Nassir Navab

Amir El-Ghoussani, André Kaup, Nassir Navab et al.

We propose a monocular depth estimation method based on visual autoregressive (VAR) priors, offering an alternative to diffusion-based approaches. Our method adapts a large-scale text-to-image VAR model and introduces a scale-wise conditional upsampling mechanism with classifier-free guidance. Our approach performs inference in ten fixed autoregressive stages, requiring only 74K synthetic samples for fine-tuning, and achieves competitive results. We report state-of-the-art performance in indoor benchmarks under constrained training conditions, and strong performance when applied to outdoor datasets. This work establishes autoregressive priors as a complementary family of geometry-aware generative models for depth estimation, highlighting advantages in data scalability, and adaptability to 3D vision tasks. Code available at "https://github.com/AmirMaEl/VAR-Depth".

Meng Wei, Kun Yuan, Shi Li et al.

Enabling intuitive, language-driven interaction with surgical scenes is a critical step toward intelligent operating rooms and autonomous surgical robotic assistance. However, the task of referring segmentation, localizing surgical instruments based on natural language descriptions, remains underexplored in surgical videos, with existing approaches struggling to generalize due to reliance on static visual cues and predefined instrument names. In this work, we introduce SurgRef, a novel motion-guided framework that grounds free-form language expressions in instrument motion, capturing how tools move and interact across time, rather than what they look like. This allows models to understand and segment instruments even under occlusion, ambiguity, or unfamiliar terminology. To train and evaluate SurgRef, we present Ref-IMotion, a diverse, multi-institutional video dataset with dense spatiotemporal masks and rich motion-centric expressions. SurgRef achieves state-of-the-art accuracy and generalization across surgical procedures, setting a new benchmark for robust, language-driven surgical video segmentation.

Feng Li, Yuan Bi, Tianyu Song et al.

Purpose: Spinal instability is a widespread condition that causes pain, fatigue, and restricted mobility, profoundly affecting patients' quality of life. In clinical practice, the gold standard for diagnosis is dynamic X-ray imaging. However, X-ray provides only 2D motion information, while 3D modalities such as computed tomography (CT) or cone beam computed tomography (CBCT) cannot efficiently capture motion. Therefore, there is a need for a system capable of visualizing real-time 3D spinal motion while minimizing radiation exposure. Methods: We propose ultrasound as an auxiliary modality for 3D spine visualization. Due to acoustic limitations, ultrasound captures only the superficial spinal surface. Therefore, the partially compounded ultrasound volume is registered to preoperative 3D imaging. In this study, CBCT provides the neutral spine configuration, while robotic ultrasound acquisition is performed at maximal spinal bending. A kinematic model is applied to the CBCT-derived spine model for coarse registration, followed by ICP for fine registration, with kinematic parameters optimized based on the registration results. Real-time ultrasound motion tracking is then used to estimate continuous 3D spinal motion by interpolating between the neutral and maximally bent states. Results: The pipeline was evaluated on a bendable 3D-printed lumbar spine phantom. The registration error was $1.941 \pm 0.199$ mm and the interpolated spinal motion error was $2.01 \pm 0.309$ mm (median). Conclusion: The proposed robotic ultrasound framework enables radiation-reduced, real-time 3D visualization of spinal motion, offering a promising 3D alternative to conventional dynamic X-ray imaging for assessing spinal instability.

Jinlin Wu, Felix Holm, Chuxi Chen et al.

While foundation models have advanced surgical video analysis, current approaches rely predominantly on pixel-level reconstruction objectives that waste model capacity on low-level visual details - such as smoke, specular reflections, and fluid motion - rather than semantic structures essential for surgical understanding. We present UniSurg, a video-native foundation model that shifts the learning paradigm from pixel-level reconstruction to latent motion prediction. Built on the Video Joint Embedding Predictive Architecture (V-JEPA), UniSurg introduces three key technical innovations tailored to surgical videos: 1) motion-guided latent prediction to prioritize semantically meaningful regions, 2) spatiotemporal affinity self-distillation to enforce relational consistency, and 3) feature diversity regularization to prevent representation collapse in texture-sparse surgical scenes. To enable large-scale pretraining, we curate UniSurg-15M, the largest surgical video dataset to date, comprising 3,658 hours of video from 50 sources across 13 anatomical regions. Extensive experiments across 17 benchmarks demonstrate that UniSurg significantly outperforms state-of-the-art methods on surgical workflow recognition (+14.6% F1 on EgoSurgery, +10.3% on PitVis), action triplet recognition (39.54% mAP-IVT on CholecT50), skill assessment, polyp segmentation, and depth estimation. These results establish UniSurg as a new standard for universal, motion-oriented surgical video understanding.

