Christian Daul

Francisco Lopez-Tiro, Juan Pablo Betancur-Rengifo, Arturo Ruiz-Sanchez et al.

Knowing the cause of kidney stone formation is crucial to establish treatments that prevent recurrence. There are currently different approaches for determining the kidney stone type. However, the reference ex-vivo identification procedure can take up to several weeks, while an in-vivo visual recognition requires highly trained specialists. Machine learning models have been developed to provide urologists with an automated classification of kidney stones during an ureteroscopy; however, there is a general lack in terms of quality of the training data and methods. In this work, a two-step transfer learning approach is used to train the kidney stone classifier. The proposed approach transfers knowledge learned on a set of images of kidney stones acquired with a CCD camera (ex-vivo dataset) to a final model that classifies images from endoscopic images (ex-vivo dataset). The results show that learning features from different domains with similar information helps to improve the performance of a model that performs classification in real conditions (for instance, uncontrolled lighting conditions and blur). Finally, in comparison to models that are trained from scratch or by initializing ImageNet weights, the obtained results suggest that the two-step approach extracts features improving the identification of kidney stones in endoscopic images.

Axel Garcia-Vega, Ricardo Espinosa, Luis Ramirez-Guzman et al.

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.

Axel Garcia-Vega, Ricardo Espinosa, Gilberto Ochoa-Ruiz et al.

Endoscopy is the most widely used medical technique for cancer and polyp detection inside hollow organs. However, images acquired by an endoscope are frequently affected by illumination artefacts due to the enlightenment source orientation. There exist two major issues when the endoscope's light source pose suddenly changes: overexposed and underexposed tissue areas are produced. These two scenarios can result in misdiagnosis due to the lack of information in the affected zones or hamper the performance of various computer vision methods (e.g., SLAM, structure from motion, optical flow) used during the non invasive examination. The aim of this work is two-fold: i) to introduce a new synthetically generated data-set generated by a generative adversarial techniques and ii) and to explore both shallow based and deep learning-based image-enhancement methods in overexposed and underexposed lighting conditions. Best quantitative results (i.e., metric based results), were obtained by the deep-learnnig-based LMSPEC method,besides a running time around 7.6 fps)

Elias Villalvazo-Avila, Francisco Lopez-Tiro, Jonathan El-Beze et al.

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.

Mauricio Mendez-Ruiz, Francisco Lopez-Tiro, Jonathan El-Beze et al.

Deep learning has shown great promise in diverse areas of computer vision, such as image classification, object detection and semantic segmentation, among many others. However, as it has been repeatedly demonstrated, deep learning methods trained on a dataset do not generalize well to datasets from other domains or even to similar datasets, due to data distribution shifts. In this work, we propose the use of a meta-learning based few-shot learning approach to alleviate these problems. In order to demonstrate its efficacy, we use two datasets of kidney stones samples acquired with different endoscopes and different acquisition conditions. The results show how such methods are indeed capable of handling domain-shifts by attaining an accuracy of 74.38% and 88.52% in the 5-way 5-shot and 5-way 20-shot settings respectively. Instead, in the same dataset, traditional Deep Learning (DL) methods attain only an accuracy of 45%.

Daniel Flores-Araiza, Francisco Lopez-Tiro, Jonathan El-Beze et al.

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.

Jorge Gonzalez-Zapata, Francisco Lopez-Tiro, Elias Villalvazo-Avila et al.

Several Deep Learning (DL) methods have recently been proposed for an automated identification of kidney stones during an ureteroscopy to enable rapid therapeutic decisions. Even if these DL approaches led to promising results, they are mainly appropriate for kidney stone types for which numerous labelled data are available. However, only few labelled images are available for some rare kidney stone types. This contribution exploits Deep Metric Learning (DML) methods i) to handle such classes with few samples, ii) to generalize well to out of distribution samples, and iii) to cope better with new classes which are added to the database. The proposed Guided Deep Metric Learning approach is based on a novel architecture which was designed to learn data representations in an improved way. The solution was inspired by Few-Shot Learning (FSL) and makes use of a teacher-student approach. The teacher model (GEMINI) generates a reduced hypothesis space based on prior knowledge from the labeled data, and is used it as a guide to a student model (i.e., ResNet50) through a Knowledge Distillation scheme. Extensive tests were first performed on two datasets separately used for the recognition, namely a set of images acquired for the surfaces of the kidney stone fragments, and a set of images of the fragment sections. The proposed DML-approach improved the identification accuracy by 10% and 12% in comparison to DL-methods and other DML-approaches, respectively. Moreover, model embeddings from the two dataset types were merged in an organized way through a multi-view scheme to simultaneously exploit the information of surface and section fragments. Test with the resulting mixed model improves the identification accuracy by at least 3% and up to 30% with respect to DL-models and shallow machine learning methods, respectively.

