Anirban Mukhopadhyay

Nicolas Wagner, Moritz Fuchs, Yuri Tolkach et al.

Although deep federated learning has received much attention in recent years, progress has been made mainly in the context of natural images and barely for computational pathology. However, deep federated learning is an opportunity to create datasets that reflect the data diversity of many laboratories. Further, the effort of dataset construction can be divided among many. Unfortunately, existing algorithms cannot be easily applied to computational pathology since previous work presupposes that data distributions of laboratories must be similar. This is an unlikely assumption, mainly since different laboratories have different staining styles. As a solution, we propose BottleGAN, a generative model that can computationally align the staining styles of many laboratories and can be trained in a privacy-preserving manner to foster federated learning in computational pathology. We construct a heterogenic multi-institutional dataset based on the PESO segmentation dataset and improve the IOU by 42\% compared to existing federated learning algorithms. An implementation of BottleGAN is available at https://github.com/MECLabTUDA/BottleGAN

Yannik Frisch, Moritz Fuchs, Antoine Sanner et al.

Cataract surgery is a frequently performed procedure that demands automation and advanced assistance systems. However, gathering and annotating data for training such systems is resource intensive. The publicly available data also comprises severe imbalances inherent to the surgical process. Motivated by this, we analyse cataract surgery video data for the worst-performing phases of a pre-trained downstream tool classifier. The analysis demonstrates that imbalances deteriorate the classifier's performance on underrepresented cases. To address this challenge, we utilise a conditional generative model based on Denoising Diffusion Implicit Models (DDIM) and Classifier-Free Guidance (CFG). Our model can synthesise diverse, high-quality examples based on complex multi-class multi-label conditions, such as surgical phases and combinations of surgical tools. We affirm that the synthesised samples display tools that the classifier recognises. These samples are hard to differentiate from real images, even for clinical experts with more than five years of experience. Further, our synthetically extended data can improve the data sparsity problem for the downstream task of tool classification. The evaluations demonstrate that the model can generate valuable unseen examples, allowing the tool classifier to improve by up to 10% for rare cases. Overall, our approach can facilitate the development of automated assistance systems for cataract surgery by providing a reliable source of realistic synthetic data, which we make available for everyone.

Amin Ranem, Niklas Babendererde, Moritz Fuchs et al.

Medical imaging plays a critical role in the diagnosis and treatment planning of various medical conditions, with radiology and pathology heavily reliant on precise image segmentation. The Segment Anything Model (SAM) has emerged as a promising framework for addressing segmentation challenges across different domains. In this white paper, we delve into SAM, breaking down its fundamental components and uncovering the intricate interactions between them. We also explore the fine-tuning of SAM and assess its profound impact on the accuracy and reliability of segmentation results, focusing on applications in radiology (specifically, brain tumor segmentation) and pathology (specifically, breast cancer segmentation). Through a series of carefully designed experiments, we analyze SAM's potential application in the field of medical imaging. We aim to bridge the gap between advanced segmentation techniques and the demanding requirements of healthcare, shedding light on SAM's transformative capabilities.

Christian Harder, Moritz Fuchs, Yuri Tolkach et al.

Traditional initialisation methods, e.g. He and Xavier, have been effective in avoiding the problem of vanishing or exploding gradients in neural networks. However, they only use simple pointwise distributions, which model one-dimensional variables. Moreover, they ignore most information about the architecture and disregard past training experiences. These limitations can be overcome by employing generative models for initialisation. In this paper, we introduce two groups of new initialisation methods. First, we locally initialise weight groups by employing variational autoencoders. Secondly, we globally initialise full weight sets by employing graph hypernetworks. We thoroughly evaluate the impact of the employed generative models on state-of-the-art neural networks in terms of accuracy, convergence speed and ensembling. Our results show that global initialisations result in higher accuracy and faster initial convergence speed. However, the implementation through graph hypernetworks leads to diminished ensemble performance on out of distribution data. To counteract, we propose a modification called noise graph hypernetwork, which encourages diversity in the produced ensemble members. Furthermore, our approach might be able to transfer learned knowledge to different image distributions. Our work provides insights into the potential, the trade-offs and possible modifications of these new initialisation methods.

