Francisco Vasconcelos

Bohan Zhan, Wang Zhao, Yi Fang et al.

Accurate tracking of tissues and instruments in videos is crucial for Robotic-Assisted Minimally Invasive Surgery (RAMIS), as it enables the robot to comprehend the surgical scene with precise locations and interactions of tissues and tools. Traditional keypoint-based sparse tracking is limited by featured points, while flow-based dense two-view matching suffers from long-term drifts. Recently, the Tracking Any Point (TAP) algorithm was proposed to overcome these limitations and achieve dense accurate long-term tracking. However, its efficacy in surgical scenarios remains untested, largely due to the lack of a comprehensive surgical tracking dataset for evaluation. To address this gap, we introduce a new annotated surgical tracking dataset for benchmarking tracking methods for surgical scenarios, comprising real-world surgical videos with complex tissue and instrument motions. We extensively evaluate state-of-the-art (SOTA) TAP-based algorithms on this dataset and reveal their limitations in challenging surgical scenarios, including fast instrument motion, severe occlusions, and motion blur, etc. Furthermore, we propose a new tracking method, namely SurgMotion, to solve the challenges and further improve the tracking performance. Our proposed method outperforms most TAP-based algorithms in surgical instruments tracking, and especially demonstrates significant improvements over baselines in challenging medical videos. Our code and dataset are available at https://github.com/zhanbh1019/SurgicalMotion.

Yitong Zhang, Sophia Bano, Ann-Sophie Page et al.

In minimally invasive surgery, surgical workflow segmentation from video analysis is a well studied topic. The conventional approach defines it as a multi-class classification problem, where individual video frames are attributed a surgical phase label. We introduce a novel reinforcement learning formulation for offline phase transition retrieval. Instead of attempting to classify every video frame, we identify the timestamp of each phase transition. By construction, our model does not produce spurious and noisy phase transitions, but contiguous phase blocks. We investigate two different configurations of this model. The first does not require processing all frames in a video (only <60% and <20% of frames in 2 different applications), while producing results slightly under the state-of-the-art accuracy. The second configuration processes all video frames, and outperforms the state-of-the art at a comparable computational cost. We compare our method against the recent top-performing frame-based approaches TeCNO and Trans-SVNet on the public dataset Cholec80 and also on an in-house dataset of laparoscopic sacrocolpopexy. We perform both a frame-based (accuracy, precision, recall and F1-score) and an event-based (event ratio) evaluation of our algorithms.

Sophia Bano, Alessandro Casella, Francisco Vasconcelos et al.

Fetoscopy laser photocoagulation is a widely adopted procedure for treating Twin-to-Twin Transfusion Syndrome (TTTS). The procedure involves photocoagulation pathological anastomoses to regulate blood exchange among twins. The procedure is particularly challenging due to the limited field of view, poor manoeuvrability of the fetoscope, poor visibility, and variability in illumination. These challenges may lead to increased surgery time and incomplete ablation. Computer-assisted intervention (CAI) can provide surgeons with decision support and context awareness by identifying key structures in the scene and expanding the fetoscopic field of view through video mosaicking. Research in this domain has been hampered by the lack of high-quality data to design, develop and test CAI algorithms. Through the Fetoscopic Placental Vessel Segmentation and Registration (FetReg2021) challenge, which was organized as part of the MICCAI2021 Endoscopic Vision challenge, we released the first largescale multicentre TTTS dataset for the development of generalized and robust semantic segmentation and video mosaicking algorithms. For this challenge, we released a dataset of 2060 images, pixel-annotated for vessels, tool, fetus and background classes, from 18 in-vivo TTTS fetoscopy procedures and 18 short video clips. Seven teams participated in this challenge and their model performance was assessed on an unseen test dataset of 658 pixel-annotated images from 6 fetoscopic procedures and 6 short clips. The challenge provided an opportunity for creating generalized solutions for fetoscopic scene understanding and mosaicking. In this paper, we present the findings of the FetReg2021 challenge alongside reporting a detailed literature review for CAI in TTTS fetoscopy. Through this challenge, its analysis and the release of multi-centre fetoscopic data, we provide a benchmark for future research in this field.

Alessandro Casella, Sophia Bano, Francisco Vasconcelos et al.

