invasive surgery in a variety of organs within the body cavity. Endoscopy may also be used to guide the introduction of certain items (e.g., stents) into the body. Endoscopic navigation systems seek to integrate big data with multimodal information (e.g., computed tomography, magnetic resonance images, endoscopic video sequences, ultrasound images, external trackers) relative to the patient's anatomy, control the movement of medical endoscopes and surgical tools, and guide the surgeon's actions during endoscopic interventions. Nevertheless, it remains challenging to realize the next generation of context-aware navigated endoscopy. This review presents a broad survey of various aspects of endoscopic navigation, particularly with respect to the development of endoscopic navigation techniques. First, we investigate big data with multimodal information involved in endoscopic navigation. Next, we focus on numerous methodologies used for endoscopic navigation. We then review different endoscopic procedures in clinical applications. Finally, we discuss novel techniques and promising directions for the development of endoscopic navigation.X.L. acknowledges funding from the Fundamental Research Funds for the Central Universities. T.M.P. acknowledges funding from the Canadian Foundation for Innovation, the Canadian Institutes for Health Research, the National Sciences and Engineering Research Council of Canada, and a grant from Intuitive Surgical Inc

Endoscopic image analysis of aberrant crypt foci

Tese de Mestrado Integrado. Bioengenharia. Faculdade de Engenharia. Universidade do Porto. 201

Color Image Enhancement Techniques for Endoscopic images

Modern endoscopes play an important role in diagnosing various gastrointestinal (GI) tract related diseases. Although clinical findings of modern endoscopic imaging techniques are encouraging, there still remains much room for improvement of image quality. Of greatest concern, endoscopic images suffer from various degradations, such as specular highlights, non-uniform brightness and poor contrast. As a result, gastroenterologists often face difficulty in successfully identifying the subtle features, such as mucosal surface and structures, pit patterns, size and pattern of micro-vessels, tissue and vascular characteristics, superficial layer of mucosal and abnormal growths in endoscopic images. The improved visual quality of images can provide better diagnosis. This paper presents two proposed post-processing techniques for enhancing the subtle features of endoscopic images. The first proposed technique is named as endoscopic image enhancement based on adaptive sigmoid function and space-variant color reproduction (ASSVCR). It is achieved in two stages: image enhancement at gray level followed by color reproduction with the help of space variant chrominance mapping. Image enhancement is achieved by performing adaptive sigmoid function and uniform distribution of sigmoid pixels. Then color reproduction is used to generate new chrominance components. The second proposed technique is named as tri-scan. It is achieved in three stages: (1) Tissue and surface enhancement: a modified linear unsharp masking is used to sharpen the surface and edges of tissue and vascular characteristics, (2) Mucosa layer enhancement: an adaptive sigmoid function similar to the ASSVCR technique is employed on the R plane of the image to highlight the superficial layers of mucosa, (3) Color tone enhancement: the pixels are uniformly distributed to create a different color effect to highlight mucosa structures, superficial layers of mucosa and tissue characteristics. Both techniques are compared with other related works. Several performance metrics like focus value, statistic of visual representation, measurement of uniform distribution, color similarity test, color enhancement factor (CEF) and time complexity are used to assess the performance. The results showed improved performance compared to similar existing methods. In the post-processed images, we have observed that the ASSVCR can enhance and highlight pit patterns, tissue and vascular characteristics, mucosa structures and abnormal growths. It cannot highlight size and pattern of micro-vessels, and superficial layer of mucosa. In contrast, tri-scan can enhance and highlight all above mentioned features of endoscopic images