Takayuki Kitasaka

Hanna Hoffmann, Setareh Bady, Claas de Boer et al.

Achieving high levels of surgical skill through effective training is essential for optimal patient outcomes. Automated, data-driven skill assessment holds significant potential to improve surgical training. While machine learning-based methods are increasingly popular for assessing skills in minimally invasive surgery, their application to open surgery remains limited. We present the results of a dedicated MICCAI challenge designed to benchmark and advance vision-based skill assessment in open surgery. The challenge dataset comprises videos of an open suturing training task recorded with a static GoPro camera in a dry-lab setting, with instrument trajectories available in addition to the primary video modality. The OSS Challenge was hosted over two consecutive years, comprising two and three independent tasks, respectively: (1) classifying skill level into four classes, (2) predicting the full Objective Structured Assessment of Technical Skills across eight categories, and (3) tracking hands and surgical tools. Participants submitted diverse solutions including deep learning-based video models, tracking-driven methods, and hybrid approaches. General-purpose spatiotemporal video models consistently achieved the strongest performance, though conceptually diverse approaches reached competitive levels when well-executed. Predicting fine-grained OSATS scores remains challenging but benefits substantially from increased training data. Keypoint tracking proves difficult given frequent occlusions and out-of-frame instances, limiting current applicability for motion-based skill analysis. This work benchmarks innovative and diverse solutions for surgical skill assessment, highlighting both the promise and current limitations of video-based evaluation in open surgery and identifying critical directions for advancing automated skill assessment toward clinical impact.

Zhou Zheng, Yuichiro Hayashi, Masahiro Oda et al.

In this paper, we study weakly-supervised laparoscopic image segmentation with sparse annotations. We introduce a novel Bayesian deep learning approach designed to enhance both the accuracy and interpretability of the model's segmentation, founded upon a comprehensive Bayesian framework, ensuring a robust and theoretically validated method. Our approach diverges from conventional methods that directly train using observed images and their corresponding weak annotations. Instead, we estimate the joint distribution of both images and labels given the acquired data. This facilitates the sampling of images and their high-quality pseudo-labels, enabling the training of a generalizable segmentation model. Each component of our model is expressed through probabilistic formulations, providing a coherent and interpretable structure. This probabilistic nature benefits accurate and practical learning from sparse annotations and equips our model with the ability to quantify uncertainty. Extensive evaluations with two public laparoscopic datasets demonstrated the efficacy of our method, which consistently outperformed existing methods. Furthermore, our method was adapted for scribble-supervised cardiac multi-structure segmentation, presenting competitive performance compared to previous methods. The code is available at https://github.com/MoriLabNU/Bayesian_WSS.

Masahiro Oda, Tomoaki Suito, Yuichiro Hayashi et al.

CT image-based diagnosis of the stomach is developed as a new way of diagnostic method. A virtual unfolded (VU) view is suitable for displaying its wall. In this paper, we propose a semi-automated method for generating VU views of the stomach. Our method requires minimum manual operations. The determination of the unfolding forces and the termination of the unfolding process are automated. The unfolded shape of the stomach is estimated based on its radius. The unfolding forces are determined so that the stomach wall is deformed to the expected shape. The iterative deformation process is terminated if the difference of the shapes between the deformed shape and expected shape is small. Our experiments using 67 CT volumes showed that our proposed method can generate good VU views for 76.1% cases.

Masahiro Oda, Natsuki Shimizu, Ken'ichi Karasawa et al.

This paper proposes a fully automated atlas-based pancreas segmentation method from CT volumes utilizing atlas localization by regression forest and atlas generation using blood vessel information. Previous probabilistic atlas-based pancreas segmentation methods cannot deal with spatial variations that are commonly found in the pancreas well. Also, shape variations are not represented by an averaged atlas. We propose a fully automated pancreas segmentation method that deals with two types of variations mentioned above. The position and size of the pancreas is estimated using a regression forest technique. After localization, a patient-specific probabilistic atlas is generated based on a new image similarity that reflects the blood vessel position and direction information around the pancreas. We segment it using the EM algorithm with the atlas as prior followed by the graph-cut. In evaluation results using 147 CT volumes, the Jaccard index and the Dice overlap of the proposed method were 62.1% and 75.1%, respectively. Although we automated all of the segmentation processes, segmentation results were superior to the other state-of-the-art methods in the Dice overlap.

Masahiro Oda, Holger R. Roth, Takayuki Kitasaka et al.