In Twin-to-Twin Transfusion Syndrome (TTTS), abnormal vascular anastomoses in the monochorionic placenta can produce uneven blood flow between the two fetuses. In the current practice, TTTS is treated surgically by closing abnormal anastomoses using laser ablation. This surgery is minimally invasive and relies on fetoscopy. Limited field of view makes anastomosis identification a challenging task for the surgeon. To tackle this challenge, we propose a learning-based framework for in-vivo fetoscopy frame registration for field-of-view expansion. The novelties of this framework relies on a learning-based keypoint proposal network and an encoding strategy to filter (i) irrelevant keypoints based on fetoscopic image segmentation and (ii) inconsistent homographies. We validate of our framework on a dataset of 6 intraoperative sequences from 6 TTTS surgeries from 6 different women against the most recent state of the art algorithm, which relies on the segmentation of placenta vessels. The proposed framework achieves higher performance compared to the state of the art, paving the way for robust mosaicking to provide surgeons with context awareness during TTTS surgery.

Chiara Di Vece, Maela Le Lous, Brian Dromey et al.

In obstetric ultrasound (US) scanning, the learner's ability to mentally build a three-dimensional (3D) map of the fetus from a two-dimensional (2D) US image represents a significant challenge in skill acquisition. We aim to build a US plane localization system for 3D visualization, training, and guidance without integrating additional sensors. This work builds on top of our previous work, which predicts the six-dimensional (6D) pose of arbitrarily oriented US planes slicing the fetal brain with respect to a normalized reference frame using a convolutional neural network (CNN) regression network. Here, we analyze in detail the assumptions of the normalized fetal brain reference frame and quantify its accuracy with respect to the acquisition of transventricular (TV) standard plane (SP) for fetal biometry. We investigate the impact of registration quality in the training and testing data and its subsequent effect on trained models. Finally, we introduce data augmentations and larger training sets that improve the results of our previous work, achieving median errors of 2.97 mm and 6.63 degrees for translation and rotation, respectively.

Adrito Das, Danyal Z. Khan, Dimitrios Psychogyios et al.

The field of computer vision applied to videos of minimally invasive surgery is ever-growing. Workflow recognition pertains to the automated recognition of various aspects of a surgery: including which surgical steps are performed; and which surgical instruments are used. This information can later be used to assist clinicians when learning the surgery; during live surgery; and when writing operation notes. The Pituitary Vision (PitVis) 2023 Challenge tasks the community to step and instrument recognition in videos of endoscopic pituitary surgery. This is a unique task when compared to other minimally invasive surgeries due to the smaller working space, which limits and distorts vision; and higher frequency of instrument and step switching, which requires more precise model predictions. Participants were provided with 25-videos, with results presented at the MICCAI-2023 conference as part of the Endoscopic Vision 2023 Challenge in Vancouver, Canada, on 08-Oct-2023. There were 18-submissions from 9-teams across 6-countries, using a variety of deep learning models. A commonality between the top performing models was incorporating spatio-temporal and multi-task methods, with greater than 50% and 10% macro-F1-score improvement over purely spacial single-task models in step and instrument recognition respectively. The PitVis-2023 Challenge therefore demonstrates state-of-the-art computer vision models in minimally invasive surgery are transferable to a new dataset, with surgery specific techniques used to enhance performance, progressing the field further. Benchmark results are provided in the paper, and the dataset is publicly available at: https://doi.org/10.5522/04/26531686.

Baoru Huang, Tuan Vo, Chayun Kongtongvattana et al.

Real-time visual feedback from catheterization analysis is crucial for enhancing surgical safety and efficiency during endovascular interventions. However, existing datasets are often limited to specific tasks, small scale, and lack the comprehensive annotations necessary for broader endovascular intervention understanding. To tackle these limitations, we introduce CathAction, a large-scale dataset for catheterization understanding. Our CathAction dataset encompasses approximately 500,000 annotated frames for catheterization action understanding and collision detection, and 25,000 ground truth masks for catheter and guidewire segmentation. For each task, we benchmark recent related works in the field. We further discuss the challenges of endovascular intentions compared to traditional computer vision tasks and point out open research questions. We hope that CathAction will facilitate the development of endovascular intervention understanding methods that can be applied to real-world applications. The dataset is available at https://airvlab.github.io/cathaction/.

Joao Cartucho, Alistair Weld, Samyakh Tukra et al.

