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

A High-level Methodology for Automatically Generating Dynamic Partially Reconfigurable Systems using IP-XACT and the UML MARTE Profile

International audienceDynamic Partial Reconfiguration (DPR) has been introduced in recent years as a method to increase the flexibility of FPGA designs. However, using DPR for building com- plex systems remains a daunting task. Recently, approaches based on Model-Driven Engi- neering (MDE) and UML MARTE standard have emerged which aim to simplify the design of complex SoCs, and in some cases, DPR systems. Nevertheless, many of these approaches lacked a standard intermediate representation to pass from high-levels of descriptions to ex- ecutable models. However, with the recent standardization of the IP-XACT specification, there is an increasing interest to use it in MDE methodologies to ease system integration and to enable design flow automation. In this paper we propose an MARTE/MDE approach which exploits the capabilities of IP-XACT to model and automatically generate DPR SoC designs. We present the MARTE modeling concepts and how these models are mapped to IP-XACT objects; the emphasis is given to the generation of IP cores that can be used in the Xilinx EDK (Embedded Design Kit) environment, since we aim to develop a complete flow around their Dynamic Partial Reconfiguration design flow. Finally, we present a case study integrating the presented concepts, showing the benefits in design efforts compared with a purely VHDL approach and using solely EDK. Experimental results show a reduction of the design efforts required to obtain the netlist required for the DPR design flow from hours required in VHDL and Xilinx EDK, to less the one hour and minutes for IP integration

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

Causal Scoring Medical Image Explanations: A Case Study On Ex-vivo Kidney Stone Images

On the promise that if human users know the cause of an output, it would enable them to grasp the process responsible for the output, and hence provide understanding, many explainable methods have been proposed to indicate the cause for the output of a model based on its input. Nonetheless, little has been reported on quantitative measurements of such causal relationships between the inputs, the explanations, and the outputs of a model, leaving the assessment to the user, independent of his level of expertise in the subject. To address this situation, we explore a technique for measuring the causal relationship between the features from the area of the object of interest in the images of a class and the output of a classifier. Our experiments indicate improvement in the causal relationships measured when the area of the object of interest per class is indicated by a mask from an explainable method than when it is indicated by human annotators. Hence the chosen name of Causal Explanation Score (CaES

Comparison of automatic prostate zones segmentation models in MRI images using U-net-like architectures

Prostate cancer is the second-most frequently diagnosed cancer and the sixth leading cause of cancer death in males worldwide. The main problem that specialists face during the diagnosis of prostate cancer is the localization of Regions of Interest (ROI) containing a tumor tissue. Currently, the segmentation of this ROI in most cases is carried out manually by expert doctors, but the procedure is plagued with low detection rates (of about 27-44%) or overdiagnosis in some patients. Therefore, several research works have tackled the challenge of automatically segmenting and extracting features of the ROI from magnetic resonance images, as this process can greatly facilitate many diagnostic and therapeutic applications. However, the lack of clear prostate boundaries, the heterogeneity inherent to the prostate tissue, and the variety of prostate shapes makes this process very difficult to automate.In this work, six deep learning models were trained and analyzed with a dataset of MRI images obtained from the Centre Hospitalaire de Dijon and Universitat Politecnica de Catalunya. We carried out a comparison of multiple deep learning models (i.e. U-Net, Attention U-Net, Dense-UNet, Attention Dense-UNet, R2U-Net, and Attention R2U-Net) using categorical cross-entropy loss function. The analysis was performed using three metrics commonly used for image segmentation: Dice score, Jaccard index, and mean squared error. The model that give us the best result segmenting all the zones was R2U-Net, which achieved 0.869, 0.782, and 0.00013 for Dice, Jaccard and mean squared error, respectively

FAU-Net: An Attention U-Net Extension with Feature Pyramid Attention for Prostate Cancer Segmentation