This paper presents a colonoscope tracking method utilizing a colon shape estimation method. CT colonography is used as a less-invasive colon diagnosis method. If colonic polyps or early-stage cancers are found, they are removed in a colonoscopic examination. In the colonoscopic examination, understanding where the colonoscope running in the colon is difficult. A colonoscope navigation system is necessary to reduce overlooking of polyps. We propose a colonoscope tracking method for navigation systems. Previous colonoscope tracking methods caused large tracking errors because they do not consider deformations of the colon during colonoscope insertions. We utilize the shape estimation network (SEN), which estimates deformed colon shape during colonoscope insertions. The SEN is a neural network containing long short-term memory (LSTM) layer. To perform colon shape estimation suitable to the real clinical situation, we trained the SEN using data obtained during colonoscope operations of physicians. The proposed tracking method performs mapping of the colonoscope tip position to a position in the colon using estimation results of the SEN. We evaluated the proposed method in a phantom study. We confirmed that tracking errors of the proposed method was enough small to perform navigation in the ascending, transverse, and descending colons.

Masahiro Oda, Holger R. Roth, Takayuki Kitasaka et al.

We propose an estimation method using a recurrent neural network (RNN) of the colon's shape where deformation was occurred by a colonoscope insertion. Colonoscope tracking or a navigation system that navigates physician to polyp positions is needed to reduce such complications as colon perforation. Previous tracking methods caused large tracking errors at the transverse and sigmoid colons because these areas largely deform during colonoscope insertion. Colon deformation should be taken into account in tracking processes. We propose a colon deformation estimation method using RNN and obtain the colonoscope shape from electromagnetic sensors during its insertion into the colon. This method obtains positional, directional, and an insertion length from the colonoscope shape. From its shape, we also calculate the relative features that represent the positional and directional relationships between two points on a colonoscope. Long short-term memory is used to estimate the current colon shape from the past transition of the features of the colonoscope shape. We performed colon shape estimation in a phantom study and correctly estimated the colon shapes during colonoscope insertion with 12.39 (mm) estimation error.

Hirohisa Oda, Kohei Nishio, Takayuki Kitasaka et al.

This paper presents a visualization method of intestine (the small and large intestines) regions and their stenosed parts caused by ileus from CT volumes. Since it is difficult for non-expert clinicians to find stenosed parts, the intestine and its stenosed parts should be visualized intuitively. Furthermore, the intestine regions of ileus cases are quite hard to be segmented. The proposed method segments intestine regions by 3D FCN (3D U-Net). Intestine regions are quite difficult to be segmented in ileus cases since the inside the intestine is filled with fluids. These fluids have similar intensities with intestinal wall on 3D CT volumes. We segment the intestine regions by using 3D U-Net trained by a weak annotation approach. Weak-annotation makes possible to train the 3D U-Net with small manually-traced label images of the intestine. This avoids us to prepare many annotation labels of the intestine that has long and winding shape. Each intestine segment is volume-rendered and colored based on the distance from its endpoint in volume rendering. Stenosed parts (disjoint points of an intestine segment) can be easily identified on such visualization. In the experiments, we showed that stenosed parts were intuitively visualized as endpoints of segmented regions, which are colored by red or blue.

Chenglong Wang, Holger R. Roth, Takayuki Kitasaka et al.

This paper presents a new approach for precisely estimating the renal vascular dominant region using a Voronoi diagram. To provide computer-assisted diagnostics for the pre-surgical simulation of partial nephrectomy surgery, we must obtain information on the renal arteries and the renal vascular dominant regions. We propose a fully automatic segmentation method that combines a neural network and tensor-based graph-cut methods to precisely extract the kidney and renal arteries. First, we use a convolutional neural network to localize the kidney regions and extract tiny renal arteries with a tensor-based graph-cut method. Then we generate a Voronoi diagram to estimate the renal vascular dominant regions based on the segmented kidney and renal arteries. The accuracy of kidney segmentation in 27 cases with 8-fold cross validation reached a Dice score of 95%. The accuracy of renal artery segmentation in 8 cases obtained a centerline overlap ratio of 80%. Each partition region corresponds to a renal vascular dominant region. The final dominant-region estimation accuracy achieved a Dice coefficient of 80%. A clinical application showed the potential of our proposed estimation approach in a real clinical surgical environment. Further validation using large-scale database is our future work.

Masahiro Oda, Natsuki Shimizu, Holger R. Roth et al.