This paper introduces the ``SurgT: Surgical Tracking" challenge which was organised in conjunction with MICCAI 2022. There were two purposes for the creation of this challenge: (1) the establishment of the first standardised benchmark for the research community to assess soft-tissue trackers; and (2) to encourage the development of unsupervised deep learning methods, given the lack of annotated data in surgery. A dataset of 157 stereo endoscopic videos from 20 clinical cases, along with stereo camera calibration parameters, have been provided. Participants were assigned the task of developing algorithms to track the movement of soft tissues, represented by bounding boxes, in stereo endoscopic videos. At the end of the challenge, the developed methods were assessed on a previously hidden test subset. This assessment uses benchmarking metrics that were purposely developed for this challenge, to verify the efficacy of unsupervised deep learning algorithms in tracking soft-tissue. The metric used for ranking the methods was the Expected Average Overlap (EAO) score, which measures the average overlap between a tracker's and the ground truth bounding boxes. Coming first in the challenge was the deep learning submission by ICVS-2Ai with a superior EAO score of 0.617. This method employs ARFlow to estimate unsupervised dense optical flow from cropped images, using photometric and regularization losses. Second, Jmees with an EAO of 0.583, uses deep learning for surgical tool segmentation on top of a non-deep learning baseline method: CSRT. CSRT by itself scores a similar EAO of 0.563. The results from this challenge show that currently, non-deep learning methods are still competitive. The dataset and benchmarking tool created for this challenge have been made publicly available at https://surgt.grand-challenge.org/.

Krittin Pachtrachai, Francisco Vasconcelos, Danail Stoyanov

Hand-eye calibration algorithms are mature and provide accurate transformation estimations for an effective camera-robot link but rely on a sufficiently wide range of calibration data to avoid errors and degenerate configurations. To solve the hand-eye problem in robotic-assisted minimally invasive surgery and also simplify the calibration procedure by using neural network method cooporating with the new objective function. We present a neural network-based solution that estimates the transformation from a sequence of images and kinematic data which significantly simplifies the calibration procedure. The network utilises the long short-term memory architecture to extract temporal information from the data and solve the hand-eye problem. The objective function is derived from the linear combination of remote centre of motion constraint, the re-projection error and its derivative to induce a small change in the hand-eye transformation. The method is validated with the data from da Vinci Si and the result shows that the estimated hand-eye matrix is able to re-project the end-effector from the robot coordinate to the camera coordinate within 10 to 20 pixels of accuracy in both testing dataset. The calibration performance is also superior to the previous neural network-based hand-eye method. The proposed algorithm shows that the calibration procedure can be simplified by using deep learning techniques and the performance is improved by the assumption of non-static hand-eye transformations.

Sierra Bonilla, Chiara Di Vece, Rema Daher et al.

Three-dimensional (3D) reconstruction from two-dimensional images is an active research field in computer vision, with applications ranging from navigation and object tracking to segmentation and three-dimensional modeling. Traditionally, parametric techniques have been employed for this task. However, recent advancements have seen a shift towards learning-based methods. Given the rapid pace of research and the frequent introduction of new image matching methods, it is essential to evaluate them. In this paper, we present a comprehensive evaluation of various image matching methods using a structure-from-motion pipeline. We assess the performance of these methods on both in-domain and out-of-domain datasets, identifying key limitations in both the methods and benchmarks. We also investigate the impact of edge detection as a pre-processing step. Our analysis reveals that image matching for 3D reconstruction remains an open challenge, necessitating careful selection and tuning of models for specific scenarios, while also highlighting mismatches in how metrics currently represent method performance.

Chiara Di Vece, Zhehua Mao, Netanell Avisdris et al.

Accurate fetal growth assessment from ultrasound (US) relies on precise biometry measured by manually identifying anatomical landmarks in standard planes. Manual landmarking is time-consuming, operator-dependent, and sensitive to variability across scanners and sites, limiting the reproducibility of automated approaches. There is a need for multi-source annotated datasets to develop artificial intelligence-assisted fetal growth assessment methods. To address this bottleneck, we present an open, multi-centre, multi-device benchmark dataset of fetal US images with expert anatomical landmark annotations for clinically used fetal biometric measurements. These measurements include head bi-parietal and occipito-frontal diameters, abdominal transverse and antero-posterior diameters, and femoral length. The dataset comprises 4,513 de-identified US images from 1,904 subjects acquired at three clinical sites using seven different US devices. We provide standardised, subject-disjoint train/test splits, evaluation code, and baseline results to enable fair and reproducible comparison of methods. Using an automatic biometry model, we quantify domain shift and demonstrate that training and evaluation confined to a single centre substantially overestimate performance relative to multi-centre testing. To the best of our knowledge, this is the first publicly available multi-centre, multi-device, landmark-annotated dataset that covers all primary fetal biometry measures, providing a robust benchmark for domain adaptation and multi-centre generalisation in fetal biometry and enabling more reliable AI-assisted fetal growth assessment across centres. All data, annotations, training code, and evaluation pipelines are made publicly available.

