Dense Vision in Image-guided Surgery

Image-guided surgery needs an efficient and effective camera tracking system in order to perform augmented reality for overlaying preoperative models or label cancerous tissues on the 2D video images of the surgical scene. Tracking in endoscopic/laparoscopic scenes however is an extremely difficult task primarily due to tissue deformation, instrument invasion into the surgical scene and the presence of specular highlights. State of the art feature-based SLAM systems such as PTAM fail in tracking such scenes since the number of good features to track is very limited. When the scene is smoky and when there are instrument motions, it will cause feature-based tracking to fail immediately. The work of this thesis provides a systematic approach to this problem using dense vision. We initially attempted to register a 3D preoperative model with multiple 2D endoscopic/laparoscopic images using a dense method but this approach did not perform well. We subsequently proposed stereo reconstruction to directly obtain the 3D structure of the scene. By using the dense reconstructed model together with robust estimation, we demonstrate that dense stereo tracking can be incredibly robust even within extremely challenging endoscopic/laparoscopic scenes. Several validation experiments have been conducted in this thesis. The proposed stereo reconstruction algorithm has turned out to be the state of the art method for several publicly available ground truth datasets. Furthermore, the proposed robust dense stereo tracking algorithm has been proved highly accurate in synthetic environment (< 0.1 mm RMSE) and qualitatively extremely robust when being applied to real scenes in RALP prostatectomy surgery. This is an important step toward achieving accurate image-guided laparoscopic surgery.Open Acces

Real-time Geometry-Aware Augmented Reality in Minimally Invasive Surgery

The potential of Augmented Reality (AR) technology to assist minimally invasive surgeries (MIS) lies in its computational performanceand accuracy in dealing with challenging MIS scenes. Even with the latest hardware and software technologies, achieving both real-timeand accurate augmented information overlay in MIS is still a formidable task. In this paper, we present a novel real-time AR frameworkfor MIS that achieves interactive geometric aware augmented reality in endoscopic surgery with stereo views. Our framework tracks themovement of the endoscopic camera and simultaneously reconstructs a dense geometric mesh of the MIS scene. The movement of the camerais predicted by minimising the re-projection error to achieve a fast tracking performance, while the 3D mesh is incrementally built by a densezero mean normalised cross correlation stereo matching method to improve the accuracy of the surface reconstruction. Our proposed systemdoes not require any prior template or pre-operative scan and can infer the geometric information intra-operatively in real-time. With thegeometric information available, our proposed AR framework is able to interactively add annotations, localisation of tumors and vessels,and measurement labeling with greater precision and accuracy compared with the state of the art approaches

Recent Developments and Future Challenges in Medical Mixed Reality

As AR technology matures, we have seen many applicationsemerge in entertainment, education and training. However, the useof AR is not yet common in medical practice, despite the great po-tential of this technology to help not only learning and training inmedicine, but also in assisting diagnosis and surgical guidance. Inthis paper, we present recent trends in the use of AR across all med-ical specialties and identify challenges that must be overcome tonarrow the gap between academic research and practical use of ARin medicine. A database of 1403 relevant research papers publishedover the last two decades has been reviewed by using a novel re-search trend analysis method based on text mining algorithm. Wesemantically identified 10 topics including varies of technologiesand applications based on the non-biased and in-personal cluster-ing results from the Latent Dirichlet Allocatio (LDA) model andanalysed the trend of each topic from 1995 to 2015. The statisticresults reveal a taxonomy that can best describes the developmentof the medical AR research during the two decades. And the trendanalysis provide a higher level of view of how the taxonomy haschanged and where the focus will goes. Finally, based on the valu-able results, we provide a insightful discussion to the current limi-tations, challenges and future directions in the field. Our objectiveis to aid researchers to focus on the application areas in medicalAR that are most needed, as well as providing medical practitioners with latest technology advancements

Self-Supervised Siamese Learning on Stereo Image Pairs for Depth Estimation in Robotic Surgery

