Dingjie Su

Yike Zhang, Eduardo Davalos, Dingjie Su et al.

Cochlear Implant (CI) procedures require the insertion of an electrode array into the cochlea within the inner ear. To achieve this, mastoidectomy, a surgical procedure involving the removal of part of the mastoid region of the temporal bone using a high-speed drill provides safe access to the cochlea through the middle and inner ear. In this paper, we propose a novel Mamba-based method to synthesize the mastoidectomy volume using only preoperative Computed Tomography (CT) scans, where the mastoid remains intact. Our approach introduces a self-supervised learning framework designed to predict the mastoidectomy shape and reconstruct a 3D post-mastoidectomy surface directly from preoperative CT scans. This reconstruction aligns with intraoperative microscope views, enabling various downstream surgical applications. For training, we leverage postoperative CT scans to bypass manual data cleaning and labeling, even when the region removed during mastoidectomy is affected by challenges such as metal artifacts, low signal-to-noise ratio, or electrode wiring. Our method achieves a mean Dice score of 0.70 in estimating mastoidectomy regions, demonstrating its effectiveness for accurate and efficient surgical preoperative planning.

Dingjie Su, Weixiang Hong, Benoit M. Dawant et al.

We propose a novel method for establishing correspondence between two sequences of 2D images. One particular application of this technique is slice-level content navigation, where the goal is to localize specific 2D slices within a 3D volume or determine the anatomical coverage of a 3D scan based on its 2D slices. This serves as an important preprocessing step for various diagnostic tasks, as well as for automatic registration and segmentation pipelines. Our approach builds sequence correspondence by training a network to learn how to insert a slice from one sequence into the appropriate position in another. This is achieved by encoding contextual representations of each slice and modeling the insertion process using a slice-to-slice attention mechanism. We apply this method to localize manually labeled key slices in body CT scans and compare its performance to the current state-of-the-art alternative known as body part regression, which predicts anatomical position scores for individual slices. Unlike body part regression, which treats each slice independently, our method leverages contextual information from the entire sequence. Experimental results show that the insertion network reduces slice localization errors in supervised settings from 8.4 mm to 5.4 mm, demonstrating a substantial improvement in accuracy.

Yike Zhang, Eduardo Davalos, Dingjie Su et al.

For those experiencing severe-to-profound sensorineural hearing loss, the cochlear implant (CI) is the preferred treatment. Augmented reality (AR) aided surgery can potentially improve CI procedures and hearing outcomes. Typically, AR solutions for image-guided surgery rely on optical tracking systems to register pre-operative planning information to the display so that hidden anatomy or other important information can be overlayed and co-registered with the view of the surgical scene. In this paper, our goal is to develop a method that permits direct 2D-to-3D registration of the microscope video to the pre-operative Computed Tomography (CT) scan without the need for external tracking equipment. Our proposed solution involves using surface mapping of a portion of the incus in surgical recordings and determining the pose of this structure relative to the surgical microscope by performing pose estimation via the perspective-n-point (PnP) algorithm. This registration can then be applied to pre-operative segmentations of other anatomy-of-interest, as well as the planned electrode insertion trajectory to co-register this information for the AR display. Our results demonstrate the accuracy with an average rotation error of less than 25 degrees and a translation error of less than 2 mm, 3 mm, and 0.55% for the x, y, and z axes, respectively. Our proposed method has the potential to be applicable and generalized to other surgical procedures while only needing a monocular microscope during intra-operation.

Yike Zhang, Eduardo Davalos, Dingjie Su et al.