Xinwei Ju, Rema Daher, Razvan Caramalau et al.

Colorectal cancer (CRC) remains a leading cause of cancer-related deaths worldwide, with polyp removal being an effective early screening method. However, navigating the colon for thorough polyp detection poses significant challenges. To advance camera navigation in colonoscopy, we propose the Semantic Segmentation for Tools and Fold Edges in Colonoscopy (SegCol) Challenge. This challenge introduces a dataset from the EndoMapper repository, featuring manually annotated, pixel-level semantic labels for colon folds and endoscopic tools across selected frames from 96 colonoscopy videos. By providing fold edges as anatomical landmarks and depth discontinuity information from both fold and tool labels, the dataset is aimed to improve depth perception and localization methods. Hosted as part of the Endovis Challenge at MICCAI 2024, SegCol aims to drive innovation in colonoscopy navigation systems. Details are available at https://www.synapse.org/Synapse:syn54124209/wiki/626563, and code resources at https://github.com/surgical-vision/segcol_challenge .

Rema Daher, Francisco Vasconcelos, Danail Stoyanov

Purpose: Visual 3D scene reconstruction can support colonoscopy navigation. It can help in recognising which portions of the colon have been visualised and characterising the size and shape of polyps. This is still a very challenging problem due to complex illumination variations, including abundant specular reflections. We investigate how to effectively decouple light and depth in this problem. Methods: We introduce a self-supervised model that simultaneously characterises the shape and lighting of the visualised colonoscopy scene. Our model estimates shading, albedo, depth, and specularities (SHADeS) from single images. Unlike previous approaches (IID), we use a non-Lambertian model that treats specular reflections as a separate light component. The implementation of our method is available at https://github.com/RemaDaher/SHADeS. Results: We demonstrate on real colonoscopy images (Hyper Kvasir) that previous models for light decomposition (IID) and depth estimation (MonoVIT, ModoDepth2) are negatively affected by specularities. In contrast, SHADeS can simultaneously produce light decomposition and depth maps that are robust to specular regions. We also perform a quantitative comparison on phantom data (C3VD) where we further demonstrate the robustness of our model. Conclusion: Modelling specular reflections improves depth estimation in colonoscopy. We propose an effective self-supervised approach that uses this insight to jointly estimate light decomposition and depth. Light decomposition has the potential to help with other problems, such as place recognition within the colon.

Sierra Bonilla, Shuai Zhang, Dimitrios Psychogyios et al.

Within colorectal cancer diagnostics, conventional colonoscopy techniques face critical limitations, including a limited field of view and a lack of depth information, which can impede the detection of precancerous lesions. Current methods struggle to provide comprehensive and accurate 3D reconstructions of the colonic surface which can help minimize the missing regions and reinspection for pre-cancerous polyps. Addressing this, we introduce 'Gaussian Pancakes', a method that leverages 3D Gaussian Splatting (3D GS) combined with a Recurrent Neural Network-based Simultaneous Localization and Mapping (RNNSLAM) system. By introducing geometric and depth regularization into the 3D GS framework, our approach ensures more accurate alignment of Gaussians with the colon surface, resulting in smoother 3D reconstructions with novel viewing of detailed textures and structures. Evaluations across three diverse datasets show that Gaussian Pancakes enhances novel view synthesis quality, surpassing current leading methods with a 18% boost in PSNR and a 16% improvement in SSIM. It also delivers over 100X faster rendering and more than 10X shorter training times, making it a practical tool for real-time applications. Hence, this holds promise for achieving clinical translation for better detection and diagnosis of colorectal cancer.

Jialei Chen, Xin Zhang, Mobarakol Islam et al.

