Simeon Allmendinger

Joao Cartucho, Alistair Weld, Samyakh Tukra et al.

This paper introduces the ``SurgT: Surgical Tracking" challenge which was organised in conjunction with MICCAI 2022. There were two purposes for the creation of this challenge: (1) the establishment of the first standardised benchmark for the research community to assess soft-tissue trackers; and (2) to encourage the development of unsupervised deep learning methods, given the lack of annotated data in surgery. A dataset of 157 stereo endoscopic videos from 20 clinical cases, along with stereo camera calibration parameters, have been provided. Participants were assigned the task of developing algorithms to track the movement of soft tissues, represented by bounding boxes, in stereo endoscopic videos. At the end of the challenge, the developed methods were assessed on a previously hidden test subset. This assessment uses benchmarking metrics that were purposely developed for this challenge, to verify the efficacy of unsupervised deep learning algorithms in tracking soft-tissue. The metric used for ranking the methods was the Expected Average Overlap (EAO) score, which measures the average overlap between a tracker's and the ground truth bounding boxes. Coming first in the challenge was the deep learning submission by ICVS-2Ai with a superior EAO score of 0.617. This method employs ARFlow to estimate unsupervised dense optical flow from cropped images, using photometric and regularization losses. Second, Jmees with an EAO of 0.583, uses deep learning for surgical tool segmentation on top of a non-deep learning baseline method: CSRT. CSRT by itself scores a similar EAO of 0.563. The results from this challenge show that currently, non-deep learning methods are still competitive. The dataset and benchmarking tool created for this challenge have been made publicly available at https://surgt.grand-challenge.org/.

Leopold Müller, Patrick Hemmer, Moritz Queisner et al.

A significant challenge in image-guided surgery is the accurate measurement task of relevant structures such as vessel segments, resection margins, or bowel lengths. While this task is an essential component of many surgeries, it involves substantial human effort and is prone to inaccuracies. In this paper, we develop a novel human-AI-based method for laparoscopic measurements utilizing stereo vision that has been guided by practicing surgeons. Based on a holistic qualitative requirements analysis, this work proposes a comprehensive measurement method, which comprises state-of-the-art machine learning architectures, such as RAFT-Stereo and YOLOv8. The developed method is assessed in various realistic experimental evaluation environments. Our results outline the potential of our method achieving high accuracies in distance measurements with errors below 1 mm. Furthermore, on-surface measurements demonstrate robustness when applied in challenging environments with textureless regions. Overall, by addressing the inherent challenges of image-guided surgery, we lay the foundation for a more robust and accurate solution for intra- and postoperative measurements, enabling more precise, safe, and efficient surgical procedures.

Simeon Allmendinger, Luca Deck, Lucas Mueller

Rapid advances in Generative AI are giving rise to increasingly sophisticated Multi-Agent AI (MAAI) systems. While AI fairness has been extensively studied in traditional predictive scenarios, its examination in MAAI remains nascent and fragmented. This scoping review critically synthesizes existing research on fairness in MAAI systems. Through a qualitative content analysis of 23 selected studies, we identify five archetypal approaches. Our findings reveal that fairness in MAAI systems is often addressed superficially, lacks robust normative foundations, and frequently overlooks the complex dynamics introduced by agent autonomy and system-level interactions. We argue that fairness must be embedded structurally throughout the development lifecycle of MAAI, rather than appended as a post-hoc consideration. Meaningful evaluation requires explicit human oversight, normative clarity, and a precise articulation of fairness objectives and beneficiaries. This review provides a foundation for advancing fairness research in MAAI systems by highlighting critical gaps, exposing prevailing limitations, and suggesting pathways.

Luca Deck, Simeon Allmendinger, Lucas Müller et al.