Cochlear Implant (CI) surgery treats severe hearing loss by inserting an electrode array into the cochlea to stimulate the auditory nerve. An important step in this procedure is mastoidectomy, which removes part of the mastoid region of the temporal bone to provide surgical access. Accurate mastoidectomy shape prediction from preoperative imaging improves pre-surgical planning, reduces risks, and enhances surgical outcomes. Despite its importance, there are limited deep-learning-based studies regarding this topic due to the challenges of acquiring ground-truth labels. We address this gap by investigating self-supervised and weakly-supervised learning models to predict the mastoidectomy region without human annotations. We propose a hybrid self-supervised and weakly-supervised learning framework to predict the mastoidectomy region directly from preoperative CT scans, where the mastoid remains intact. Our hybrid method achieves a mean Dice score of 0.72 when predicting the complex and boundary-less mastoidectomy shape, surpassing state-of-the-art approaches and demonstrating strong performance. The method provides groundwork for constructing 3D postmastoidectomy surfaces directly from the corresponding preoperative CT scans. To our knowledge, this is the first work that integrating self-supervised and weakly-supervised learning for mastoidectomy shape prediction, offering a robust and efficient solution for CI surgical planning while leveraging 3D T-distribution loss in weakly-supervised medical imaging.

Han Liu, Yubo Fan, Can Cui et al.

Automatic methods to segment the vestibular schwannoma (VS) tumors and the cochlea from magnetic resonance imaging (MRI) are critical to VS treatment planning. Although supervised methods have achieved satisfactory performance in VS segmentation, they require full annotations by experts, which is laborious and time-consuming. In this work, we aim to tackle the VS and cochlea segmentation problem in an unsupervised domain adaptation setting. Our proposed method leverages both the image-level domain alignment to minimize the domain divergence and semi-supervised training to further boost the performance. Furthermore, we propose to fuse the labels predicted from multiple models via noisy label correction. In the MICCAI 2021 crossMoDA challenge, our results on the final evaluation leaderboard showed that our proposed method has achieved promising segmentation performance with mean dice score of 79.9% and 82.5% and ASSD of 1.29 mm and 0.18 mm for VS tumor and cochlea, respectively. The cochlea ASSD achieved by our method has outperformed all other competing methods as well as the supervised nnU-Net.

Han Liu, Yubo Fan, Can Cui et al.

Automatic methods to segment the vestibular schwannoma (VS) tumors and the cochlea from magnetic resonance imaging (MRI) are critical to VS treatment planning. Although supervised methods have achieved satisfactory performance in VS segmentation, they require full annotations by experts, which is laborious and time-consuming. In this work, we aim to tackle the VS and cochlea segmentation problem in an unsupervised domain adaptation setting. Our proposed method leverages both the image-level domain alignment to minimize the domain divergence and semi-supervised training to further boost the performance. Furthermore, we propose to fuse the labels predicted from multiple models via noisy label correction. Our results on the challenge validation leaderboard showed that our unsupervised method has achieved promising VS and cochlea segmentation performance with mean dice score of 0.8261 $\pm$ 0.0416; The mean dice value for the tumor is 0.8302 $\pm$ 0.0772. This is comparable to the weakly-supervised based method.

Jianing Wang, Dingjie Su, Yubo Fan et al.

We propose an atlas-based method to segment the intracochlear anatomy (ICA) in the post-implantation CT (Post-CT) images of cochlear implant (CI) recipients that preserves the point-to-point correspondence between the meshes in the atlas and the segmented volumes. To solve this problem, which is challenging because of the strong artifacts produced by the implant, we use a pair of co-trained deep networks that generate dense deformation fields (DDFs) in opposite directions. One network is tasked with registering an atlas image to the Post-CT images and the other network is tasked with registering the Post-CT images to the atlas image. The networks are trained using loss functions based on voxel-wise labels, image content, fiducial registration error, and cycle-consistency constraint. The segmentation of the ICA in the Post-CT images is subsequently obtained by transferring the predefined segmentation meshes of the ICA in the atlas image to the Post-CT images using the corresponding DDFs generated by the trained registration networks. Our model can learn the underlying geometric features of the ICA even though they are obscured by the metal artifacts. We show that our end-to-end network produces results that are comparable to the current state of the art (SOTA) that relies on a two-steps approach that first uses conditional generative adversarial networks to synthesize artifact-free images from the Post-CT images and then uses an active shape model-based method to segment the ICA in the synthetic images. Our method requires a fraction of the time needed by the SOTA, which is important for end-user acceptance.