Accurate 3D reconstruction of dynamic surgical scenes from endoscopic video is essential for robotic-assisted surgery. While recent 3D Gaussian Splatting methods have shown promise in achieving high-quality reconstructions with fast rendering speeds, their use of inverse depth loss functions compresses depth variations. This can lead to a loss of fine geometric details, limiting their ability to capture precise 3D geometry and effectiveness in intraoperative application. To address these challenges, we present SurgicalGS, a dynamic 3D Gaussian Splatting framework specifically designed for surgical scene reconstruction with improved geometric accuracy. Our approach first initialises a Gaussian point cloud using depth priors, employing binary motion masks to identify pixels with significant depth variations and fusing point clouds from depth maps across frames for initialisation. We use the Flexible Deformation Model to represent dynamic scene and introduce a normalised depth regularisation loss along with an unsupervised depth smoothness constraint to ensure more accurate geometric reconstruction. Extensive experiments on two real surgical datasets demonstrate that SurgicalGS achieves state-of-the-art reconstruction quality, especially in terms of accurate geometry, advancing the usability of 3D Gaussian Splatting in robotic-assisted surgery.

Chiara Di Vece, Antonio Cirigliano, Meala Le Lous et al.

This paper introduces a novel pipeline designed to bring ultrasound (US) plane pose estimation closer to clinical use for more effective navigation to the standard planes (SPs) in the fetal brain. We propose a semi-supervised segmentation model utilizing both labeled SPs and unlabeled 3D US volume slices. Our model enables reliable segmentation across a diverse set of fetal brain images. Furthermore, the model incorporates a classification mechanism to identify the fetal brain precisely. Our model not only filters out frames lacking the brain but also generates masks for those containing it, enhancing the relevance of plane pose regression in clinical settings. We focus on fetal brain navigation from 2D ultrasound (US) video analysis and combine this model with a US plane pose regression network to provide sensorless proximity detection to SPs and non-SPs planes; we emphasize the importance of proximity detection to SPs for guiding sonographers, offering a substantial advantage over traditional methods by allowing earlier and more precise adjustments during scanning. We demonstrate the practical applicability of our approach through validation on real fetal scan videos obtained from sonographers of varying expertise levels. Our findings demonstrate the potential of our approach to complement existing fetal US technologies and advance prenatal diagnostic practices.

Ali Youssef, Francisco Vasconcelos

Feature point detection and description is the backbone for various computer vision applications, such as Structure-from-Motion, visual SLAM, and visual place recognition. While learning-based methods have surpassed traditional handcrafted techniques, their training often relies on simplistic homography-based simulations of multi-view perspectives, limiting model generalisability. This paper presents a novel approach leveraging Neural Radiance Fields (NeRFs) to generate a diverse and realistic dataset consisting of indoor and outdoor scenes. Our proposed methodology adapts state-of-the-art feature detectors and descriptors for training on multi-view NeRF-synthesised data, with supervision achieved through perspective projective geometry. Experiments demonstrate that the proposed methodology achieves competitive or superior performance on standard benchmarks for relative pose estimation, point cloud registration, and homography estimation while requiring significantly less training data and time compared to existing approaches.

Tianyi Song, Danail Stoyanov, Evangelos Mazomenos et al.

Real-time reconstruction of deformable surgical scenes is vital for advancing robotic surgery, improving surgeon guidance, and enabling automation. Recent methods achieve dense reconstructions from da Vinci robotic surgery videos, with Gaussian Splatting (GS) offering real-time performance via graphics acceleration. However, reconstruction quality in occluded regions remains limited, and depth accuracy has not been fully assessed, as benchmarks like EndoNeRF and StereoMIS lack 3D ground truth. We propose Diff2DGS, a novel two-stage framework for reliable 3D reconstruction of occluded surgical scenes. In the first stage, a diffusion-based video module with temporal priors inpaints tissue occluded by instruments with high spatial-temporal consistency. In the second stage, we adapt 2D Gaussian Splatting (2DGS) with a Learnable Deformation Model (LDM) to capture dynamic tissue deformation and anatomical geometry. We also extend evaluation beyond prior image-quality metrics by performing quantitative depth accuracy analysis on the SCARED dataset. Diff2DGS outperforms state-of-the-art approaches in both appearance and geometry, reaching 38.02 dB PSNR on EndoNeRF and 34.40 dB on StereoMIS. Furthermore, our experiments demonstrate that optimizing for image quality alone does not necessarily translate into optimal 3D reconstruction accuracy. To address this, we further optimize the depth quality of the reconstructed 3D results, ensuring more faithful geometry in addition to high-fidelity appearance.

Baoru Huang, Yida Wang, Anh Nguyen et al.