Amin Ranem, John Kalkhof, Anirban Mukhopadhyay

Continual learning (CL) in medical imaging presents a unique challenge, requiring models to adapt to new domains while retaining previously acquired knowledge. We introduce NCAdapt, a Neural Cellular Automata (NCA) based method designed to address this challenge. NCAdapt features a domain-specific multi-head structure, integrating adaptable convolutional layers into the NCA backbone for each new domain encountered. After initial training, the NCA backbone is frozen, and only the newly added adaptable convolutional layers, consisting of 384 parameters, are trained along with domain-specific NCA convolutions. We evaluate NCAdapt on hippocampus segmentation tasks, benchmarking its performance against Lifelong nnU-Net and U-Net models with state-of-the-art (SOTA) CL methods. Our lightweight approach achieves SOTA performance, underscoring its effectiveness in addressing CL challenges in medical imaging. Upon acceptance, we will make our code base publicly accessible to support reproducibility and foster further advancements in medical CL.

Nicolas Wagner, Anirban Mukhopadhyay

Super-Selfish is an easy to use PyTorch framework for image-based self-supervised learning. Features can be learned with 13 algorithms that span from simple classification to more complex state of theart contrastive pretext tasks. The framework is easy to use and allows for pretraining any PyTorch neural network with only two lines of code. Simultaneously, full flexibility is maintained through modular design choices. The code can be found at https://github.com/MECLabTUDA/Super_Selfish and installed using pip install super-selfish.

John Kalkhof, Arlene Kühn, Yannik Frisch et al.

Despite considerable success, large Denoising Diffusion Models (DDMs) with UNet backbone pose practical challenges, particularly on limited hardware and in processing gigapixel images. To address these limitations, we introduce two Neural Cellular Automata (NCA)-based DDMs: Diff-NCA and FourierDiff-NCA. Capitalizing on the local communication capabilities of NCA, Diff-NCA significantly reduces the parameter counts of NCA-based DDMs. Integrating Fourier-based diffusion enables global communication early in the diffusion process. This feature is particularly valuable in synthesizing complex images with important global features, such as the CelebA dataset. We demonstrate that even a 331k parameter Diff-NCA can generate 512x512 pathology slices, while FourierDiff-NCA (1.1m parameters) reaches a three times lower FID score of 43.86, compared to the four times bigger UNet (3.94m parameters) with a score of 128.2. Additionally, FourierDiff-NCA can perform diverse tasks such as super-resolution, out-of-distribution image synthesis, and inpainting without explicit training.

Kang Wang, Chen Qin, Zhang Shi et al.

Deep learning models have achieved state-of-the-art performance in automated Cardiac Magnetic Resonance (CMR) analysis. However, the efficacy of these models is highly dependent on the availability of high-quality, artifact-free images. In clinical practice, CMR acquisitions are frequently degraded by respiratory motion, yet the robustness of deep learning models against such artifacts remains an underexplored problem. To promote research in this domain, we organized the MICCAI CMRxMotion challenge. We curated and publicly released a dataset of 320 CMR cine series from 40 healthy volunteers who performed specific breathing protocols to induce a controlled spectrum of motion artifacts. The challenge comprised two tasks: 1) automated image quality assessment to classify images based on motion severity, and 2) robust myocardial segmentation in the presence of motion artifacts. A total of 22 algorithms were submitted and evaluated on the two designated tasks. This paper presents a comprehensive overview of the challenge design and dataset, reports the evaluation results for the top-performing methods, and further investigates the impact of motion artifacts on five clinically relevant biomarkers. All resources and code are publicly available at: https://github.com/CMRxMotion

Yannik Frisch, Ssharvien Kumar Sivakumar, Çağhan Köksal et al.