Daniel Flores-Araiza, Francisco Lopez-Tiro, Elias Villalvazo-Avila et al.

Identifying the type of kidney stones can allow urologists to determine their formation cause, improving the early prescription of appropriate treatments to diminish future relapses. However, 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. Shallow methods have been demonstrated to be reliable and interpretable but exhibit low accuracy, while deep learning-based methods yield high accuracy but are not explainable. However, high stake decisions require understandable computer-aided diagnosis (CAD) to suggest a course of action based on reasonable evidence, rather than merely prescribe one. Herein, we investigate means for learning part-prototypes (PPs) that enable interpretable models. Our proposal suggests a classification for a kidney stone patch image and provides explanations in a similar way as those used on the MCA method.

Francisco Lopez-Tiro, Elias Villalvazo-Avila, Juan Pablo Betancur-Rengifo et al.

This contribution presents a deep-learning method for extracting and fusing image information acquired from different viewpoints, with the aim to produce more discriminant object features for the identification of the type of kidney stones seen in endoscopic images. The model was further improved with a two-step transfer learning approach and by attention blocks to refine the learned feature maps. Deep feature fusion strategies improved the results of single view extraction backbone models by more than 6% in terms of accuracy of the kidney stones classification.

Elias Villalvazo-Avila, Francisco Lopez-Tiro, Daniel Flores-Araiza et al.

This contribution presents a deep-learning method for extracting and fusing image information acquired from different viewpoints with the aim to produce more discriminant object features. Our approach was specifically designed to mimic the morpho-constitutional analysis used by urologists to visually classify kidney stones by inspecting the sections and surfaces of their fragments. Deep feature fusion strategies improved the results of single view extraction backbone models by more than 10\% in terms of precision of the kidney stones classification.

Ivan Reyes-Amezcua, Ricardo Espinosa, Christian Daul et al.

Accurate depth estimation in endoscopy is vital for successfully implementing computer vision pipelines for various medical procedures and CAD tools. In this paper, we present the EndoDepth benchmark, an evaluation framework designed to assess the robustness of monocular depth prediction models in endoscopic scenarios. Unlike traditional datasets, the EndoDepth benchmark incorporates common challenges encountered during endoscopic procedures. We present an evaluation approach that is consistent and specifically designed to evaluate the robustness performance of the model in endoscopic scenarios. Among these is a novel composite metric called the mean Depth Estimation Robustness Score (mDERS), which offers an in-depth evaluation of a model's accuracy against errors brought on by endoscopic image corruptions. Moreover, we present SCARED-C, a new dataset designed specifically to assess endoscopy robustness. Through extensive experimentation, we evaluate state-of-the-art depth prediction architectures on the EndoDepth benchmark, revealing their strengths and weaknesses in handling endoscopic challenging imaging artifacts. Our results demonstrate the importance of specialized techniques for accurate depth estimation in endoscopy and provide valuable insights for future research directions.

Ricardo Espinosa, Carlos Axel Garcia-Vega, Gilberto Ochoa-Ruiz et al.

This contribution shows how an appropriate image pre-processing can improve a deep-learning based 3D reconstruction of colon parts. The assumption is that, rather than global image illumination corrections, local under- and over-exposures should be corrected in colonoscopy. An overview of the pipeline including the image exposure correction and a RNN-SLAM is first given. Then, this paper quantifies the reconstruction accuracy of the endoscope trajectory in the colon with and without appropriate illumination correction

Pedro Esteban Chavarrias-Solano, Carlos Axel Garcia-Vega, Francisco Javier Lopez-Tiro et al.

In this contribution we use an ensemble deep-learning method for combining the prediction of two individual one-stage detectors (i.e., YOLOv4 and Yolact) with the aim to detect artefacts in endoscopic images. This ensemble strategy enabled us to improve the robustness of the individual models without harming their real-time computation capabilities. We demonstrated the effectiveness of our approach by training and testing the two individual models and various ensemble configurations on the "Endoscopic Artifact Detection Challenge" dataset. Extensive experiments show the superiority, in terms of mean average precision, of the ensemble approach over the individual models and previous works in the state of the art.