In surgical oncology, screening colonoscopy plays a pivotal role in providing diagnostic assistance, such as biopsy, and facilitating surgical navigation, particularly in polyp detection. Computer-assisted endoscopic surgery has recently gained attention and amalgamated various 3D computer vision techniques, including camera localization, depth estimation, surface reconstruction, etc. Neural Radiance Fields (NeRFs) and Neural Implicit Surfaces (NeuS) have emerged as promising methodologies for deriving accurate 3D surface models from sets of registered images, addressing the limitations of existing colon reconstruction approaches stemming from constrained camera movement. However, the inadequate tissue texture representation and confused scale problem in monocular colonoscopic image reconstruction still impede the progress of the final rendering results. In this paper, we introduce a novel method for colon section reconstruction by leveraging NeuS applied to endoscopic images, supplemented by a single frame of depth map. Notably, we pioneered the exploration of utilizing only one frame depth map in photorealistic reconstruction and neural rendering applications while this single depth map can be easily obtainable from other monocular depth estimation networks with an object scale. Through rigorous experimentation and validation on phantom imagery, our approach demonstrates exceptional accuracy in completely rendering colon sections, even capturing unseen portions of the surface. This breakthrough opens avenues for achieving stable and consistently scaled reconstructions, promising enhanced quality in cancer screening procedures and treatment interventions.

Rema Daher, Francisco Vasconcelos, Danail Stoyanov

Video streams are utilised to guide minimally-invasive surgery and diagnostic procedures in a wide range of procedures, and many computer assisted techniques have been developed to automatically analyse them. These approaches can provide additional information to the surgeon such as lesion detection, instrument navigation, or anatomy 3D shape modeling. However, the necessary image features to recognise these patterns are not always reliably detected due to the presence of irregular light patterns such as specular highlight reflections. In this paper, we aim at removing specular highlights from endoscopic videos using machine learning. We propose using a temporal generative adversarial network (GAN) to inpaint the hidden anatomy under specularities, inferring its appearance spatially and from neighbouring frames where they are not present in the same location. This is achieved using in-vivo data of gastric endoscopy (Hyper-Kvasir) in a fully unsupervised manner that relies on automatic detection of specular highlights. System evaluations show significant improvements to traditional methods through direct comparison as well as other machine learning techniques through an ablation study that depicts the importance of the network's temporal and transfer learning components. The generalizability of our system to different surgical setups and procedures was also evaluated qualitatively on in-vivo data of gastric endoscopy and ex-vivo porcine data (SERV-CT, SCARED). We also assess the effect of our method in computer vision tasks that underpin 3D reconstruction and camera motion estimation, namely stereo disparity, optical flow, and sparse point feature matching. These are evaluated quantitatively and qualitatively and results show a positive effect of specular highlight inpainting on these tasks in a novel comprehensive analysis.

Sophia Bano, Brian Dromey, Francisco Vasconcelos et al.

During pregnancy, ultrasound examination in the second trimester can assess fetal size according to standardized charts. To achieve a reproducible and accurate measurement, a sonographer needs to identify three standard 2D planes of the fetal anatomy (head, abdomen, femur) and manually mark the key anatomical landmarks on the image for accurate biometry and fetal weight estimation. This can be a time-consuming operator-dependent task, especially for a trainee sonographer. Computer-assisted techniques can help in automating the fetal biometry computation process. In this paper, we present a unified automated framework for estimating all measurements needed for the fetal weight assessment. The proposed framework semantically segments the key fetal anatomies using state-of-the-art segmentation models, followed by region fitting and scale recovery for the biometry estimation. We present an ablation study of segmentation algorithms to show their robustness through 4-fold cross-validation on a dataset of 349 ultrasound standard plane images from 42 pregnancies. Moreover, we show that the network with the best segmentation performance tends to be more accurate for biometry estimation. Furthermore, we demonstrate that the error between clinically measured and predicted fetal biometry is lower than the permissible error during routine clinical measurements.

Sophia Bano, Alessandro Casella, Francisco Vasconcelos et al.

