Anant Vemuri

Leonardo Ayala, Sebastian Wirkert, Anant Vemuri et al.

Multispectral and hyperspectral imaging (MSI/HSI) can provide clinically relevant information on morphological and functional tissue properties. Application in the operating room (OR), however, has so far been limited by complex hardware setups and slow acquisition times. To overcome these limitations, we propose a novel imaging system for video-rate spectral imaging in the clinical workflow. The system integrates a small snapshot multispectral camera with a standard laparoscope and a clinically commonly used light source, enabling the recording of multispectral images with a spectral dimension of 16 at a frame rate of 25 Hz. An ongoing in patient study shows that multispectral recordings from this system can help detect perfusion changes in partial nephrectomy surgery, thus opening the doors to a wide range of clinical applications.

Anant S. Vemuri

This paper attempts to provide the reader a place to begin studying the application of computer vision and machine learning to gastrointestinal (GI) endoscopy. They have been classified into 18 categories. It should be be noted by the reader that this is a review from pre-deep learning era. A lot of deep learning based applications have not been covered in this thesis.

Tim J. Adler, Lynton Ardizzone, Anant Vemuri et al.

Purpose: Optical imaging is evolving as a key technique for advanced sensing in the operating room. Recent research has shown that machine learning algorithms can be used to address the inverse problem of converting pixel-wise multispectral reflectance measurements to underlying tissue parameters, such as oxygenation. Assessment of the specific hardware used in conjunction with such algorithms, however, has not properly addressed the possibility that the problem may be ill-posed. Methods: We present a novel approach to the assessment of optical imaging modalities, which is sensitive to the different types of uncertainties that may occur when inferring tissue parameters. Based on the concept of invertible neural networks, our framework goes beyond point estimates and maps each multispectral measurement to a full posterior probability distribution which is capable of representing ambiguity in the solution via multiple modes. Performance metrics for a hardware setup can then be computed from the characteristics of the posteriors. Results: Application of the assessment framework to the specific use case of camera selection for physiological parameter estimation yields the following insights: (1) Estimation of tissue oxygenation from multispectral images is a well-posed problem, while (2) blood volume fraction may not be recovered without ambiguity. (3) In general, ambiguity may be reduced by increasing the number of spectral bands in the camera. Conclusion: Our method could help to optimize optical camera design in an application-specific manner.

Tobias Ross, David Zimmerer, Anant Vemuri et al.

Surgical data science is a new research field that aims to observe all aspects of the patient treatment process in order to provide the right assistance at the right time. Due to the breakthrough successes of deep learning-based solutions for automatic image annotation, the availability of reference annotations for algorithm training is becoming a major bottleneck in the field. The purpose of this paper was to investigate the concept of self-supervised learning to address this issue. Our approach is guided by the hypothesis that unlabeled video data can be used to learn a representation of the target domain that boosts the performance of state-of-the-art machine learning algorithms when used for pre-training. Core of the method is an auxiliary task based on raw endoscopic video data of the target domain that is used to initialize the convolutional neural network (CNN) for the target task. In this paper, we propose the re-colorization of medical images with a generative adversarial network (GAN)-based architecture as auxiliary task. A variant of the method involves a second pre-training step based on labeled data for the target task from a related domain. We validate both variants using medical instrument segmentation as target task. The proposed approach can be used to radically reduce the manual annotation effort involved in training CNNs. Compared to the baseline approach of generating annotated data from scratch, our method decreases exploratively the number of labeled images by up to 75% without sacrificing performance. Our method also outperforms alternative methods for CNN pre-training, such as pre-training on publicly available non-medical or medical data using the target task (in this instance: segmentation). As it makes efficient use of available (non-)public and (un-)labeled data, the approach has the potential to become a valuable tool for CNN (pre-)training.

S. Moccia, S. J. Wirkert, H. Kenngott et al.

Objective: Surgical data science is evolving into a research field that aims to observe everything occurring within and around the treatment process to provide situation-aware data-driven assistance. In the context of endoscopic video analysis, the accurate classification of organs in the field of view of the camera proffers a technical challenge. Herein, we propose a new approach to anatomical structure classification and image tagging that features an intrinsic measure of confidence to estimate its own performance with high reliability and which can be applied to both RGB and multispectral imaging (MI) data. Methods: Organ recognition is performed using a superpixel classification strategy based on textural and reflectance information. Classification confidence is estimated by analyzing the dispersion of class probabilities. Assessment of the proposed technology is performed through a comprehensive in vivo study with seven pigs. Results: When applied to image tagging, mean accuracy in our experiments increased from 65% (RGB) and 80% (MI) to 90% (RGB) and 96% (MI) with the confidence measure. Conclusion: Results showed that the confidence measure had a significant influence on the classification accuracy, and MI data are better suited for anatomical structure labeling than RGB data. Significance: This work significantly enhances the state of art in automatic labeling of endoscopic videos by introducing the use of the confidence metric, and by being the first study to use MI data for in vivo laparoscopic tissue classification. The data of our experiments will be released as the first in vivo MI dataset upon publication of this paper.

Anant S. Vemuri, Stephane A. Nicolau, Jacques Marescaux et al.

Esophageal adenocarcinoma arises from Barrett's esophagus, which is the most serious complication of gastroesophageal reflux disease. Strategies for screening involve periodic surveillance and tissue biopsies. A major challenge in such regular examinations is to record and track the disease evolution and re-localization of biopsied sites to provide targeted treatments. In this paper, we extend our original inter-operative relocalization framework to provide a constrained image based search for obtaining the best view-point match to the live view. Within this context we investigate the effect of: the choice of feature descriptors and color-space; filtering of uninformative frames and endoscopic modality, for view-point localization. Our experiments indicate an improvement in the best view-point retrieval rate to [92%,87%] from [73%,76%] (in our previous approach) for NBI and WL.