Ivan Reyes-Amezcua, Michael Rojas-Ruiz, Gilberto Ochoa-Ruiz et al.

Deep learning developments have improved medical imaging diagnoses dramatically, increasing accuracy in several domains. Nonetheless, obstacles continue to exist because of the requirement for huge datasets and legal limitations on data exchange. A solution is provided by Federated Learning (FL), which permits decentralized model training while maintaining data privacy. However, FL models are susceptible to data corruption, which may result in performance degradation. Using pre-trained models, this research suggests a strong FL framework to improve kidney stone diagnosis. Two different kidney stone datasets, each with six different categories of images, are used in our experimental setting. Our method involves two stages: Learning Parameter Optimization (LPO) and Federated Robustness Validation (FRV). We achieved a peak accuracy of 84.1% with seven epochs and 10 rounds during LPO stage, and 77.2% during FRV stage, showing enhanced diagnostic accuracy and robustness against image corruption. This highlights the potential of merging pre-trained models with FL to address privacy and performance concerns in medical diagnostics, and guarantees improved patient care and enhanced trust in FL-based medical systems.

Daniel Flores-Araiza, Francisco Lopez-Tiro, Clément Larose et al.

The in-vivo identification of the kidney stone types during an ureteroscopy would be a major medical advance in urology, as it could reduce the time of the tedious renal calculi extraction process, while diminishing infection risks. Furthermore, such an automated procedure would make possible to prescribe anti-recurrence treatments immediately. Nowadays, only few experienced urologists are able to recognize the kidney stone types in the images of the videos displayed on a screen during the endoscopy. Thus, several deep learning (DL) models have recently been proposed to automatically recognize the kidney stone types using ureteroscopic images. However, these DL models are of black box nature whicl limits their applicability in clinical settings. This contribution proposes a case-based reasoning DL model which uses prototypical parts (PPs) and generates local and global descriptors. The PPs encode for each class (i.e., kidney stone type) visual feature information (hue, saturation, intensity and textures) similar to that used by biologists. The PPs are optimally generated due a new loss function used during the model training. Moreover, the local and global descriptors of PPs allow to explain the decisions ("what" information, "where in the images") in an understandable way for biologists and urologists. The proposed DL model has been tested on a database including images of the six most widespread kidney stone types. The overall average classification accuracy was 90.37. When comparing this results with that of the eight other DL models of the kidney stone state-of-the-art, it can be seen that the valuable gain in explanability was not reached at the expense of accuracy which was even slightly increased with respect to that (88.2) of the best method of the literature. These promising and interpretable results also encourage urologists to put their trust in AI-based solutions.

Ivan Reyes-Amezcua, Francisco Lopez-Tiro, Clément Larose et al.

The reliability of artificial intelligence (AI) in medical imaging critically depends on its robustness to heterogeneous and corrupted images acquired with diverse devices across different hospitals which is highly challenging. Therefore, this paper introduces FedAgain, a trust-based Federated Learning (Federated Learning) strategy designed to enhance robustness and generalization for automated kidney stone identification from endoscopic images. FedAgain integrates a dual trust mechanism that combines benchmark reliability and model divergence to dynamically weight client contributions, mitigating the impact of noisy or adversarial updates during aggregation. The framework enables the training of collaborative models across multiple institutions while preserving data privacy and promoting stable convergence under real-world conditions. Extensive experiments across five datasets, including two canonical benchmarks (MNIST and CIFAR-10), two private multi-institutional kidney stone datasets, and one public dataset (MyStone), demonstrate that FedAgain consistently outperforms standard Federated Learning baselines under non-identically and independently distributed (non-IID) data and corrupted-client scenarios. By maintaining diagnostic accuracy and performance stability under varying conditions, FedAgain represents a practical advance toward reliable, privacy-preserving, and clinically deployable federated AI for medical imaging.

Ruben Gonzalez-Perez, Francisco Lopez-Tiro, Ivan Reyes-Amezcua et al.

