Efficient video indexing for monitoring disease activity and progression in the upper gastrointestinal tract

Endoscopy is a routine imaging technique used for both diagnosis and minimally invasive surgical treatment. While the endoscopy video contains a wealth of information, tools to capture this information for the purpose of clinical reporting are rather poor. In date, endoscopists do not have any access to tools that enable them to browse the video data in an efficient and user friendly manner. Fast and reliable video retrieval methods could for example, allow them to review data from previous exams and therefore improve their ability to monitor disease progression. Deep learning provides new avenues of compressing and indexing video in an extremely efficient manner. In this study, we propose to use an autoencoder for efficient video compression and fast retrieval of video images. To boost the accuracy of video image retrieval and to address data variability like multi-modality and view-point changes, we propose the integration of a Siamese network. We demonstrate that our approach is competitive in retrieving images from 3 large scale videos of 3 different patients obtained against the query samples of their previous diagnosis. Quantitative validation shows that the combined approach yield an overall improvement of 5% and 8% over classical and variational autoencoders, respectively.Comment: Accepted at IEEE International Symposium on Biomedical Imaging (ISBI), 201

Real-time polyp segmentation using U-net with IoU loss

Colonoscopy is the third leading cause of cancer deaths worldwide. While automated segmentation methods can help detect polyps and consequently improve their surgical removal, the clinical usability of these methods requires a trade-off between accuracy and speed. In this work, we exploit the traditional U-Net methods and compare different segmentation-loss functions. Our results demonstrate that IoU loss results in an improved segmentation performance (nearly 3% improvement on Dice) for real-time polyp segmentation

SSL-CPCD: Self-supervised learning with composite pretext-class discrimination for improved generalisability in endoscopic image analysis

Data-driven methods have shown tremendous progress in medical image analysis. In this context, deep learning-based supervised methods are widely popular. However, they require a large amount of training data and face issues in generalisability to unseen datasets that hinder clinical translation. Endoscopic imaging data incorporates large inter- and intra-patient variability that makes these models more challenging to learn representative features for downstream tasks. Thus, despite the publicly available datasets and datasets that can be generated within hospitals, most supervised models still underperform. While self-supervised learning has addressed this problem to some extent in natural scene data, there is a considerable performance gap in the medical image domain. In this paper, we propose to explore patch-level instance-group discrimination and penalisation of inter-class variation using additive angular margin within the cosine similarity metrics. Our novel approach enables models to learn to cluster similar representative patches, thereby improving their ability to provide better separation between different classes. Our results demonstrate significant improvement on all metrics over the state-of-the-art (SOTA) methods on the test set from the same and diverse datasets. We evaluated our approach for classification, detection, and segmentation. SSL-CPCD achieves 79.77% on Top 1 accuracy for ulcerative colitis classification, 88.62% on mAP for polyp detection, and 82.32% on dice similarity coefficient for segmentation tasks are nearly over 4%, 2%, and 3%, respectively, compared to the baseline architectures. We also demonstrate that our method generalises better than all SOTA methods to unseen datasets, reporting nearly 7% improvement in our generalisability assessment.Comment: 1

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

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

SUPRA: Superpixel Guided Loss for Improved Multi-modal Segmentation in Endoscopy

Domain shift is a well-known problem in the medical imaging community. In particular, for endoscopic image analysis where the data can have different modalities the performance of deep learning (DL) methods gets adversely affected. In other words, methods developed on one modality cannot be used for a different modality. However, in real clinical settings, endoscopists switch between modalities for better mucosal visualisation. In this paper, we explore the domain generalisation technique to enable DL methods to be used in such scenarios. To this extend, we propose to use super pixels generated with Simple Linear Iterative Clustering (SLIC) which we refer to as "SUPRA" for SUPeRpixel Augmented method. SUPRA first generates a preliminary segmentation mask making use of our new loss "SLICLoss" that encourages both an accurate and color-consistent segmentation. We demonstrate that SLICLoss when combined with Binary Cross Entropy loss (BCE) can improve the model's generalisability with data that presents significant domain shift. We validate this novel compound loss on a vanilla U-Net using the EndoUDA dataset, which contains images for Barret's Esophagus and polyps from two modalities. We show that our method yields an improvement of nearly 20% in the target domain set compared to the baseline.Comment: This work has been accepted at the LatinX in Computer Vision Research Workshop at CVPR 202

Multi-task learning with cross-task consistency for improved depth estimation in colonoscopy

Colonoscopy screening is the gold standard procedure for assessing abnormalities in the colon and rectum, such as ulcers and cancerous polyps. Measuring the abnormal mucosal area and its 3D reconstruction can help quantify the surveyed area and objectively evaluate disease burden. However, due to the complex topology of these organs and variable physical conditions, for example, lighting, large homogeneous texture, and image modality estimating distance from the camera aka depth) is highly challenging. Moreover, most colonoscopic video acquisition is monocular, making the depth estimation a non-trivial problem. While methods in computer vision for depth estimation have been proposed and advanced on natural scene datasets, the efficacy of these techniques has not been widely quantified on colonoscopy datasets. As the colonic mucosa has several low-texture regions that are not well pronounced, learning representations from an auxiliary task can improve salient feature extraction, allowing estimation of accurate camera depths. In this work, we propose to develop a novel multi-task learning (MTL) approach with a shared encoder and two decoders, namely a surface normal decoder and a depth estimator decoder. Our depth estimator incorporates attention mechanisms to enhance global context awareness. We leverage the surface normal prediction to improve geometric feature extraction. Also, we apply a cross-task consistency loss among the two geometrically related tasks, surface normal and camera depth. We demonstrate an improvement of 14.17% on relative error and 10.4% improvement on $\delta_{1}$ accuracy over the most accurate baseline state-of-the-art BTS approach. All experiments are conducted on a recently released C3VD dataset; thus, we provide a first benchmark of state-of-the-art methods.Comment: 19 page

Patch-level instance-group discrimination with pretext-invariant learning for colitis scoring

Inflammatory bowel disease (IBD), in particular ulcerative colitis (UC), is graded by endoscopists and this assessment is the basis for risk stratification and therapy monitoring. Presently, endoscopic characterisation is largely operator dependant leading to sometimes undesirable clinical outcomes for patients with IBD. We focus on the Mayo Endoscopic Scoring (MES) system which is widely used but requires the reliable identification of subtle changes in mucosal inflammation. Most existing deep learning classification methods cannot detect these fine-grained changes which make UC grading such a challenging task. In this work, we introduce a novel patch-level instance-group discrimination with pretext-invariant representation learning (PLD-PIRL) for self-supervised learning (SSL). Our experiments demonstrate both improved accuracy and robustness compared to the baseline supervised network and several state-of-the-art SSL methods. Compared to the baseline (ResNet50) supervised classification our proposed PLD-PIRL obtained an improvement of 4.75% on hold-out test data and 6.64% on unseen center test data for top-1 accuracy.Comment: 1