Winnie Pang

Chinedu Innocent Nwoye, Deepak Alapatt, Tong Yu et al.

Context-aware decision support in the operating room can foster surgical safety and efficiency by leveraging real-time feedback from surgical workflow analysis. Most existing works recognize surgical activities at a coarse-grained level, such as phases, steps or events, leaving out fine-grained interaction details about the surgical activity; yet those are needed for more helpful AI assistance in the operating room. Recognizing surgical actions as triplets of <instrument, verb, target> combination delivers comprehensive details about the activities taking place in surgical videos. This paper presents CholecTriplet2021: an endoscopic vision challenge organized at MICCAI 2021 for the recognition of surgical action triplets in laparoscopic videos. The challenge granted private access to the large-scale CholecT50 dataset, which is annotated with action triplet information. In this paper, we present the challenge setup and assessment of the state-of-the-art deep learning methods proposed by the participants during the challenge. A total of 4 baseline methods from the challenge organizers and 19 new deep learning algorithms by competing teams are presented to recognize surgical action triplets directly from surgical videos, achieving mean average precision (mAP) ranging from 4.2% to 38.1%. This study also analyzes the significance of the results obtained by the presented approaches, performs a thorough methodological comparison between them, in-depth result analysis, and proposes a novel ensemble method for enhanced recognition. Our analysis shows that surgical workflow analysis is not yet solved, and also highlights interesting directions for future research on fine-grained surgical activity recognition which is of utmost importance for the development of AI in surgery.

Satoshi Tsutsui, Winnie Pang, Bihan Wen

The examination of blood samples at a microscopic level plays a fundamental role in clinical diagnostics, influencing a wide range of medical conditions. For instance, an in-depth study of White Blood Cells (WBCs), a crucial component of our blood, is essential for diagnosing blood-related diseases such as leukemia and anemia. While multiple datasets containing WBC images have been proposed, they mostly focus on cell categorization, often lacking the necessary morphological details to explain such categorizations, despite the importance of explainable artificial intelligence (XAI) in medical domains. This paper seeks to address this limitation by introducing comprehensive annotations for WBC images. Through collaboration with pathologists, a thorough literature review, and manual inspection of microscopic images, we have identified 11 morphological attributes associated with the cell and its components (nucleus, cytoplasm, and granules). We then annotated ten thousand WBC images with these attributes. Moreover, we conduct experiments to predict these attributes from images, providing insights beyond basic WBC classification. As the first public dataset to offer such extensive annotations, we also illustrate specific applications that can benefit from our attribute annotations. Overall, our dataset paves the way for interpreting WBC recognition models, further advancing XAI in the fields of pathology and hematology.

Winnie Pang, Xueyi Ke, Satoshi Tsutsui et al.

Concept bottleneck models (CBMs), which predict human-interpretable concepts (e.g., nucleus shapes in cell images) before predicting the final output (e.g., cell type), provide insights into the decision-making processes of the model. However, training CBMs solely in a data-driven manner can introduce undesirable biases, which may compromise prediction performance, especially when the trained models are evaluated on out-of-domain images (e.g., those acquired using different devices). To mitigate this challenge, we propose integrating clinical knowledge to refine CBMs, better aligning them with clinicians' decision-making processes. Specifically, we guide the model to prioritize the concepts that clinicians also prioritize. We validate our approach on two datasets of medical images: white blood cell and skin images. Empirical validation demonstrates that incorporating medical guidance enhances the model's classification performance on unseen datasets with varying preparation methods, thereby increasing its real-world applicability.

Yuxuan Cai, Xiyu Wang, Satoshi Tsutsui et al.

Concept Bottleneck Models (CBMs) aim to enhance interpretability by predicting human-understandable concepts as intermediates for decision-making. However, these models often face challenges in ensuring reliable concept representations, which can propagate to downstream tasks and undermine robustness, especially under distribution shifts. Two inherent issues contribute to concept unreliability: sensitivity to concept-irrelevant features (e.g., background variations) and lack of semantic consistency for the same concept across different samples. To address these limitations, we propose the Reliability-Enhanced Concept Embedding Model (RECEM), which introduces a two-fold strategy: Concept-Level Disentanglement to separate irrelevant features from concept-relevant information and a Concept Mixup mechanism to ensure semantic alignment across samples. These mechanisms work together to improve concept reliability, enabling the model to focus on meaningful object attributes and generate faithful concept representations. Experimental results demonstrate that RECEM consistently outperforms existing baselines across multiple datasets, showing superior performance under background and domain shifts. These findings highlight the effectiveness of disentanglement and alignment strategies in enhancing both reliability and robustness in CBMs.

Aneeq Zia, Max Berniker, Rogerio Garcia Nespolo et al.

Robotic assisted (RA) surgery promises to transform surgical intervention. Intuitive Surgical is committed to fostering these changes and the machine learning models and algorithms that will enable them. With these goals in mind we have invited the surgical data science community to participate in a yearly competition hosted through the Medical Imaging Computing and Computer Assisted Interventions (MICCAI) conference. With varying changes from year to year, we have challenged the community to solve difficult machine learning problems in the context of advanced RA applications. Here we document the results of these challenges, focusing on surgical tool localization (SurgToolLoc). The publicly released dataset that accompanies these challenges is detailed in a separate paper arXiv:2501.09209 [1].