Currently, the Morpho-Constitutional Analysis (MCA) is the de facto approach for the etiological diagnosis of kidney stone formation, and it is an important step for establishing personalized treatment to avoid relapses. More recently, research has focused on performing such tasks intra-operatively, an approach known as Endoscopic Stone Recognition (ESR). Both methods rely on features observed in the surface and the section of kidney stones to separate the analyzed samples into several sub-groups. However, given the high intra-observer variability and the complex operating conditions found in ESR, there is a lot of interest in using AI for computer-aided diagnosis. However, current AI models require large datasets to attain a good performance and for generalizing to unseen distributions. This is a major problem as large labeled datasets are very difficult to acquire, and some classes of kidney stones are very rare. Thus, in this paper, we present a method based on diffusion as a way of augmenting pre-existing ex-vivo kidney stone datasets. Our aim is to create plausible diverse kidney stone images that can be used for pre-training models using ex-vivo data. We show that by mixing natural and synthetic images of CCD images, it is possible to train models capable of performing very well on unseen intra-operative data. Our results show that is possible to attain an improvement of 10% in terms of accuracy compared to a baseline model pre-trained only on ImageNet. Moreover, our results show an improvement of 6% for surface images and 10% for section images compared to a model train on CCD images only, which demonstrates the effectiveness of using synthetic images.

Ivan Reyes-Amezcua, Francisco Lopez-Tiro, Clement Larose et al.

Kidney stone classification from endoscopic images is critical for personalized treatment and recurrence prevention. While convolutional neural networks (CNNs) have shown promise in this task, their limited ability to capture long-range dependencies can hinder performance under variable imaging conditions. This study presents a comparative analysis between Vision Transformers (ViTs) and CNN-based models, evaluating their performance on two ex vivo datasets comprising CCD camera and flexible ureteroscope images. The ViT-base model pretrained on ImageNet-21k consistently outperformed a ResNet50 baseline across multiple imaging conditions. For instance, in the most visually complex subset (Section patches from endoscopic images), the ViT model achieved 95.2% accuracy and 95.1% F1-score, compared to 64.5% and 59.3% with ResNet50. In the mixed-view subset from CCD-camera images, ViT reached 87.1% accuracy versus 78.4% with CNN. These improvements extend across precision and recall as well. The results demonstrate that ViT-based architectures provide superior classification performance and offer a scalable alternative to conventional CNNs for kidney stone image analysis.

Carlos Salazar-Ruiz, Francisco Lopez-Tiro, Ivan Reyes-Amezcua et al.

Determining the type of kidney stones is crucial for prescribing appropriate treatments to prevent recurrence. Currently, various approaches exist to identify the type of kidney stones. However, obtaining results through the reference ex vivo identification procedure can take several weeks, while in vivo visual recognition requires highly trained specialists. For this reason, deep learning models have been developed to provide urologists with an automated classification of kidney stones during ureteroscopies. Nevertheless, a common issue with these models is the lack of training data. This contribution presents a deep learning method based on few-shot learning, aimed at producing sufficiently discriminative features for identifying kidney stone types in endoscopic images, even with a very limited number of samples. This approach was specifically designed for scenarios where endoscopic images are scarce or where uncommon classes are present, enabling classification even with a limited training dataset. The results demonstrate that Prototypical Networks, using up to 25% of the training data, can achieve performance equal to or better than traditional deep learning models trained with the complete dataset.

Martin Villagrana, Francisco Lopez-Tiro, Clement Larose et al.

The segmentation of kidney stones is regarded as a critical preliminary step to enable the identification of urinary stone types through machine- or deep-learning-based approaches. In urology, manual segmentation is considered tedious and impractical due to the typically large scale of image databases and the continuous generation of new data. In this study, the potential of the Segment Anything Model (SAM) -- a state-of-the-art deep learning framework -- is investigated for the automation of kidney stone segmentation. The performance of SAM is evaluated in comparison to traditional models, including U-Net, Residual U-Net, and Attention U-Net, which, despite their efficiency, frequently exhibit limitations in generalizing to unseen datasets. The findings highlight SAM's superior adaptability and efficiency. While SAM achieves comparable performance to U-Net on in-distribution data (Accuracy: 97.68 + 3.04; Dice: 97.78 + 2.47; IoU: 95.76 + 4.18), it demonstrates significantly enhanced generalization capabilities on out-of-distribution data, surpassing all U-Net variants by margins of up to 23 percent.

Sharib Ali, Noha Ghatwary, Debesh Jha et al.