This paper presents a fully automated atlas-based pancreas segmentation method from CT volumes utilizing 3D fully convolutional network (FCN) feature-based pancreas localization. Segmentation of the pancreas is difficult because it has larger inter-patient spatial variations than other organs. Previous pancreas segmentation methods failed to deal with such variations. We propose a fully automated pancreas segmentation method that contains novel localization and segmentation. Since the pancreas neighbors many other organs, its position and size are strongly related to the positions of the surrounding organs. We estimate the position and the size of the pancreas (localized) from global features by regression forests. As global features, we use intensity differences and 3D FCN deep learned features, which include automatically extracted essential features for segmentation. We chose 3D FCN features from a trained 3D U-Net, which is trained to perform multi-organ segmentation. The global features include both the pancreas and surrounding organ information. After localization, a patient-specific probabilistic atlas-based pancreas segmentation is performed. In evaluation results with 146 CT volumes, we achieved 60.6% of the Jaccard index and 73.9% of the Dice overlap.

Masahiro Oda, Takayuki Kitasaka, Kazuhiro Furukawa et al.

This paper presents a colon deformation estimation method, which can be used to estimate colon deformations during colonoscope insertions. Colonoscope tracking or navigation system that navigates a physician to polyp positions during a colonoscope insertion is required to reduce complications such as colon perforation. A previous colonoscope tracking method obtains a colonoscope position in the colon by registering a colonoscope shape and a colon shape. The colonoscope shape is obtained using an electromagnetic sensor, and the colon shape is obtained from a CT volume. However, large tracking errors were observed due to colon deformations occurred during colonoscope insertions. Such deformations make the registration difficult. Because the colon deformation is caused by a colonoscope, there is a strong relationship between the colon deformation and the colonoscope shape. An estimation method of colon deformations occur during colonoscope insertions is necessary to reduce tracking errors. We propose a colon deformation estimation method. This method is used to estimate a deformed colon shape from a colonoscope shape. We use the regression forests algorithm to estimate a deformed colon shape. The regression forests algorithm is trained using pairs of colon and colonoscope shapes, which contains deformations occur during colonoscope insertions. As a preliminary study, we utilized the method to estimate deformations of a colon phantom. In our experiments, the proposed method correctly estimated deformed colon phantom shapes.

Holger Roth, Masahiro Oda, Natsuki Shimizu et al.

Pancreas segmentation in computed tomography imaging has been historically difficult for automated methods because of the large shape and size variations between patients. In this work, we describe a custom-build 3D fully convolutional network (FCN) that can process a 3D image including the whole pancreas and produce an automatic segmentation. We investigate two variations of the 3D FCN architecture; one with concatenation and one with summation skip connections to the decoder part of the network. We evaluate our methods on a dataset from a clinical trial with gastric cancer patients, including 147 contrast enhanced abdominal CT scans acquired in the portal venous phase. Using the summation architecture, we achieve an average Dice score of 89.7 $\pm$ 3.8 (range [79.8, 94.8]) % in testing, achieving the new state-of-the-art performance in pancreas segmentation on this dataset.

Qier Meng, Takayuki Kitasaka, Masahiro Oda et al.

Some lung diseases are related to bronchial airway structures and morphology. Although airway segmentation from chest CT volumes is an important task in the computer-aided diagnosis and surgery assistance systems for the chest, complete 3-D airway structure segmentation is a quite challenging task due to its complex tree-like structure. In this paper, we propose a new airway segmentation method from 3D chest CT volumes based on volume of interests (VOI) using gradient vector flow (GVF). This method segments the bronchial regions by applying the cavity enhancement filter (CEF) to trace the bronchial tree structure from the trachea. It uses the CEF in the VOI to segment each branch. And a tube-likeness function based on GVF and the GVF magnitude map in each VOI are utilized to assist predicting the positions and directions of child branches. By calculating the tube-likeness function based on GVF and the GVF magnitude map, the airway-like candidate structures are identified and their centrelines are extracted. Based on the extracted centrelines, we can detect the branch points of the bifurcations and directions of the airway branches in the next level. At the same time, a leakage detection is performed to avoid the leakage by analysing the pixel information and the shape information of airway candidate regions extracted in the VOI. Finally, we unify all of the extracted bronchial regions to form an integrated airway tree. Preliminary experiments using four cases of chest CT volumes demonstrated that the proposed method can extract more bronchial branches in comparison with other methods.