Theo J. M. Ruers

Lianne Feenstra, Maud Lambregts, Theo J. M Ruers et al.

The correlation of optical measurements with a correct pathology label is often hampered by imprecise registration caused by deformations in histology images. This study explores an automated multi-modal image registration technique utilizing deep learning principles to align snapshot breast specimen images with corresponding histology images. The input images, acquired through different modalities, present challenges due to variations in intensities and structural visibility, making linear assumptions inappropriate. An unsupervised and supervised learning approach, based on the VoxelMorph model, was explored, making use of a dataset with manually registered images used as ground truth. Evaluation metrics, including Dice scores and mutual information, reveal that the unsupervised model outperforms the supervised (and manual approach) significantly, achieving superior image alignment. This automated registration approach holds promise for improving the validation of optical technologies by minimizing human errors and inconsistencies associated with manual registration.

Lianne Feenstra, Stefan D. van der Stel, Marcos Da Silva Guimaraes et al.

Validation of newly developed optical tissue sensing techniques for tumor detection during cancer surgery requires an accurate correlation with histological results. Additionally, such accurate correlation facilitates precise data labeling for developing high-performance machine-learning tissue classification models. In this paper, a newly developed Point Projection Mapping system will be introduced, which allows non-destructive tracking of the measurement locations on tissue specimens. Additionally, a framework for accurate registration, validation, and labeling with histopathology results is proposed and validated on a case study. The proposed framework provides a more robust and accurate method for tracking and validation of optical tissue sensing techniques, which saves time and resources compared to conventional techniques available.

Tiziano Natali, Liza M. Kurucz, Matteo Fusaglia et al.

Prostate cancer is a leading health concern among men, requiring accurate and accessible methods for early detection and risk stratification. Prostate volume (PV) is a key parameter in multivariate risk stratification for early prostate cancer detection, commonly estimated using transrectal ultrasound (TRUS). While TRUS provides precise prostate volume measurements, its invasive nature often compromises patient comfort. Transabdominal ultrasound (TAUS) provides a non-invasive alternative but faces challenges such as lower image quality, complex interpretation, and reliance on operator expertise. This study introduces a new deep-learning-based framework for automatic PV estimation using TAUS, emphasizing its potential to enable accurate and non-invasive prostate cancer risk stratification. A dataset of TAUS videos from 100 individual patients was curated, with manually delineated prostate boundaries and calculated diameters by an expert clinician as ground truth. The introduced framework integrates deep-learning models for prostate segmentation in both axial and sagittal planes, automatic prostate diameter estimation, and PV calculation. Segmentation performance was evaluated using Dice correlation coefficient (%) and Hausdorff distance (mm). Framework's volume estimation capabilities were evaluated on volumetric error (mL). The framework demonstrates that it can estimate PV from TAUS videos with a mean volumetric error of -5.5 mL, which results in an average relative error between 5 and 15%. The introduced framework for automatic PV estimation from TAUS images, utilizing deep learning models for prostate segmentation, shows promising results. It effectively segments the prostate and estimates its volume, offering potential for reliable, non-invasive risk stratification for early prostate detection.

Karin A. Olthof, Matteo Fusagli, Bianca Güttner et al.

Background: The aim of this study was to develop and evaluate a deep learning-based automated segmentation method for hepatic anatomy (i.e., parenchyma, tumors, portal vein, hepatic vein and biliary tree) from the hepatobiliary phase of gadoxetic acid-enhanced MRI. This method should ease the clinical workflow of preoperative planning. Methods: Manual segmentation was performed on hepatobiliary phase MRI scans from 90 consecutive patients who underwent liver surgery between January 2020 and October 2023. A deep learning network (nnU-Net v1) was trained on 72 patients with an extra focus on thin structures and topography preservation. Performance was evaluated on an 18-patient test set by comparing automated and manual segmentations using Dice similarity coefficient (DSC). Following clinical integration, 10 segmentations (assessment dataset) were generated using the network and manually refined for clinical use to quantify required adjustments using DSC. Results: In the test set, DSCs were 0.97+/-0.01 for liver parenchyma, 0.80+/-0.04 for hepatic vein, 0.79+/-0.07 for biliary tree, 0.77+/-0.17 for tumors, and 0.74+/-0.06 for portal vein. Average tumor detection rate was 76.6+/-24.1%, with a median of one false-positive per patient. The assessment dataset showed minor adjustments were required for clinical use of the 3D models, with high DSCs for parenchyma (1.00+/-0.00), portal vein (0.98+/-0.01) and hepatic vein (0.95+/-0.07). Tumor segmentation exhibited greater variability (DSC 0.80+/-0.27). During prospective clinical use, the model detected three additional tumors initially missed by radiologists. Conclusions: The proposed nnU-Net-based segmentation method enables accurate and automated delineation of hepatic anatomy. This enables 3D planning to be applied efficiently as a standard-of-care for every patient undergoing liver surgery.

Muzammil Khan, Enzo Kerkhof, Matteo Fusaglia et al.

Accurate endoscope pose estimation and 3D tissue surface reconstruction significantly enhances monocular minimally invasive surgical procedures by enabling accurate navigation and improved spatial awareness. However, monocular endoscope pose estimation and tissue reconstruction face persistent challenges, including depth ambiguity, physiological tissue deformation, inconsistent endoscope motion, limited texture fidelity, and a restricted field of view. To overcome these limitations, a unified framework for monocular endoscopic tissue reconstruction that integrates scale-aware depth prediction with temporally-constrained perceptual refinement is presented. This framework incorporates a novel MAPIS-Depth module, which leverages Depth Pro for robust initialisation and Depth Anything for efficient per-frame depth prediction, in conjunction with L-BFGS-B optimisation, to generate pseudo-metric depth estimates. These estimates are temporally refined by computing pixel correspondences using RAFT and adaptively blending flow-warped frames based on LPIPS perceptual similarity, thereby reducing artefacts arising from physiological tissue deformation and motion. To ensure accurate registration of the synthesised pseudo-RGBD frames from MAPIS-Depth, a novel WEMA-RTDL module is integrated, optimising both rotation and translation. Finally, truncated signed distance function-based volumetric fusion and marching cubes are applied to extract a comprehensive 3D surface mesh. Evaluations on HEVD and SCARED, with ablation and comparative analyses, demonstrate the framework's robustness and superiority over state-of-the-art methods.