Polyps are well-known cancer precursors identified by colonoscopy. However, variability in their size, location, and surface largely affect identification, localisation, and characterisation. Moreover, colonoscopic surveillance and removal of polyps (referred to as polypectomy ) are highly operator-dependent procedures. There exist a high missed detection rate and incomplete removal of colonic polyps due to their variable nature, the difficulties to delineate the abnormality, the high recurrence rates, and the anatomical topography of the colon. There have been several developments in realising automated methods for both detection and segmentation of these polyps using machine learning. However, the major drawback in most of these methods is their ability to generalise to out-of-sample unseen datasets that come from different centres, modalities and acquisition systems. To test this hypothesis rigorously we curated a multi-centre and multi-population dataset acquired from multiple colonoscopy systems and challenged teams comprising machine learning experts to develop robust automated detection and segmentation methods as part of our crowd-sourcing Endoscopic computer vision challenge (EndoCV) 2021. In this paper, we analyse the detection results of the four top (among seven) teams and the segmentation results of the five top teams (among 16). Our analyses demonstrate that the top-ranking teams concentrated on accuracy (i.e., accuracy > 80% on overall Dice score on different validation sets) over real-time performance required for clinical applicability. We further dissect the methods and provide an experiment-based hypothesis that reveals the need for improved generalisability to tackle diversity present in multi-centre datasets.

Francisco Lopez-Tiro, Vincent Estrade, Jacques Hubert et al.

Determining the type of kidney stones allows urologists to prescribe a treatment to avoid recurrence of renal lithiasis. An automated in-vivo image-based classification method would be an important step towards an immediate identification of the kidney stone type required as a first phase of the diagnosis. In the literature it was shown on ex-vivo data (i.e., in very controlled scene and image acquisition conditions) that an automated kidney stone classification is indeed feasible. This pilot study compares the kidney stone recognition performances of six shallow machine learning methods and three deep-learning architectures which were tested with in-vivo images of the four most frequent urinary calculi types acquired with an endoscope during standard ureteroscopies. This contribution details the database construction and the design of the tested kidney stones classifiers. Even if the best results were obtained by the Inception v3 architecture (weighted precision, recall and F1-score of 0.97, 0.98 and 0.97, respectively), it is also shown that choosing an appropriate colour space and texture features allows a shallow machine learning method to approach closely the performances of the most promising deep-learning methods (the XGBoost classifier led to weighted precision, recall and F1-score values of 0.96). This paper is the first one that explores the most discriminant features to be extracted from images acquired during ureteroscopies.

Sharib Ali, Debesh Jha, Noha Ghatwary et al.

Polyps in the colon are widely known cancer precursors identified by colonoscopy. Whilst most polyps are benign, the polyp's number, size and surface structure are linked to the risk of colon cancer. Several methods have been developed to automate polyp detection and segmentation. However, the main issue is that they are not tested rigorously on a large multicentre purpose-built dataset, one reason being the lack of a comprehensive public dataset. As a result, the developed methods may not generalise to different population datasets. To this extent, we have curated a dataset from six unique centres incorporating more than 300 patients. The dataset includes both single frame and sequence data with 3762 annotated polyp labels with precise delineation of polyp boundaries verified by six senior gastroenterologists. To our knowledge, this is the most comprehensive detection and pixel-level segmentation dataset (referred to as \textit{PolypGen}) curated by a team of computational scientists and expert gastroenterologists. The paper provides insight into data construction and annotation strategies, quality assurance, and technical validation. Our dataset can be downloaded from \url{ https://doi.org/10.7303/syn26376615}.

Francisco Lopez, Andres Varela, Oscar Hinojosa et al.

Knowing the type (i.e., the biochemical composition) of kidney stones is crucial to prevent relapses with an appropriate treatment. During ureteroscopies, kidney stones are fragmented, extracted from the urinary tract, and their composition is determined using a morpho-constitutional analysis. This procedure is time consuming (the morpho-constitutional analysis results are only available after some days) and tedious (the fragment extraction lasts up to an hour). Identifying the kidney stone type only with the in-vivo endoscopic images would allow for the dusting of the fragments, while the morpho-constitutional analysis could be avoided. Only few contributions dealing with the in vivo identification of kidney stones were published. This paper discusses and compares five classification methods including deep convolutional neural networks (DCNN)-based approaches and traditional (non DCNN-based) ones. Even if the best method is a DCCN approach with a precision and recall of 98% and 97% over four classes, this contribution shows that a XGBoost classifier exploiting well-chosen feature vectors can closely approach the performances of DCNN classifiers for a medical application with a limited number of annotated data.

Sharib Ali, Mariia Dmitrieva, Noha Ghatwary et al.

