SSIS-Seg: Simulation-supervised image synthesis for surgical instrument segmentation

Surgical instrument segmentation can be used in a range of computer assisted interventions and automation in surgical robotics. While deep learning architectures have rapidly advanced the robustness and performance of segmentation models, most are still reliant on supervision and large quantities of labelled data. In this paper, we present a novel method for surgical image generation that can fuse robotic instrument simulation and recent domain adaptation techniques to synthesize artificial surgical images to train surgical instrument segmentation models. We integrate attention modules into well established image generation pipelines and propose a novel cost function to support supervision from simulation frames in model training. We provide an extensive evaluation of our method in terms of segmentation performance along with a validation study on image quality using evaluation metrics. Additionally, we release a novel segmentation dataset from real surgeries that will be shared for research purposes. Both binary and semantic segmentation have been considered, and we show the capability of our synthetic images to train segmentation models compared with the latest methods from the literature

Fast and Data-Efficient Image Segmentation

Abundance and affordability of cameras has enabled scalable and affordable collection of image data. This has led to many research opportunities both in robot-assisted surgery and general computer vision domain related to image segmentation. In this thesis, we focus on image segmentation problem as it is a fundamental task which has many applications including pose estimation of surgical tools in robotic surgery and eye tracking in head mounted displays. As a result of our work we present a data-efficient method that does not require human annotation of data and exhibits real-time inference. First, we introduce the use of residual neural networks for surgical instrument segmentation for robotic surgery. We show state of the art results on multiple instrument segmentation datasets. Second, we introduce a neural architecture search method that is able to find a very efficient image segmentation model capable of realtime inference. Real-time inference is a crucial requirement for image segmentation methods for robotic surgery. Third, to reduce the amount of annotation required for our method, we introduce a semi-supervised approach which leverages unlabeled images and synthetic training data. Finally, we introduce the use of generative adversarial networks for unsupervised discovery of segmentation classes from unlabeled image data. Here, we show for this first time that this task is possible without any annotated data. Data annotation for image segmentation is a very time consuming procedure as it requires every pixel of an image to be classified into one of the classes. We study the ability of recently introduced multimodal approaches like CLIP to assign text labels to our discovered segmentation regions. At the end, we present a model that is able to not only discover segmentation regions automatically but also assigns text labels them

A comprehensive survey on recent deep learning-based methods applied to surgical data

Minimally invasive surgery is highly operator dependant with a lengthy procedural time causing fatigue to surgeon and risks to patients such as injury to organs, infection, bleeding, and complications of anesthesia. To mitigate such risks, real-time systems are desired to be developed that can provide intra-operative guidance to surgeons. For example, an automated system for tool localization, tool (or tissue) tracking, and depth estimation can enable a clear understanding of surgical scenes preventing miscalculations during surgical procedures. In this work, we present a systematic review of recent machine learning-based approaches including surgical tool localization, segmentation, tracking, and 3D scene perception. Furthermore, we provide a detailed overview of publicly available benchmark datasets widely used for surgical navigation tasks. While recent deep learning architectures have shown promising results, there are still several open research problems such as a lack of annotated datasets, the presence of artifacts in surgical scenes, and non-textured surfaces that hinder 3D reconstruction of the anatomical structures. Based on our comprehensive review, we present a discussion on current gaps and needed steps to improve the adaptation of technology in surgery.Comment: This paper is to be submitted to International journal of computer visio

Simulation-to-Real domain adaptation with teacher-student learning for endoscopic instrument segmentation

Purpose: Segmentation of surgical instruments in endoscopic videos is essential for automated surgical scene understanding and process modeling. However, relying on fully supervised deep learning for this task is challenging because manual annotation occupies valuable time of the clinical experts. Methods: We introduce a teacher-student learning approach that learns jointly from annotated simulation data and unlabeled real data to tackle the erroneous learning problem of the current consistency-based unsupervised domain adaptation framework. Results: Empirical results on three datasets highlight the effectiveness of the proposed framework over current approaches for the endoscopic instrument segmentation task. Additionally, we provide analysis of major factors affecting the performance on all datasets to highlight the strengths and failure modes of our approach. Conclusion: We show that our proposed approach can successfully exploit the unlabeled real endoscopic video frames and improve generalization performance over pure simulation-based training and the previous state-of-the-art. This takes us one step closer to effective segmentation of surgical tools in the annotation scarce setting.Comment: Accepted at IPCAI202

From Fully-Supervised Single-Task to Semi-Supervised Multi-Task Deep Learning Architectures for Segmentation in Medical Imaging Applications

