PURPOSE: Fetoscopic laser photocoagulation is a minimally invasive procedure to treat twin-to-twin transfusion syndrome during pregnancy by stopping irregular blood flow in the placenta. Building an image mosaic of the placenta and its network of vessels could assist surgeons to navigate in the challenging fetoscopic environment during the procedure. METHODOLOGY: We propose a fetoscopic mosaicking approach by combining deep learning-based optical flow with robust estimation for filtering inconsistent motions that occurs due to floating particles and specularities. While the current state of the art for fetoscopic mosaicking relies on clearly visible vessels for registration, our approach overcomes this limitation by considering the motion of all consistent pixels within consecutive frames. We also overcome the challenges in applying off-the-shelf optical flow to fetoscopic mosaicking through the use of robust estimation and local refinement. RESULTS: We compare our proposed method against the state-of-the-art vessel-based and optical flow-based image registration methods, and robust estimation alternatives. We also compare our proposed pipeline using different optical flow and robust estimation alternatives. CONCLUSIONS: Through analysis of our results, we show that our method outperforms both the vessel-based state of the art and LK, noticeably when vessels are either poorly visible or too thin to be reliably identified. Our approach is thus able to build consistent placental vessel mosaics in challenging cases where currently available alternatives fail