The Endoscopy Computer Vision Challenge (EndoCV) is a crowd-sourcing initiative to address eminent problems in developing reliable computer aided detection and diagnosis endoscopy systems and suggest a pathway for clinical translation of technologies. Whilst endoscopy is a widely used diagnostic and treatment tool for hollow-organs, there are several core challenges often faced by endoscopists, mainly: 1) presence of multi-class artefacts that hinder their visual interpretation, and 2) difficulty in identifying subtle precancerous precursors and cancer abnormalities. Artefacts often affect the robustness of deep learning methods applied to the gastrointestinal tract organs as they can be confused with tissue of interest. EndoCV2020 challenges are designed to address research questions in these remits. In this paper, we present a summary of methods developed by the top 17 teams and provide an objective comparison of state-of-the-art methods and methods designed by the participants for two sub-challenges: i) artefact detection and segmentation (EAD2020), and ii) disease detection and segmentation (EDD2020). Multi-center, multi-organ, multi-class, and multi-modal clinical endoscopy datasets were compiled for both EAD2020 and EDD2020 sub-challenges. The out-of-sample generalization ability of detection algorithms was also evaluated. Whilst most teams focused on accuracy improvements, only a few methods hold credibility for clinical usability. The best performing teams provided solutions to tackle class imbalance, and variabilities in size, origin, modality and occurrences by exploring data augmentation, data fusion, and optimal class thresholding techniques.

Sharib Ali, Noha Ghatwary, Barbara Braden et al.

Whilst many technologies are built around endoscopy, there is a need to have a comprehensive dataset collected from multiple centers to address the generalization issues with most deep learning frameworks. What could be more important than disease detection and localization? Through our extensive network of clinical and computational experts, we have collected, curated and annotated gastrointestinal endoscopy video frames. We have released this dataset and have launched disease detection and segmentation challenge EDD2020 https://edd2020.grand-challenge.org to address the limitations and explore new directions. EDD2020 is a crowd sourcing initiative to test the feasibility of recent deep learning methods and to promote research for building robust technologies. In this paper, we provide an overview of the EDD2020 dataset, challenge tasks, evaluation strategies and a short summary of results on test data. A detailed paper will be drafted after the challenge workshop with more detailed analysis of the results.

Sharib Ali, Felix Zhou, Christian Daul et al.

Endoscopic artifacts are a core challenge in facilitating the diagnosis and treatment of diseases in hollow organs. Precise detection of specific artifacts like pixel saturations, motion blur, specular reflections, bubbles and debris is essential for high-quality frame restoration and is crucial for realizing reliable computer-assisted tools for improved patient care. At present most videos in endoscopy are currently not analyzed due to the abundant presence of multi-class artifacts in video frames. Through the endoscopic artifact detection (EAD 2019) challenge, we address this key bottleneck problem by solving the accurate identification and localization of endoscopic frame artifacts to enable further key quantitative analysis of unusable video frames such as mosaicking and 3D reconstruction which is crucial for delivering improved patient care. This paper summarizes the challenge tasks and describes the dataset and evaluation criteria established in the EAD 2019 challenge.

Achraf Ben-Hamadou, Christian Daul, Charles Soussen

3D extended field of views (FOVs) of the internal bladder wall facilitate lesion diagnosis, patient follow-up and treatment traceability. In this paper, we propose a 3D image mosaicing algorithm guided by 2D cystoscopic video-image registration for obtaining textured FOV mosaics. In this feasibility study, the registration makes use of data from a 3D cystoscope prototype providing, in addition to each small FOV image, some 3D points located on the surface. This proof of concept shows that textured surfaces can be constructed with minimally modified cystoscopes. The potential of the method is demonstrated on numerical and real phantoms reproducing various surface shapes. Pig and human bladder textures are superimposed on phantoms with known shape and dimensions. These data allow for quantitative assessment of the 3D mosaicing algorithm based on the registration of images simulating bladder textures.

Achraf Ben-Hamadou, Charles Soussen, Walter Blondel et al.

Bladder cancer is widely spread in the world. Many adequate diagnosis techniques exist. Video-endoscopy remains the standard clinical procedure for visual exploration of the bladder internal surface. However, video-endoscopy presents the limit that the imaged area for each image is about nearly 1cm2. And, lesions are, typically, spread over several images. The aim of this contribution is to assess the performance of two mosaicing algorithms leading to the construction of panoramic maps (one unique image) of bladder walls. The quantitative comparison study is performed on a set of real endoscopic exam data and on simulated data relative to bladder phantom.