Fetoscopy laser photocoagulation is a widely used procedure for the treatment of Twin-to-Twin Transfusion Syndrome (TTTS), that occur in mono-chorionic multiple pregnancies due to placental vascular anastomoses. This procedure is particularly challenging due to limited field of view, poor manoeuvrability of the fetoscope, poor visibility due to fluid turbidity, variability in light source, and unusual position of the placenta. This may lead to increased procedural time and incomplete ablation, resulting in persistent TTTS. Computer-assisted intervention may help overcome these challenges by expanding the fetoscopic field of view through video mosaicking and providing better visualization of the vessel network. However, the research and development in this domain remain limited due to unavailability of high-quality data to encode the intra- and inter-procedure variability. Through the \textit{Fetoscopic Placental Vessel Segmentation and Registration (FetReg)} challenge, we present a large-scale multi-centre dataset for the development of generalized and robust semantic segmentation and video mosaicking algorithms for the fetal environment with a focus on creating drift-free mosaics from long duration fetoscopy videos. In this paper, we provide an overview of the FetReg dataset, challenge tasks, evaluation metrics and baseline methods for both segmentation and registration. Baseline methods results on the FetReg dataset shows that our dataset poses interesting challenges, offering large opportunity for the creation of novel methods and models through a community effort initiative guided by the FetReg challenge.

Sophia Bano, Francisco Vasconcelos, Luke M. Shepherd et al.

During fetoscopic laser photocoagulation, a treatment for twin-to-twin transfusion syndrome (TTTS), the clinician first identifies abnormal placental vascular connections and laser ablates them to regulate blood flow in both fetuses. The procedure is challenging due to the mobility of the environment, poor visibility in amniotic fluid, occasional bleeding, and limitations in the fetoscopic field-of-view and image quality. Ideally, anastomotic placental vessels would be automatically identified, segmented and registered to create expanded vessel maps to guide laser ablation, however, such methods have yet to be clinically adopted. We propose a solution utilising the U-Net architecture for performing placental vessel segmentation in fetoscopic videos. The obtained vessel probability maps provide sufficient cues for mosaicking alignment by registering consecutive vessel maps using the direct intensity-based technique. Experiments on 6 different in vivo fetoscopic videos demonstrate that the vessel intensity-based registration outperformed image intensity-based registration approaches showing better robustness in qualitative and quantitative comparison. We additionally reduce drift accumulation to negligible even for sequences with up to 400 frames and we incorporate a scheme for quantifying drift error in the absence of the ground-truth. Our paper provides a benchmark for fetoscopy placental vessel segmentation and registration by contributing the first in vivo vessel segmentation and fetoscopic videos dataset.

Sophia Bano, Francisco Vasconcelos, Marcel Tella Amo et al.

Twin-to-twin transfusion syndrome treatment requires fetoscopic laser photocoagulation of placental vascular anastomoses to regulate blood flow to both fetuses. Limited field-of-view (FoV) and low visual quality during fetoscopy make it challenging to identify all vascular connections. Mosaicking can align multiple overlapping images to generate an image with increased FoV, however, existing techniques apply poorly to fetoscopy due to the low visual quality, texture paucity, and hence fail in longer sequences due to the drift accumulated over time. Deep learning techniques can facilitate in overcoming these challenges. Therefore, we present a new generalized Deep Sequential Mosaicking (DSM) framework for fetoscopic videos captured from different settings such as simulation, phantom, and real environments. DSM extends an existing deep image-based homography model to sequential data by proposing controlled data augmentation and outlier rejection methods. Unlike existing methods, DSM can handle visual variations due to specular highlights and reflection across adjacent frames, hence reducing the accumulated drift. We perform experimental validation and comparison using 5 diverse fetoscopic videos to demonstrate the robustness of our framework.

Rene Lacher, Francisco Vasconcelos, Norman Williams et al.

Accounting for 26% of all new cancer cases worldwide, breast cancer remains the most common form of cancer in women. Although early breast cancer has a favourable long-term prognosis, roughly a third of patients suffer from a suboptimal aesthetic outcome despite breast conserving cancer treatment. Clinical-quality 3D modelling of the breast surface therefore assumes an increasingly important role in advancing treatment planning, prediction and evaluation of breast cosmesis. Yet, existing 3D torso scanners are expensive and either infrastructure-heavy or subject to motion artefacts. In this paper we employ a single consumer-grade RGBD camera with an ICP-based registration approach to jointly align all points from a sequence of depth images non-rigidly. Subtle body deformation due to postural sway and respiration is successfully mitigated leading to a higher geometric accuracy through regularised locally affine transformations. We present results from 6 clinical cases where our method compares well with the gold standard and outperforms a previous approach. We show that our method produces better reconstructions qualitatively by visual assessment and quantitatively by consistently obtaining lower landmark error scores and yielding more accurate breast volume estimates.