Robotic surgery has become a powerful tool for performing minimally invasive procedures, providing advantages in dexterity, precision, and 3D vision, over traditional surgery. One popular robotic system is the da Vinci surgical platform, which allows preoperative information to be incorporated into live procedures using Augmented Reality (AR). Scene depth estimation is a prerequisite for AR, as accurate registration requires 3D correspondences between preoperative and intraoperative organ models. In the past decade, there has been much progress on depth estimation for surgical scenes, such as using monocular or binocular laparoscopes [1,2]. More recently, advances in deep learning have enabled depth estimation via Convolutional Neural Networks (CNNs) [3], but training requires a large image dataset with ground truth depths. Inspired by [4], we propose a deep learning framework for surgical scene depth estimation using self-supervision for scalable data acquisition. Our framework consists of an autoencoder for depth prediction, and a differentiable spatial transformer for training the autoencoder on stereo image pairs without ground truth depths. Validation was conducted on stereo videos collected in robotic partial nephrectomy.Comment: A two-page short report to be presented at the Hamlyn Symposium on Medical Robotics 2017. An extension of this work is on progres

The Challenge of Augmented Reality in Surgery

Imaging has revolutionized surgery over the last 50 years. Diagnostic imaging is a key tool for deciding to perform surgery during disease management; intraoperative imaging is one of the primary drivers for minimally invasive surgery (MIS), and postoperative imaging enables effective follow-up and patient monitoring. However, notably, there is still relatively little interchange of information or imaging modality fusion between these different clinical pathway stages. This book chapter provides a critique of existing augmented reality (AR) methods or application studies described in the literature using relevant examples. The aim is not to provide a comprehensive review, but rather to give an indication of the clinical areas in which AR has been proposed, to begin to explain the lack of clinical systems and to provide some clear guidelines to those intending pursue research in this area

On-the-fly dense 3D surface reconstruction for geometry-aware augmented reality.

Augmented Reality (AR) is an emerging technology that makes seamless connections between virtual space and the real world by superimposing computer-generated information onto the real-world environment. AR can provide additional information in a more intuitive and natural way than any other information-delivery method that a human has ever in- vented. Camera tracking is the enabling technology for AR and has been well studied for the last few decades. Apart from the tracking problems, sensing and perception of the surrounding environment are also very important and challenging problems. Although there are existing hardware solutions such as Microsoft Kinect and HoloLens that can sense and build the environmental structure, they are either too bulky or too expensive for AR. In this thesis, the challenging real-time dense 3D surface reconstruction technologies are studied and reformulated for the reinvention of basic position-aware AR towards geometry-aware and the outlook of context- aware AR. We initially propose to reconstruct the dense environmental surface using the sparse point from Simultaneous Localisation and Map- ping (SLAM), but this approach is prone to fail in challenging Minimally Invasive Surgery (MIS) scenes such as the presence of deformation and surgical smoke. We subsequently adopt stereo vision with SLAM for more accurate and robust results. With the success of deep learning technology in recent years, we present learning based single image re- construction and achieve the state-of-the-art results. Moreover, we pro- posed context-aware AR, one step further from purely geometry-aware AR towards the high-level conceptual interaction modelling in complex AR environment for enhanced user experience. Finally, a learning-based smoke removal method is proposed to ensure an accurate and robust reconstruction under extreme conditions such as the presence of surgical smoke

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

Ultrasound-Augmented Laparoscopy

Laparoscopic surgery is perhaps the most common minimally invasive procedure for many diseases in the abdomen. Since the laparoscopic camera provides only the surface view of the internal organs, in many procedures, surgeons use laparoscopic ultrasound (LUS) to visualize deep-seated surgical targets. Conventionally, the 2D LUS image is visualized in a display spatially separate from that displays the laparoscopic video. Therefore, reasoning about the geometry of hidden targets requires mentally solving the spatial alignment, and resolving the modality differences, which is cognitively very challenging. Moreover, the mental representation of hidden targets in space acquired through such cognitive medication may be error prone, and cause incorrect actions to be performed. To remedy this, advanced visualization strategies are required where the US information is visualized in the context of the laparoscopic video. To this end, efficient computational methods are required to accurately align the US image coordinate system with that centred in the camera, and to render the registered image information in the context of the camera such that surgeons perceive the geometry of hidden targets accurately. In this thesis, such a visualization pipeline is described. A novel method to register US images with a camera centric coordinate system is detailed with an experimental investigation into its accuracy bounds. An improved method to blend US information with the surface view is also presented with an experimental investigation into the accuracy of perception of the target locations in space