Ziheng Wang

Chinedu Innocent Nwoye, Tong Yu, Saurav Sharma et al.

Formalizing surgical activities as triplets of the used instruments, actions performed, and target anatomies is becoming a gold standard approach for surgical activity modeling. The benefit is that this formalization helps to obtain a more detailed understanding of tool-tissue interaction which can be used to develop better Artificial Intelligence assistance for image-guided surgery. Earlier efforts and the CholecTriplet challenge introduced in 2021 have put together techniques aimed at recognizing these triplets from surgical footage. Estimating also the spatial locations of the triplets would offer a more precise intraoperative context-aware decision support for computer-assisted intervention. This paper presents the CholecTriplet2022 challenge, which extends surgical action triplet modeling from recognition to detection. It includes weakly-supervised bounding box localization of every visible surgical instrument (or tool), as the key actors, and the modeling of each tool-activity in the form of <instrument, verb, target> triplet. The paper describes a baseline method and 10 new deep learning algorithms presented at the challenge to solve the task. It also provides thorough methodological comparisons of the methods, an in-depth analysis of the obtained results across multiple metrics, visual and procedural challenges; their significance, and useful insights for future research directions and applications in surgery.

Ziheng Wang, Xinhe Li, Haruki Momma et al.

To enhance therapeutic outcomes from a pharmacological perspective, we propose MiranDa, designed for medication recommendation, which is the first actionable model capable of providing the estimated length of stay in hospitals (ELOS) as counterfactual outcomes that guide clinical practice and model training. In detail, MiranDa emulates the educational trajectory of doctors through two gradient-scaling phases shifted by ELOS: an Evidence-based Training Phase that utilizes supervised learning and a Therapeutic Optimization Phase grounds in reinforcement learning within the gradient space, explores optimal medications by perturbations from ELOS. Evaluation of the Medical Information Mart for Intensive Care III dataset and IV dataset, showcased the superior results of our model across five metrics, particularly in reducing the ELOS. Surprisingly, our model provides structural attributes of medication combinations proved in hyperbolic space and advocated "procedure-specific" medication combinations. These findings posit that MiranDa enhanced medication efficacy. Notably, our paradigm can be applied to nearly all medical tasks and those with information to evaluate predicted outcomes. The source code of the MiranDa model is available at https://github.com/azusakou/MiranDa.

Ziheng Wang, Andrea Mariani, Arianna Menciassi et al.

Objective technical skill assessment is crucial for effective training of new surgeons in robot-assisted surgery. With advancements in surgical training programs in both physical and virtual environments, it is imperative to develop generalizable methods for automatically assessing skills. In this paper, we propose a novel approach for skill assessment by transferring domain knowledge from labeled kinematic data to unlabeled data. Our approach leverages labeled data from common surgical training tasks such as Suturing, Needle Passing, and Knot Tying to jointly train a model with both labeled and unlabeled data. Pseudo labels are generated for the unlabeled data through an iterative manner that incorporates uncertainty estimation to ensure accurate labeling. We evaluate our method on a virtual reality simulated training task (Ring Transfer) using data from the da Vinci Research Kit (dVRK). The results show that trainees with robotic assistance have significantly higher expert probability compared to these without any assistance, p < 0.05, which aligns with previous studies showing the benefits of robotic assistance in improving training proficiency. Our method offers a significant advantage over other existing works as it does not require manual labeling or prior knowledge of the surgical training task for robot-assisted surgery.

Ziheng Wang, Conor Perreault, Xi Liu et al.

Endoscopic video recordings are widely used in minimally invasive robot-assisted surgery, but when the endoscope is outside the patient's body, it can capture irrelevant segments that may contain sensitive information. To address this, we propose a framework that accurately detects out-of-body frames in surgical videos by leveraging self-supervision with minimal data labels. We use a massive amount of unlabeled endoscopic images to learn meaningful representations in a self-supervised manner. Our approach, which involves pre-training on an auxiliary task and fine-tuning with limited supervision, outperforms previous methods for detecting out-of-body frames in surgical videos captured from da Vinci X and Xi surgical systems. The average F1 scores range from 96.00 to 98.02. Remarkably, using only 5% of the training labels, our approach still maintains an average F1 score performance above 97, outperforming fully-supervised methods with 95% fewer labels. These results demonstrate the potential of our framework to facilitate the safe handling of surgical video recordings and enhance data privacy protection in minimally invasive surgery.

Ye Wang, Ziheng Wang, Boshen Xu et al.