In the late 2010s, the fashion trend NormCore framed sameness as a signal of belonging, illustrating how norms emerge through collective coordination. Today, similar forms of normative coordination can be observed in systems based on Multi-agent Artificial Intelligence (MAAI), as AI-based agents deliberate, negotiate, and converge on shared decisions in fairness-sensitive domains. Yet, existing empirical approaches often treat norms as targets for alignment or replication, implicitly assuming equivalence between human subjects and AI agents and leaving collective normative dynamics insufficiently examined. To address this gap, we propose Normative Common Ground Replication (NormCoRe), a novel methodological framework to systematically translate the design of human subject experiments into MAAI environments. Building on behavioral science, replication research, and state-of-the-art MAAI architectures, NormCoRe maps the structural layers of human subject studies onto the design of AI agent studies, enabling systematic documentation of study design and analysis of norms in MAAI. We demonstrate the utility of NormCoRe by replicating a seminal experimental study on distributive justice, in which participants negotiate fairness principles under a "veil of ignorance". We show that normative judgments in AI agent studies can differ from human baselines and are sensitive to the choice of the foundation model and the language used to instantiate agent personas. Our work provides a principled pathway for analyzing norms in MAAI and helps to guide, reflect, and document design choices whenever AI agents are used to automate or support tasks formerly carried out by humans.

Ivan Iliash, Simeon Allmendinger, Felix Meissen et al.

Generative AI, in general, and synthetic visual data generation, in specific, hold much promise for benefiting surgical training by providing photorealism to simulation environments. Current training methods primarily rely on reading materials and observing live surgeries, which can be time-consuming and impractical. In this work, we take a significant step towards improving the training process. Specifically, we use diffusion models in combination with a zero-shot video diffusion method to interactively generate realistic laparoscopic images and videos by specifying a surgical action through text and guiding the generation with tool positions through segmentation masks. We demonstrate the performance of our approach using the publicly available Cholec dataset family and evaluate the fidelity and factual correctness of our generated images using a surgical action recognition model as well as the pixel-wise F1-score for the spatial control of tool generation. We achieve an FID of 38.097 and an F1-score of 0.71.

Simeon Allmendinger, Patrick Hemmer, Moritz Queisner et al.

Recent advances in synthetic imaging open up opportunities for obtaining additional data in the field of surgical imaging. This data can provide reliable supplements supporting surgical applications and decision-making through computer vision. Particularly the field of image-guided surgery, such as laparoscopic and robotic-assisted surgery, benefits strongly from synthetic image datasets and virtual surgical training methods. Our study presents an intuitive approach for generating synthetic laparoscopic images from short text prompts using diffusion-based generative models. We demonstrate the usage of state-of-the-art text-to-image architectures in the context of laparoscopic imaging with regard to the surgical removal of the gallbladder as an example. Results on fidelity and diversity demonstrate that diffusion-based models can acquire knowledge about the style and semantics in the field of image-guided surgery. A validation study with a human assessment survey underlines the realistic nature of our synthetic data, as medical personnel detects actual images in a pool with generated images causing a false-positive rate of 66%. In addition, the investigation of a state-of-the-art machine learning model to recognize surgical actions indicates enhanced results when trained with additional generated images of up to 5.20%. Overall, the achieved image quality contributes to the usage of computer-generated images in surgical applications and enhances its path to maturity.

Paul Zaha, Lars Böcking, Simeon Allmendinger et al.

