Katjana Ehrlich

Mohamed Abul Hassan, Pu Sun, Xiangnan Zhou et al.

This study introduces a novel data-centric approach to improve real-time surgical guidance using fiber-based fluorescence lifetime imaging (FLIm). A key aspect of the methodology is the accurate detection of the aiming beam, which is essential for localizing points used to map FLIm measurements onto the tissue region within the surgical field. The primary challenge arises from the complex and variable conditions encountered in the surgical environment, particularly in Transoral Robotic Surgery (TORS). Uneven illumination in the surgical field can cause reflections, reduce contrast, and results in inconsistent color representation, further complicating aiming beam detection. To overcome these challenges, an instance segmentation model was developed using a data-centric training strategy that improves accuracy by minimizing label noise and enhancing detection robustness. The model was evaluated on a dataset comprising 40 in vivo surgical videos, demonstrating a median detection rate of 85%. This performance was maintained when the model was integrated in a clinical system, achieving a similar detection rate of 85% during TORS procedures conducted in patients. The system's computational efficiency, measured at approximately 24 frames per second (FPS), was sufficient for real-time surgical guidance. This study enhances the reliability of FLIm-based aiming beam detection in complex surgical environments, advancing the feasibility of real-time, image-guided interventions for improved surgical precision

Xilin Yang, Musa Aydin, Yuhong Lu et al.

Assessing resection margins is central to pathological specimen evaluation and has profound implications for patient outcomes. Current practice employs physical inking, which is applied variably, and cautery artifacts can obscure the true margin on histological sections. We present a virtual inking network (VIN) that autonomously localizes the surgical cut surface on whole-slide images, reducing reliance on inks and standardizing margin-focused review. VIN uses a frozen foundation model as the feature extractor and a compact two-layer multilayer perceptron trained for patch-level classification of cautery-consistent features. The dataset comprised 120 hematoxylin and eosin (H&E) stained slides from 12 human tonsil tissue blocks, resulting in ~2 TB of uncompressed raw image data, where a board-certified pathologist provided boundary annotations. In blind testing with 20 slides from previously unseen blocks, VIN produced coherent margin overlays that qualitatively aligned with expert annotations across serial sections. Quantitatively, region-level accuracy was ~73.3% across the test set, with errors largely confined to limited areas that did not disrupt continuity of the whole-slide margin map. These results indicate that VIN captures cautery-related histomorphology and can provide a reproducible, ink-free margin delineation suitable for integration into routine digital pathology workflows and for downstream measurement of margin distances.

Lei Zhou, Nimu Yuan, Katjana Ehrlich et al.

Deformable image registration is a fundamental task in medical image processing. Traditional optimization-based methods often struggle with accuracy in dealing with complex deformation. Recently, learning-based methods have achieved good performance on public datasets, but the scarcity of medical image data makes it challenging to build a generalizable model to handle diverse real-world scenarios. To address this, we propose a training-data-free learning-based method, Neural Correspondence Field (NCF), which can learn from just one data pair. Our approach employs a compact neural network to model the correspondence field and optimize model parameters for each individual image pair. Consequently, each pair has a unique set of network weights. Notably, our model is highly efficient, utilizing only 0.06 million parameters. Evaluation results showed that the proposed method achieved superior performance on a public Lung CT dataset and outperformed a traditional method on a head and neck dataset, demonstrating both its effectiveness and efficiency.