This contribution presents a deep learning method for the segmentation of prostate zones in MRI images based on U-Net using additive and feature pyramid attention modules, which can improve the workflow of prostate cancer detection and diagnosis. The proposed model is compared to seven different U-Net-based architectures. The automatic segmentation performance of each model of the central zone (CZ), peripheral zone (PZ), transition zone (TZ) and Tumor were evaluated using Dice Score (DSC), and the Intersection over Union (IoU) metrics. The proposed alternative achieved a mean DSC of 84.15% and IoU of 76.9% in the test set, outperforming most of the studied models in this work except from R2U-Net and attention R2U-Net architectures.Comment: This paper has been accepted at the 22nd Mexican International Conference on Artificial Intelligence (MICAI 2023

Deep Prototypical-Parts Ease Morphological Kidney Stone Identification and are Competitively Robust to Photometric Perturbations

Identifying the type of kidney stones can allow urologists to determine their cause of formation, improving the prescription of appropriate treatments to diminish future relapses. Currently, the associated ex-vivo diagnosis (known as Morpho-constitutional Analysis, MCA) is time-consuming, expensive and requires a great deal of experience, as it requires a visual analysis component that is highly operator dependant. Recently, machine learning methods have been developed for in-vivo endoscopic stone recognition. Deep Learning (DL) based methods outperform non-DL methods in terms of accuracy but lack explainability. Despite this trade-off, when it comes to making high-stakes decisions, it's important to prioritize understandable Computer-Aided Diagnosis (CADx) that suggests a course of action based on reasonable evidence, rather than a model prescribing a course of action. In this proposal, we learn Prototypical Parts (PPs) per kidney stone subtype, which are used by the DL model to generate an output classification. Using PPs in the classification task enables case-based reasoning explanations for such output, thus making the model interpretable. In addition, we modify global visual characteristics to describe their relevance to the PPs and the sensitivity of our model's performance. With this, we provide explanations with additional information at the sample, class and model levels in contrast to previous works. Although our implementation's average accuracy is lower than state-of-the-art (SOTA) non-interpretable DL models by 1.5 %, our models perform 2.8% better on perturbed images with a lower standard deviation, without adversarial training. Thus, Learning PPs has the potential to create more robust DL models.Comment: This paper has been accepted at the LatinX in Computer Vision Research Workshop at CVPR2023 as a full paper and it will appear on the CVPR proceeding

Improved Kidney Stone Recognition Through Attention and Multi-View Feature Fusion Strategies

This contribution presents a deep learning method for the extraction and fusion of information relating to kidney stone fragments acquired from different viewpoints of the endoscope. Surface and section fragment images are jointly used during the training of the classifier to improve the discrimination power of the features by adding attention layers at the end of each convolutional block. This approach is specifically designed to mimic the morpho-constitutional analysis performed in ex-vivo by biologists to visually identify kidney stones by inspecting both views. The addition of attention mechanisms to the backbone improved the results of single view extraction backbones by 4% on average. Moreover, in comparison to the state-of-the-art, the fusion of the deep features improved the overall results up to 11% in terms of kidney stone classification accuracy.Comment: This work has been submitted to the IEEE for possible publication. Copyright may be transferred without notice, after which this version may no longer be accessibl

Multi-Scale Structural-aware Exposure Correction for Endoscopic Imaging

Endoscopy is the most widely used imaging technique for the diagnosis of cancerous lesions in hollow organs. However, endoscopic images are often affected by illumination artefacts: image parts may be over- or underexposed according to the light source pose and the tissue orientation. These artifacts have a strong negative impact on the performance of computer vision or AI-based diagnosis tools. Although endoscopic image enhancement methods are greatly required, little effort has been devoted to over- and under-exposition enhancement in real-time. This contribution presents an extension to the objective function of LMSPEC, a method originally introduced to enhance images from natural scenes. It is used here for the exposure correction in endoscopic imaging and the preservation of structural information. To the best of our knowledge, this contribution is the first one that addresses the enhancement of endoscopic images using deep learning (DL) methods. Tested on the Endo4IE dataset, the proposed implementation has yielded a significant improvement over LMSPEC reaching a SSIM increase of 4.40% and 4.21% for over- and underexposed images, respectively.Comment: This work has been submitted to the IEEE for possible publication. Copyright may be transferred without notice, after which this version may no longer be accessibl