Surgical simulation offers a promising addition to conventional surgical training. However, available simulation tools lack photorealism and rely on hardcoded behaviour. Denoising Diffusion Models are a promising alternative for high-fidelity image synthesis, but existing state-of-the-art conditioning methods fall short in providing precise control or interactivity over the generated scenes. We introduce SurGrID, a Scene Graph to Image Diffusion Model, allowing for controllable surgical scene synthesis by leveraging Scene Graphs. These graphs encode a surgical scene's components' spatial and semantic information, which are then translated into an intermediate representation using our novel pre-training step that explicitly captures local and global information. Our proposed method improves the fidelity of generated images and their coherence with the graph input over the state-of-the-art. Further, we demonstrate the simulation's realism and controllability in a user assessment study involving clinical experts. Scene Graphs can be effectively used for precise and interactive conditioning of Denoising Diffusion Models for simulating surgical scenes, enabling high fidelity and interactive control over the generated content.

Avni Mittal, John Kalkhof, Anirban Mukhopadhyay et al.

Denoising Diffusion Models (DDMs) are widely used for high-quality image generation and medical image segmentation but often rely on Unet-based architectures, leading to high computational overhead, especially with high-resolution images. This work proposes three NCA-based improvements for diffusion-based medical image segmentation. First, Multi-MedSegDiffNCA uses a multilevel NCA framework to refine rough noise estimates generated by lower level NCA models. Second, CBAM-MedSegDiffNCA incorporates channel and spatial attention for improved segmentation. Third, MultiCBAM-MedSegDiffNCA combines these methods with a new RGB channel loss for semantic guidance. Evaluations on Lesion segmentation show that MultiCBAM-MedSegDiffNCA matches Unet-based model performance with dice score of 87.84% while using 60-110 times fewer parameters, offering a more efficient solution for low resource medical settings.

Amin Ranem, John Kalkhof, Anirban Mukhopadhyay

Medical image registration is a critical process that aligns various patient scans, facilitating tasks like diagnosis, surgical planning, and tracking. Traditional optimization based methods are slow, prompting the use of Deep Learning (DL) techniques, such as VoxelMorph and Transformer-based strategies, for faster results. However, these DL methods often impose significant resource demands. In response to these challenges, we present NCA-Morph, an innovative approach that seamlessly blends DL with a bio-inspired communication and networking approach, enabled by Neural Cellular Automata (NCAs). NCA-Morph not only harnesses the power of DL for efficient image registration but also builds a network of local communications between cells and respective voxels over time, mimicking the interaction observed in living systems. In our extensive experiments, we subject NCA-Morph to evaluations across three distinct 3D registration tasks, encompassing Brain, Prostate and Hippocampus images from both healthy and diseased patients. The results showcase NCA-Morph's ability to achieve state-of-the-art performance. Notably, NCA-Morph distinguishes itself as a lightweight architecture with significantly fewer parameters; 60% and 99.7% less than VoxelMorph and TransMorph. This characteristic positions NCA-Morph as an ideal solution for resource-constrained medical applications, such as primary care settings and operating rooms.

Mirko Konstantin, Moritz Fuchs, Anirban Mukhopadhyay

Federated Learning (FL) allows the training of deep neural networks in a distributed and privacy-preserving manner. However, this concept suffers from malfunctioning updates sent by the attending clients that cause global model performance degradation. Reasons for this malfunctioning might be technical issues, disadvantageous training data, or malicious attacks. Most of the current defense mechanisms are meant to require impractical prerequisites like knowledge about the number of malfunctioning updates, which makes them unsuitable for real-world applications. To counteract these problems, we introduce a novel method called Angular Support for Malfunctioning Client Resilience (ASMR), that dynamically excludes malfunctioning clients based on their angular distance. Our novel method does not require any hyperparameters or knowledge about the number of malfunctioning clients. Our experiments showcase the detection capabilities of ASMR in an image classification task on a histopathological dataset, while also presenting findings on the significance of dynamically adapting decision boundaries.

Yannik Frisch, Christina Bornberg, Moritz Fuchs et al.