Medical imaging is routinely performed in clinics worldwide for the diagnosis and treatment of numerous medical conditions in children and adults. With the advent of these medical imaging modalities, radiologists can visualize both the structure of the body as well as the tissues within the body. However, analyzing these high-dimensional (2D/3D/4D) images demands a significant amount of time and effort from radiologists. Hence, there is an ever-growing need for medical image computing tools to extract relevant information from the image data to help radiologists perform efficiently. Image analysis based on machine learning has pivotal potential to improve the entire medical imaging pipeline, providing support for clinical decision-making and computer-aided diagnosis. To be effective in addressing challenging image analysis tasks such as classification, detection, registration, and segmentation, specifically for medical imaging applications, deep learning approaches have shown significant improvement in performance. While deep learning has shown its potential in a variety of medical image analysis problems including segmentation, motion estimation, etc., generalizability is still an unsolved problem and many of these successes are achieved at the cost of a large pool of datasets. For most practical applications, getting access to a copious dataset can be very difficult, often impossible. Annotation is tedious and time-consuming. This cost is further amplified when annotation must be done by a clinical expert in medical imaging applications. Additionally, the applications of deep learning in the real-world clinical setting are still limited due to the lack of reliability caused by the limited prediction capabilities of some deep learning models. Moreover, while using a CNN in an automated image analysis pipeline, it’s critical to understand which segmentation results are problematic and require further manual examination. To this extent, the estimation of uncertainty calibration in a semi-supervised setting for medical image segmentation is still rarely reported. This thesis focuses on developing and evaluating optimized machine learning models for a variety of medical imaging applications, ranging from fully-supervised, single-task learning to semi-supervised, multi-task learning that makes efficient use of annotated training data. The contributions of this dissertation are as follows: (1) developing a fully-supervised, single-task transfer learning for the surgical instrument segmentation from laparoscopic images; and (2) utilizing supervised, single-task, transfer learning for segmenting and digitally removing the surgical instruments from endoscopic/laparoscopic videos to allow the visualization of the anatomy being obscured by the tool. The tool removal algorithms use a tool segmentation mask and either instrument-free reference frames or previous instrument-containing frames to fill in (inpaint) the instrument segmentation mask; (3) developing fully-supervised, single-task learning via efficient weight pruning and learned group convolution for accurate left ventricle (LV), right ventricle (RV) blood pool and myocardium localization and segmentation from 4D cine cardiac MR images; (4) demonstrating the use of our fully-supervised memory-efficient model to generate dynamic patient-specific right ventricle (RV) models from cine cardiac MRI dataset via an unsupervised learning-based deformable registration field; and (5) integrating a Monte Carlo dropout into our fully-supervised memory-efficient model with inherent uncertainty estimation, with the overall goal to estimate the uncertainty associated with the obtained segmentation and error, as a means to flag regions that feature less than optimal segmentation results; (6) developing semi-supervised, single-task learning via self-training (through meta pseudo-labeling) in concert with a Teacher network that instructs the Student network by generating pseudo-labels given unlabeled input data; (7) proposing largely-unsupervised, multi-task learning to demonstrate the power of a simple combination of a disentanglement block, variational autoencoder (VAE), generative adversarial network (GAN), and a conditioning layer-based reconstructor for performing two of the foremost critical tasks in medical imaging — segmentation of cardiac structures and reconstruction of the cine cardiac MR images; (8) demonstrating the use of 3D semi-supervised, multi-task learning for jointly learning multiple tasks in a single backbone module – uncertainty estimation, geometric shape generation, and cardiac anatomical structure segmentation of the left atrial cavity from 3D Gadolinium-enhanced magnetic resonance (GE-MR) images. This dissertation summarizes the impact of the contributions of our work in terms of demonstrating the adaptation and use of deep learning architectures featuring different levels of supervision to build a variety of image segmentation tools and techniques that can be used across a wide spectrum of medical image computing applications centered on facilitating and promoting the wide-spread computer-integrated diagnosis and therapy data science

Deep learning for unsupervised domain adaptation in medical imaging: Recent advancements and future perspectives

Deep learning has demonstrated remarkable performance across various tasks in medical imaging. However, these approaches primarily focus on supervised learning, assuming that the training and testing data are drawn from the same distribution. Unfortunately, this assumption may not always hold true in practice. To address these issues, unsupervised domain adaptation (UDA) techniques have been developed to transfer knowledge from a labeled domain to a related but unlabeled domain. In recent years, significant advancements have been made in UDA, resulting in a wide range of methodologies, including feature alignment, image translation, self-supervision, and disentangled representation methods, among others. In this paper, we provide a comprehensive literature review of recent deep UDA approaches in medical imaging from a technical perspective. Specifically, we categorize current UDA research in medical imaging into six groups and further divide them into finer subcategories based on the different tasks they perform. We also discuss the respective datasets used in the studies to assess the divergence between the different domains. Finally, we discuss emerging areas and provide insights and discussions on future research directions to conclude this survey.Comment: Under Revie