Temporal Video Grounding (TVG), the task of locating specific video segments based on language queries, is a core challenge in long-form video understanding. While recent Large Vision-Language Models (LVLMs) have shown early promise in tackling TVG through supervised fine-tuning (SFT), their abilities to generalize remain limited. To address this, we propose a novel post-training framework that enhances the generalization capabilities of LVLMs via reinforcement learning (RL). Specifically, our contributions span three key directions: (1) Time-R1: we introduce a reasoning-guided post-training framework via RL with verifiable reward to enhance the capabilities of LVLMs on the TVG task. (2) TimeRFT: we explore data-efficient post-training strategies on our curated RL-friendly dataset, which trains the model to progressively comprehend difficult samples, leading to better generalization. (3) TVGBench: we carefully construct a small yet comprehensive benchmark for LVLM evaluation, assessing 11 types of queries and featuring balanced distributions across both videos and queries. Extensive experiments demonstrate that Time-R1 achieves state-of-the-art performance across multiple downstream datasets using only 2.5K training data, while improving its general video understanding capabilities.

Aneeq Zia, Max Berniker, Rogerio Nespolo et al.

Owing to recent advances in machine learning and the ability to harvest large amounts of data during robotic-assisted surgeries, surgical data science is ripe for foundational work. We present a large dataset of surgical videos and their accompanying labels for this purpose. We describe how the data was collected and some of its unique attributes. Multiple example problems are outlined. Although the dataset was curated for a particular set of scientific challenges (in an accompanying paper), it is general enough to be used for a broad range machine learning questions. Our hope is that this dataset exposes the larger machine learning community to the challenging problems within surgical data science, and becomes a touchstone for future research. The videos are available at https://storage.googleapis.com/isi-surgvu/surgvu24_videos_only.zip, the labels at https://storage.googleapis.com/isi-surgvu/surgvu24_labels_updated_v2.zip, and a validation set for tool detection problem at https://storage.googleapis.com/isi-surgvu/cat1_test_set_public.zip.

Siyuan Shen, Ziheng Wang, Xingyue Peng et al.

Pretrained models have demonstrated impressive success in many modalities such as language and vision. Recent works facilitate the pretraining paradigm in imaging research. Transients are a novel modality, which are captured for an object as photon counts versus arrival times using a precisely time-resolved sensor. In particular for non-line-of-sight (NLOS) scenarios, transients of hidden objects are measured beyond the sensor's direct line of sight. Using NLOS transients, the majority of previous works optimize volume density or surfaces to reconstruct the hidden objects and do not transfer priors learned from datasets. In this work, we present a masked autoencoder for modeling transient imaging, or MARMOT, to facilitate NLOS applications. Our MARMOT is a self-supervised model pretrianed on massive and diverse NLOS transient datasets. Using a Transformer-based encoder-decoder, MARMOT learns features from partially masked transients via a scanning pattern mask (SPM), where the unmasked subset is functionally equivalent to arbitrary sampling, and predicts full measurements. Pretrained on TransVerse-a synthesized transient dataset of 500K 3D models-MARMOT adapts to downstream imaging tasks using direct feature transfer or decoder finetuning. Comprehensive experiments are carried out in comparisons with state-of-the-art methods. Quantitative and qualitative results demonstrate the efficiency of our MARMOT.

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].

Ziheng Wang, Cong Feng, Jie Zhang et al.

Providing an accurate and efficient assessment of operative difficulty is important for designing robot-assisted teleoperation interfaces that are easy and natural for human operators to use. In this paper, we aim to develop a data-driven approach to numerically characterize the operative difficulty demand of complex teleoperation. In effort to provide an entirely task-independent assessment, we consider using only data collected from the human user including: (1) physiological response, and (2) movement kinematics. By leveraging an unsupervised domain adaptation technique, our approach learns the user information that defines task difficulty in a well-known source, namely, a Fitt's target reaching task, and generalizes that knowledge to a more complex human motor control scenario, namely, the teleoperation of a robotic system. Our approach consists of two main parts: (1) The first part accounts for the inherent variances of user physiological and kinematic response between these cross-domain motor control scenarios that are vastly different. (2) A stacked two-layer learner is designed to improve the overall modeling performance, yielding a 96.6% accuracy in predicting the known difficulty of a Fitts' reaching task when using movement kinematic features. We then validate the effectiveness of our model by investigating teleoperated robotic needle steering as a case study. Compared with a standard NASA TLX user survey, our results indicate significant differences in the difficulty demand for various choices of needle steering control algorithms, p<0.05, as well as the difficulty of steering the needle to different targets, p<0.05. The results highlight the potential of our approach to be used as a design tool to create more intuitive and natural teleoperation interfaces in robot-assisted systems.