Augmentation by generative modelling yields a promising alternative to the accumulation of surgical data, where ethical, organisational and regulatory aspects must be considered. Yet, the joint synthesis of (image, mask) pairs for segmentation, a major application in surgery, is rather unexplored. We propose to learn semantically comprehensive yet compact latent representations of the (image, mask) space, which we jointly model with a Latent Diffusion Model. We show that our approach can effectively synthesise unseen high-quality paired segmentation data of remarkable semantic coherence. Generative augmentation is typically applied pre-training by synthesising a fixed number of additional training samples to improve downstream task models. To enhance this approach, we further propose Generative Adaptive Uncertainty-guided Diffusion-based Augmentation (GAUDA), leveraging the epistemic uncertainty of a Bayesian downstream model for targeted online synthesis. We condition the generative model on classes with high estimated uncertainty during training to produce additional unseen samples for these classes. By adaptively utilising the generative model online, we can minimise the number of additional training samples and centre them around the currently most uncertain parts of the data distribution. GAUDA effectively improves downstream segmentation results over comparable methods by an average absolute IoU of 1.6% on CaDISv2 and 1.5% on CholecSeg8k, two prominent surgical datasets for semantic segmentation.

Niklas Babendererde, Haozhe Zhu, Moritz Fuchs et al.

Federated- and Continual Learning have been established as approaches to enable privacy-aware learning on continuously changing data, as required for deploying AI systems in histopathology images. However, data shifts can occur in a dynamic world, spatially between institutions and temporally, due to changing data over time. This leads to two issues: Client Drift, where the central model degrades from aggregating data from clients trained on shifted data, and Catastrophic Forgetting, from temporal shifts such as changes in patient populations. Both tend to degrade the model's performance of previously seen data or spatially distributed training. Despite both problems arising from the same underlying problem of data shifts, existing research addresses them only individually. In this work, we introduce a method that can jointly alleviate Client Drift and Catastrophic Forgetting by using our proposed Dynamic Barlow Continuity that evaluates client updates on a public reference dataset and uses this to guide the training process to a spatially and temporally shift-invariant model. We evaluate our approach on the histopathology datasets BCSS and Semicol and prove our method to be highly effective by jointly improving the dice score as much as from 15.8% to 71.6% in Client Drift and from 42.5% to 62.8% in Catastrophic Forgetting. This enables Dynamic Learning by establishing spatio-temporal shift-invariance.

Marius Memmel, Camila Gonzalez, Anirban Mukhopadhyay

Deep learning for medical imaging suffers from temporal and privacy-related restrictions on data availability. To still obtain viable models, continual learning aims to train in sequential order, as and when data is available. The main challenge that continual learning methods face is to prevent catastrophic forgetting, i.e., a decrease in performance on the data encountered earlier. This issue makes continuous training of segmentation models for medical applications extremely difficult. Yet, often, data from at least two different domains is available which we can exploit to train the model in a way that it disregards domain-specific information. We propose an architecture that leverages the simultaneous availability of two or more datasets to learn a disentanglement between the content and domain in an adversarial fashion. The domain-invariant content representation then lays the base for continual semantic segmentation. Our approach takes inspiration from domain adaptation and combines it with continual learning for hippocampal segmentation in brain MRI. We showcase that our method reduces catastrophic forgetting and outperforms state-of-the-art continual learning methods.

Henry Krumb, Dhritimaan Das, Romol Chadda et al.

Purpose: Electromagnetic Tracking (EMT) can partially replace X-ray guidance in minimally invasive procedures, reducing radiation in the OR. However, in this hybrid setting, EMT is disturbed by metallic distortion caused by the X-ray device. We plan to make hybrid navigation clinical reality to reduce radiation exposure for patients and surgeons, by compensating EMT error. Methods: Our online compensation strategy exploits cycle-consistent generative adversarial neural networks (CycleGAN). 3D positions are translated from various bedside environments to their bench equivalents. Domain-translated points are fine-tuned to reduce error in the bench domain. We evaluate our compensation approach in a phantom experiment. Results: Since the domain-translation approach maps distorted points to their lab equivalents, predictions are consistent among different C-arm environments. Error is successfully reduced in all evaluation environments. Our qualitative phantom experiment demonstrates that our approach generalizes well to an unseen C-arm environment. Conclusion: Adversarial, cycle-consistent training is an explicable, consistent and thus interpretable approach for online error compensation. Qualitative assessment of EMT error compensation gives a glimpse to the potential of our method for rotational error compensation.

