Analyse et caractérisation temps réel de vidéos chirurgicales. Application à la chirurgie de la cataracte

Huge amounts of medical data are recorded every day. Those data could be very helpful for medical practice. The LaTIM has acquired solid know-how about the analysis of those data for decision support. In this PhD thesis, we propose to reuse annotated surgical videos previously recorded and stored in a dataset, for computer-aided surgery. To be able to provide relevant information, we first need to recognize which surgical gesture is being performed at each instant of the surgery, based on the monitoring video. This challenging task is the aim of this thesis. We propose an automatic solution to analyze cataract surgeries, in real time, while the video is being recorded. A content based video retrieval (CBVR) method is used to categorize the monitoring video, in combination with a statistical model of the surgical process to bring contextual information. The system performs an on-line analysis of the surgical process at two levels of description for a complete and precise analysis. The methods developed during this thesis have been evaluated in a dataset of cataract surgery videos collected at Brest University Hospital. Promising results were obtained for the automatic analysis of cataract surgeries and surgical gesture recognition. The statistical model allows an analysis which is both fine-tuned and comprehensive. The general approach proposed in this thesis could be easily used for computer aided surgery, by providing recommendations or video sequence examples. The method could also be used to annotate videos for indexing purposes.L'objectif de cette thèse est de fournir aux chirurgiens des aides opératoires en temps réel. Nous nous appuyons pour cela sur des vidéos préalablement archivées et interprétées. Pour que cette aide soit pertinente, il est tout d'abord nécessaire de reconnaître, à chaque instant, le geste pratiqué par le chirurgien. Ce point est essentiel et fait l'objet de cette thèse. Différentes méthodes ont été développées et évaluées, autour de la reconnaissance automatique du geste chirurgical. Nous nous sommes appuyés sur des méthodes de catégorisation (recherche des cas les plus proches basée sur l'extraction du contenu visuel) et des modèles statistiques du processus chirurgical. Les réflexions menées ont permis d'aboutir à une analyse automatique de la chirurgie à plusieurs niveaux de description. L'évaluation des méthodes a été effectuée sur une base de données de vidéos de chirurgies de la cataracte, collectées grâce à une forte collaboration avec le service d'ophtalmologie du CHRU de Brest. Des résultats encourageants ont été obtenus pour la reconnaissance automatique du geste chirurgical. Le modèle statistique multi-échelles développé permet une analyse fine et complète de la chirurgie. L'approche proposée est très générale et devrait permettre d'alerter le chirurgien sur les déroulements opératoires à risques, et lui fournir des recommandations en temps réel sur des conduites à tenir reconnues. Les méthodes développées permettront également d'indexer automatiquement des vidéos chirurgicales archivées

Enquête sur la prise en charge de la douleur aux urgences pédiatriques (analyse de 907 dossiers au Centre hospitalier de Bicêtre (hiver 2000-2001))

PARIS7-Xavier Bichat (751182101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Normalizing Videos of Anterior Eye Segment Surgeries

International audienceAnterior eye segment surgeries are usually video-recorded. If we are able to efficiently analyze surgical videos in real-time, new decision support tools will emerge. The main anatomical landmarks in these videos are the pupil boundaries and the limbus, but segmenting them is challenging due to the variety of colors and textures in the pupil, the iris, the sclera and the lids. In this paper, we present a solution to reliably normalize the center and the scale in videos, without explicitly segmenting these landmarks. First, a robust solution to track the pupil center is presented: it uses the fact that the pupil boundaries, the limbus and the sclera / lid interface are concentric. Second, a solution to estimate the zoom level is presented: it relies on the illumination pattern reflected on the cornea. The proposed solution was assessed in a dataset of 186 real-live cataract surgery videos. The distance between the true and estimated pupil centers was equal to 8.0+/-6.9% of the limbus radius. The correlation between the estimated zoom level and the true limbus size in images was high: R = 0.83

Automated Surgical Step Recognition in Normalized Cataract Surgery Videos

International audienceHuge amounts of surgical data are recorded during video-monitored surgery. Content-based video retrieval systems intent to reuse those data for computer-aided surgery. In this paper, we focus on real-time recognition of cataract surgery steps: the goal is to retrieve from a database surgery videos that were recorded during the same surgery step. The proposed system relies on motion features for video character- ization. Motion features are usually impacted by eye motion or zoom level variations, which are not necessarily relevant for surgery step recognition. Those problems certainly limit the performance of the retrieval system. We therefore propose to refine motion feature extraction by applying pre-processing steps based on a novel pupil center and scale tracking method. Those pre-processing steps are evaluated for two different motion features. In this paper, a similarity measure adapted from Piciarelli's video surveillance system is evaluated for the first time in a surgery dataset. This similarity measure provides good results and for both motion features, the proposed pre- processing steps improved the retrieval performance of the system significantly

Indexing of cataract surgery video by content based video retrieval (CBVR)

International audienceMany surgical computer-aided projects ( CAD ) have emerged in recent years, but none interested in cataract surgery . The aim of our study was to develop a method able to recognize in real time the video stream, identified surgical activities and classify them in a database. We propose to analyze the video stream using a new method describing different levels of granularity : procedure, phases, steps and activities

Real-time analysis of cataract surgery videos using statistical models

International audienceThe automatic analysis of the surgical process, from videos recorded during surgeries, could be very useful to surgeons, both for training and for acquiring new techniques. The training process could be optimized by automatically providing some targeted recommendations or warnings, similar to the expert surgeon’s guidance. In this paper, we propose to reuse videos recorded and stored during cataract surgeries to perform the analysis. The proposed system allows to automatically recognize, in real time, what the surgeon is doing: what surgical phase or, more precisely, what surgical step he or she is performing. This recognition relies on the inference of a multilevel statistical model which uses 1) the conditional relations between levels of description (steps and phases) and 2) the temporal relations among steps and among phases. The model accepts two types of inputs: 1) the presence of surgical tools, manually provided by the surgeons, or 2) motion in videos, automatically analyzed through the Content Based Video retrieval (CBVR) paradigm. Different data-driven statistical models are evaluated in this paper. For this project, a dataset of 30 cataract surgery videos was collected at Brest University hospital. The system was evaluated in terms of area under the ROC curve. Promising results were obtained using either the presence of surgical tools (Az = 0.983) or motion analysis (Az = 0.759). The generality of the method allows to adapt it to other kinds of surgeries. The proposed solution could be used in a computer assisted surgery tool to support surgeons during the surgery. © 2017, Springer Science+Business Media New York

Cohort Creation and Visualization Using Graph Model in the PREDIMED Health Data Warehouse

International audienceGrenoble Alpes University Hospital (CHUGA) is currently deploying a health data warehouse called PREDIMED [1], a platform designed to integrate and analyze for research, education and institutional management the data of patients treated at CHUGA. PREDIMED contains healthcare data, administrative data and, potentially, data from external databases. PREDIMED is hosted by the CHUGA Information Systems Department and benefits from its strict security rules. CHUGA’s institutional project PREDIMED aims to collaborate with similar projects in France and worldwide. In this paper, we present how the data model defined to implement PREDIMED at CHUGA is useful for medical experts to interactively build a cohort of patients and to visualize this cohort