Claudia D'Ettorre, George Dwyer, Xiaofei Du et al.

Robot-assisted laparoscopic prostatectomy (RALP) is a treatment for prostate cancer that involves complete or nerve sparing removal prostate tissue that contains cancer. After removal the bladder neck is successively sutured directly with the urethra. The procedure is called urethrovesical anastomosis and is one of the most dexterity demanding tasks during RALP. Two suturing instruments and a pair of needles are used in combination to perform a running stitch during urethrovesical anastomosis. While robotic instruments provide enhanced dexterity to perform the anastomosis, it is still highly challenging and difficult to learn. In this paper, we presents a vision-guided needle grasping method for automatically grasping the needle that has been inserted into the patient prior to anastomosis. We aim to automatically grasp the suturing needle in a position that avoids hand-offs and immediately enables the start of suturing. The full grasping process can be broken down into: a needle detection algorithm; an approach phase where the surgical tool moves closer to the needle based on visual feedback; and a grasping phase through path planning based on observed surgical practice. Our experimental results show examples of successful autonomous grasping that has the potential to simplify and decrease the operational time in RALP by assisting a small component of urethrovesical anastomosis.

Timur Kuzhagaliyev, Neil T. Clancy, Mirek Janatka et al.

Irreversible electroporation (IRE) is a soft tissue ablation technique suitable for treatment of inoperable tumours in the pancreas. The process involves applying a high voltage electric field to the tissue containing the mass using needle electrodes, leaving cancerous cells irreversibly damaged and vulnerable to apoptosis. Efficacy of the treatment depends heavily on the accuracy of needle placement and requires a high degree of skill from the operator. In this paper, we describe an Augmented Reality (AR) system designed to overcome the challenges associated with planning and guiding the needle insertion process. Our solution, based on the HoloLens (Microsoft, USA) platform, tracks the position of the headset, needle electrodes and ultrasound (US) probe in space. The proof of concept implementation of the system uses this tracking data to render real-time holographic guides on the HoloLens, giving the user insight into the current progress of needle insertion and an indication of the target needle trajectory. The operator's field of view is augmented using visual guides and real-time US feed rendered on a holographic plane, eliminating the need to consult external monitors. Based on these early prototypes, we are aiming to develop a system that will lower the skill level required for IRE while increasing overall accuracy of needle insertion and, hence, the likelihood of successful treatment.

Rene Lacher, Francisco Vasconcelos, David Bishop et al.

Breast cancer is the most prevalent cancer type in women, and while its survival rate is generally high the aesthetic outcome is an increasingly important factor when evaluating different treatment alternatives. 3D scanning and reconstruction techniques offer a flexible tool for building detailed and accurate 3D breast models that can be used both pre-operatively for surgical planning and post-operatively for aesthetic evaluation. This paper aims at comparing the accuracy of low-cost 3D scanning technologies with the significantly more expensive state-of-the-art 3D commercial scanners in the context of breast 3D reconstruction. We present results from 28 synthetic and clinical RGBD sequences, including 12 unique patients and an anthropomorphic phantom demonstrating the applicability of low-cost RGBD sensors to real clinical cases. Body deformation and homogeneous skin texture pose challenges to the studied reconstruction systems. Although these should be addressed appropriately if higher model quality is warranted, we observe that low-cost sensors are able to obtain valuable reconstructions comparable to the state-of-the-art within an error margin of 3 mm.

Francisco Vasconcelos, Donald Peebles, Sebastien Ourselin et al.

We propose a minimal solution for the similarity registration (rigid pose and scale) between two sets of 3D lines, and also between a set of co-planar points and a set of 3D lines. The first problem is solved up to 8 discrete solutions with a minimum of 2 line-line correspondences, while the second is solved up to 4 discrete solutions using 4 point-line correspondences. We use these algorithms to perform the extrinsic calibration between a pose tracking sensor and a 2D/3D ultrasound (US) curvilinear probe using a tracked needle as calibration target. The needle is tracked as a 3D line, and is scanned by the ultrasound as either a 3D line (3D US) or as a 2D point (2D US). Since the scale factor that converts US scan units to metric coordinates is unknown, the calibration is formulated as a similarity registration problem. We present results with both synthetic and real data and show that the minimum solutions outperform the correspondent non-minimal linear formulations.