Adit Agarwal, K. K. Shukla, Arjan Kuijper et al.

The ability to interpret decisions taken by Machine Learning (ML) models is fundamental to encourage trust and reliability in different practical applications. Recent interpretation strategies focus on human understanding of the underlying decision mechanisms of the complex ML models. However, these strategies are restricted by the subjective biases of humans. To dissociate from such human biases, we propose an interpretation-by-distillation formulation that is defined relative to other ML models. We generalize the distillation technique for quantifying interpretability, using an information-theoretic perspective, removing the role of ground-truth from the definition of interpretability. Our work defines the entropy of supervised classification models, providing bounds on the entropy of Piece-Wise Linear Neural Networks (PWLNs), along with the first theoretical bounds on the interpretability of PWLNs. We evaluate our proposed framework on the MNIST, Fashion-MNIST and Stanford40 datasets and demonstrate the applicability of the proposed theoretical framework in different supervised classification scenarios.

Karol Gotkowski, Camila Gonzalez, Andreas Bucher et al.

M3d-CAM is an easy to use library for generating attention maps of CNN-based PyTorch models improving the interpretability of model predictions for humans. The attention maps can be generated with multiple methods like Guided Backpropagation, Grad-CAM, Guided Grad-CAM and Grad-CAM++. These attention maps visualize the regions in the input data that influenced the model prediction the most at a certain layer. Furthermore, M3d-CAM supports 2D and 3D data for the task of classification as well as for segmentation. A key feature is also that in most cases only a single line of code is required for generating attention maps for a model making M3d-CAM basically plug and play.

David Kügler, Marc Uecker, Arjan Kuijper et al.

Despite recent successes, the advances in Deep Learning have not yet been fully translated to Computer Assisted Intervention (CAI) problems such as pose estimation of surgical instruments. Currently, neural architectures for classification and segmentation tasks are adopted ignoring significant discrepancies between CAI and these tasks. We propose an automatic framework (AutoSNAP) for instrument pose estimation problems, which discovers and learns the architectures for neural networks. We introduce 1)~an efficient testing environment for pose estimation, 2)~a powerful architecture representation based on novel Symbolic Neural Architecture Patterns (SNAPs), and 3)~an optimization of the architecture using an efficient search scheme. Using AutoSNAP, we discover an improved architecture (SNAPNet) which outperforms both the hand-engineered i3PosNet and the state-of-the-art architecture search method DARTS.

Salome Kazeminia, Christoph Baur, Arjan Kuijper et al.

Generative Adversarial Networks (GANs) and their extensions have carved open many exciting ways to tackle well known and challenging medical image analysis problems such as medical image de-noising, reconstruction, segmentation, data simulation, detection or classification. Furthermore, their ability to synthesize images at unprecedented levels of realism also gives hope that the chronic scarcity of labeled data in the medical field can be resolved with the help of these generative models. In this review paper, a broad overview of recent literature on GANs for medical applications is given, the shortcomings and opportunities of the proposed methods are thoroughly discussed and potential future work is elaborated. We review the most relevant papers published until the submission date. For quick access, important details such as the underlying method, datasets and performance are tabulated. An interactive visualization which categorizes all papers to keep the review alive, is available at http://livingreview.in.tum.de/GANs_for_Medical_Applications.

Arun CS Kumar, Shefali Srivastava, Anirban Mukhopadhyay et al.