Medical image segmentation is crucial for disease diagnosis and treatment planning, yet developing robust segmentation models often requires substantial computational resources and large datasets. Existing research shows that pre-trained and finetuned foundation models can boost segmentation performance. However, questions remain about how particular image preprocessing steps may influence segmentation performance across different medical imaging modalities. In particular, edges-abrupt transitions in pixel intensity-are widely acknowledged as vital cues for object boundaries but have not been systematically examined in the pre-training of foundation models. We address this gap by investigating to which extend pre-training with data processed using computationally efficient edge kernels, such as kirsch, can improve cross-modality segmentation capabilities of a foundation model. Two versions of a foundation model are first trained on either raw or edge-enhanced data across multiple medical imaging modalities, then finetuned on selected raw subsets tailored to specific medical modalities. After systematic investigation using the medical domains Dermoscopy, Fundus, Mammography, Microscopy, OCT, US, and XRay, we discover both increased and reduced segmentation performance across modalities using edge-focused pre-training, indicating the need for a selective application of this approach. To guide such selective applications, we propose a meta-learning strategy. It uses standard deviation and image entropy of the raw image to choose between a model pre-trained on edge-enhanced or on raw data for optimal performance. Our experiments show that integrating this meta-learning layer yields an overall segmentation performance improvement across diverse medical imaging tasks by 16.42% compared to models pre-trained on edge-enhanced data only and 19.30% compared to models pre-trained on raw data only.

Sarah Ball, Simeon Allmendinger, Frauke Kreuter et al.

Generative AI (GenAI) is increasingly used in survey contexts to simulate human preferences. While many research endeavors evaluate the quality of synthetic GenAI data by comparing model-generated responses to gold-standard survey results, fundamental questions about the validity and reliability of using LLMs as substitutes for human respondents remain. Our study provides a technical analysis of how demographic attributes and prompt variations influence latent opinion mappings in large language models (LLMs) and evaluates their suitability for survey-based predictions. Using 14 different models, we find that LLM-generated data fails to replicate the variance observed in real-world human responses, particularly across demographic subgroups. In the political space, persona-to-party mappings exhibit limited differentiation, resulting in synthetic data that lacks the nuanced distribution of opinions found in survey data. Moreover, we show that prompt sensitivity can significantly alter outputs for some models, further undermining the stability and predictiveness of LLM-based simulations. As a key contribution, we adapt a probe-based methodology that reveals how LLMs encode political affiliations in their latent space, exposing the systematic distortions introduced by these models. Our findings highlight critical limitations in AI-generated survey data, urging caution in its use for public opinion research, social science experimentation, and computational behavioral modeling.

Simeon Allmendinger, Domenique Zipperling, Lukas Struppek et al.

In the landscape of generative artificial intelligence, diffusion-based models have emerged as a promising method for generating synthetic images. However, the application of diffusion models poses numerous challenges, particularly concerning data availability, computational requirements, and privacy. Traditional approaches to address these shortcomings, like federated learning, often impose significant computational burdens on individual clients, especially those with constrained resources. In response to these challenges, we introduce a novel approach for distributed collaborative diffusion models inspired by split learning. Our approach facilitates collaborative training of diffusion models while alleviating client computational burdens during image synthesis. This reduced computational burden is achieved by retaining data and computationally inexpensive processes locally at each client while outsourcing the computationally expensive processes to shared, more efficient server resources. Through experiments on the common CelebA dataset, our approach demonstrates enhanced privacy by reducing the necessity for sharing raw data. These capabilities hold significant potential across various application areas, including the design of edge computing solutions. Thus, our work advances distributed machine learning by contributing to the evolution of collaborative diffusion models.

Domenique Zipperling, Simeon Allmendinger, Lukas Struppek et al.

In the landscape of generative artificial intelligence, diffusion-based models present challenges for socio-technical systems in data requirements and privacy. Traditional approaches like federated learning distribute the learning process but strain individual clients, especially with constrained resources (e.g., edge devices). In response to these challenges, we introduce CollaFuse, a novel framework inspired by split learning. Tailored for efficient and collaborative use of denoising diffusion probabilistic models, CollaFuse enables shared server training and inference, alleviating client computational burdens. This is achieved by retaining data and computationally inexpensive GPU processes locally at each client while outsourcing the computationally expensive processes to the shared server. Demonstrated in a healthcare context, CollaFuse enhances privacy by highly reducing the need for sensitive information sharing. These capabilities hold the potential to impact various application areas, such as the design of edge computing solutions, healthcare research, or autonomous driving. In essence, our work advances distributed machine learning, shaping the future of collaborative GenAI networks.