Pierre Jannin

Yueyao Chen, Kai-Ni Wang, Dario Tayupo et al.

Purpose: Surgical workflow recognition enables context-aware assistance and skill assessment in computer-assisted interventions. Despite recent advances, current methods suffer from two critical challenges: prediction jitter across consecutive frames and poor discrimination of ambiguous phases. This paper aims to develop a stable framework by selectively propagating reliable historical information and explicitly modeling uncertainty for hard sample enhancement. Methods: We propose a dual-pathway framework DSTED with Reliable Memory Propagation (RMP) and Uncertainty-Aware Prototype Retrieval (UPR). RMP maintains temporal coherence by filtering and fusing high-confidence historical features through multi-criteria reliability assessment. UPR constructs learnable class-specific prototypes from high-uncertainty samples and performs adaptive prototype matching to refine ambiguous frame representations. Finally, a confidence-driven gate dynamically balances both pathways based on prediction certainty. Results: Our method achieves state-of-the-art performance on AutoLaparo-hysterectomy with 84.36% accuracy and 65.51% F1-score, surpassing the second-best method by 3.51% and 4.88% respectively. Ablations reveal complementary gains from RMP (2.19%) and UPR (1.93%), with synergistic effects when combined. Extensive analysis confirms substantial reduction in temporal jitter and marked improvement on challenging phase transitions. Conclusion: Our dual-pathway design introduces a novel paradigm for stable workflow recognition, demonstrating that decoupling the modeling of temporal consistency and phase ambiguity yields superior performance and clinical applicability.

Elodie Germani, Krystel Nyangoh-Timoh, Pierre Jannin et al.

Promptable segmentation models (e.g., the Segment Anything Models) enable generalizable, zero-shot segmentation across diverse domains. Although predictions are deterministic for a fixed image-prompt pair, the robustness of these models to variations in user prompts, referred to as prompt dependence, remains underexplored. In safety-critical workflows with substantial inter-user variability, interpretable and informative frameworks are needed to evaluate prompt dependence. In this work, we assess the reliability of promptable segmentation by analyzing and measuring its sensitivity to prompt variability. We introduce the first formulation of prompt dependence that explicitly disentangles prompt ambiguity (inter-user variability) from local sensitivity (interaction imprecision), offering an interpretable view of segmentation robustness. Experiments on two female pelvic MRI datasets for uterus and bladder segmentation reveal a strong negative correlation between both metrics and segmentation performance, highlighting the value of our framework for assessing robustness. The two metrics have low mutual correlation, supporting the disentangled design of our formulation, and provide meaningful indicators of prompt-related failure modes.