A novel, non-learning-based, saliency-aware, shape-cognizant correspondence determination technique is proposed for matching image pairs that are significantly disparate in nature. Images in the real world often exhibit high degrees of variation in scale, orientation, viewpoint, illumination and affine projection parameters, and are often accompanied by the presence of textureless regions and complete or partial occlusion of scene objects. The above conditions confound most correspondence determination techniques by rendering impractical the use of global contour-based descriptors or local pixel-level features for establishing correspondence. The proposed deep spectral correspondence (DSC) determination scheme harnesses the representational power of local feature descriptors to derive a complex high-level global shape representation for matching disparate images. The proposed scheme reasons about correspondence between disparate images using high-level global shape cues derived from low-level local feature descriptors. Consequently, the proposed scheme enjoys the best of both worlds, i.e., a high degree of invariance to affine parameters such as scale, orientation, viewpoint, illumination afforded by the global shape cues and robustness to occlusion provided by the low-level feature descriptors. While the shape-based component within the proposed scheme infers what to look for, an additional saliency-based component dictates where to look at thereby tackling the noisy correspondences arising from the presence of textureless regions and complex backgrounds. In the proposed scheme, a joint image graph is constructed using distances computed between interest points in the appearance (i.e., image) space. Eigenspectral decomposition of the joint image graph allows for reasoning about shape similarity to be performed jointly, in the appearance space and eigenspace.

Anirban Mukhopadhyay

Interpretable deep learning is a fundamental building block towards safer AI, especially when the deployment possibilities of deep learning-based computer-aided medical diagnostic systems are so eminent. However, without a computational formulation of black-box interpretation, general interpretability research rely heavily on subjective bias. Clear decision structure of the medical diagnostics lets us approximate the decision process of a radiologist as a model - removed from subjective bias. We define the process of interpretation as a finite communication between a known model and a black-box model to optimally map the black box's decision process in the known model. Consequently, we define interpretability as maximal information gain over the initial uncertainty about the black-box's decision within finite communication. We relax this definition based on the observation that diagnostic interpretation is typically achieved by a process of minimal querying. We derive an algorithm to calculate diagnostic interpretability. The usual question of accuracy-interpretability tradeoff, i.e. whether a black-box model's prediction accuracy is dependent on its ability to be interpreted by a known source model, does not arise in this theory. With multiple example simulation experiments of various complexity levels, we demonstrate the working of such a theoretical model in synthetic supervised classification scenarios.

David Kügler, Alexander Distergoft, Arjan Kuijper et al.

Failure cases of black-box deep learning, e.g. adversarial examples, might have severe consequences in healthcare. Yet such failures are mostly studied in the context of real-world images with calibrated attacks. To demystify the adversarial examples, rigorous studies need to be designed. Unfortunately, complexity of the medical images hinders such study design directly from the medical images. We hypothesize that adversarial examples might result from the incorrect mapping of image space to the low dimensional generation manifold by deep networks. To test the hypothesis, we simplify a complex medical problem namely pose estimation of surgical tools into its barest form. An analytical decision boundary and exhaustive search of the one-pixel attack across multiple image dimensions let us localize the regions of frequent successful one-pixel attacks at the image space.

David Kügler, Anirban Mukhopadhyay

Though analysis of Medical Images by Deep Learning achieves unprecedented results across various applications, the effect of \emph{noisy training annotations} is rarely studied in a systematic manner. In Medical Image Analysis, most reports addressing this question concentrate on studying segmentation performance of deep learning classifiers. The absence of continuous ground truth annotations in these studies limits the value of conclusions for applications, where regression is the primary method of choice. In the application of surgical instrument pose estimation, where precision has a direct clinical impact on patient outcome, studying the effect of \emph{noisy annotations} on deep learning pose estimation techniques is of supreme importance. Real x-ray images are inadequate for this evaluation due to the unavailability of ground truth annotations. We circumvent this problem by generating synthetic radiographs, where the ground truth pose is known and therefore the pose estimation error made by the medical-expert can be estimated from experiments. Furthermore, this study shows the property of deep neural networks to learn dominant signals from noisy annotations with sufficient data in a regression setting.

David Kügler, Jannik Sehring, Andrei Stefanov et al.

Purpose: Accurate estimation of the position and orientation (pose) of surgical instruments is crucial for delicate minimally invasive temporal bone surgery. Current techniques lack in accuracy and/or line-of-sight constraints (conventional tracking systems) or expose the patient to prohibitive ionizing radiation (intra-operative CT). A possible solution is to capture the instrument with a c-arm at irregular intervals and recover the pose from the image. Methods: i3PosNet infers the position and orientation of instruments from images using a pose estimation network. Said framework considers localized patches and outputs pseudo-landmarks. The pose is reconstructed from pseudo-landmarks by geometric considerations. Results: We show i3PosNet reaches errors less than 0.05mm. It outperforms conventional image registration-based approaches reducing average and maximum errors by at least two thirds. i3PosNet trained on synthetic images generalizes to real x-rays without any further adaptation. Conclusion: The translation of Deep Learning based methods to surgical applications is difficult, because large representative datasets for training and testing are not available. This work empirically shows sub-millimeter pose estimation trained solely based on synthetic training data.

Johannes Fauser, Georgios Sakas, Anirban Mukhopadhyay

Purpose: Interventions at the otobasis operate in the narrow region of the temporal bone where several highly sensitive organs define obstacles with minimal clearance for surgical instruments. Nonlinear trajectories for potential minimally-invasive interventions can provide larger distances to risk structures and optimized orientations of surgical instruments, thus improving clinical outcomes when compared to existing linear approaches. In this paper, we present fast and accurate planning methods for such nonlinear access paths. Methods: We define a specific motion planning problem in SE(3) = R3 x SO(3) with notable constraints in computation time and goal pose that reflect the requirements of temporal bone surgery.We then present k-RRT-Connect: two suitable motion planners based on bidirectional Rapidly-exploring Random Trees (RRT) to solve this problem efficiently. Results: The benefits of k-RRT-Connect are demonstrated on real CT data of patients. Their general performance is shown on a large set of realistic synthetic anatomies. We also show that these new algorithms outperform state of the art methods based on circular arcs or Bezier-Splines when applied to this specific problem. Conclusion: With this work we demonstrate that pre- and intra-operative planning of nonlinear access paths is possible for minimally-invasive surgeries at the otobasis.

Manish Sahu, Anirban Mukhopadhyay, Angelika Szengel et al.

A transfer learning method for generating features suitable for surgical tools and phase recognition from the ImageNet classification features [1] is proposed here. In addition, methods are developed for generating contextual features and combining them with time series analysis for final classification using multi-class random forest. The proposed pipeline is tested over the training and testing datasets of M2CAI16 challenges: tool and phase detection. Encouraging results are obtained by leave-one-out cross validation evaluation on the training dataset.

Anirban Mukhopadhyay, Zhen Qian, Suchendra M. Bhandarkar et al.

The limitations of conventional imaging techniques have hitherto precluded a thorough and formal investigation of the complex morphology of the left ventricular (LV) endocardial surface and its relation to the severity of Coronary Artery Disease (CAD). Recent developments in high-resolution Multirow-Detector Computed Tomography (MDCT) scanner technology have enabled the imaging of LV endocardial surface morphology in a single heart beat. Analysis of high-resolution Computed Tomography (CT) images from a 320-MDCT scanner allows the study of the relationship between percent Diameter Stenosis (DS) of the major coronary arteries and localization of the cardiac segments affected by coronary arterial stenosis. In this paper a novel approach for the analysis using a combination of rigid transformation-invariant shape descriptors and a more generalized isometry-invariant Bag-of-Features (BoF) descriptor, is proposed and implemented. The proposed approach is shown to be successful in identifying, localizing and quantifying the incidence and extent of CAD and thus, is seen to have a potentially significant clinical impact. Specifically, the association between the incidence and extent of CAD, determined via the percent DS measurements of the major coronary arteries, and the alterations in the endocardial surface morphology is formally quantified. A multivariate regression test performed on a strict leave-one-out basis are shown to exhibit a distinct pattern in terms of the correlation coefficient within the cardiac segments where the incidence of coronary arterial stenosis is localized.