Ruochen Li, Kun Yuan, Yufei Xia et al.

Surgical planning integrates visual perception, long-horizon reasoning, and procedural knowledge, yet it remains unclear whether current evaluation protocols reliably assess vision-language models (VLMs) in safety-critical settings. Motivated by a goal-oriented view of surgical planning, we define planning correctness via phase-goal satisfiability, where plan validity is determined by expert-defined surgical rules. Based on this definition, we introduce a multicentric meta-evaluation benchmark with valid procedural variations and invalid plans containing order and content errors. Using this benchmark, we show that sequence similarity metrics systematically misjudge planning quality, penalizing valid plans while failing to identify invalid ones. We therefore adopt a rule-based goal-satisfiability metric as a high-precision meta-evaluation reference to assess Video-LLMs under progressively constrained settings, revealing failures due to perception errors and under-constrained reasoning. Structural knowledge consistently improves performance, whereas semantic guidance alone is unreliable and benefits larger models only when combined with structural constraints.

Tony Danjun Wang, Tolga Birdal, Nassir Navab et al.

3D pose estimation from sparse multi-views is a critical task for numerous applications, including action recognition, sports analysis, and human-robot interaction. Optimization-based methods typically follow a two-stage pipeline, first detecting 2D keypoints in each view and then associating these detections across views to triangulate the 3D pose. Existing methods rely on mere pairwise associations to model this correspondence problem, treating global consistency between views (i.e., cycle consistency) as a soft constraint. Yet, reconciling these constraints for multiple views becomes brittle when spurious associations propagate errors. We thus propose COMPOSE, a novel framework that formulates multi-view pose correspondence matching as a hypergraph partitioning problem rather than through pairwise association. While the complexity of the resulting integer linear program grows exponentially in theory, we introduce an efficient geometric pruning strategy to substantially reduce the search space. COMPOSE achieves improvements of up to 23% in average precision over previous optimization-based methods and up to 11% over self-supervised end-to-end learned methods, offering a promising solution to a widely studied problem.

Zhengyang Xu, Han Li, Jingsong Liu et al.

Recent AI navigation approaches aim to improve Whole-Slide Image (WSI) diagnosis by modeling spatial exploration and selecting diagnostically relevant regions, yet most operate at a single fixed magnification or rely on predefined magnification traversal. In clinical practice, pathologists examine slides across multiple magnifications and selectively inspect only necessary scales, dynamically integrating global and cellular evidence in a sequential manner. This mismatch prevents existing methods from modeling cross-magnification interactions and adaptive magnification selection inherent to real diagnostic workflows. To these, we propose a clinically consistent Multi-Magnification WSI Navigation Agent (MMNavAgent) that explicitly models multi magnification interaction and adaptive magnification selection. Specifically, we introduce a Cross-Magnification navigation Tool (CMT) that aggregates contextual information from adjacent magnifications to enhance discriminative representations along the navigation path. We further introduce a Magnification Selection Tool (MST) that leverages memory-driven reasoning within the agent framework to enable interactive and adaptive magnification selection, mimicking the sequential decision process of pathologists. Extensive experiments on a public dataset demonstrate improved diagnostic performance, with 1.45% gain of AUC and 2.93% gain of BACC over a non-agent baseline. Code will be public upon acceptance.

Jiamei Guo, Zhehao Duan, Maria Neiiendam et al.

Purpose: Ultrasound-guided needle interventions are widely used in clinical practice, but their success critically depends on accurate needle placement, which is frequently hindered by the poor and intermittent visibility of needles in ultrasound images. Existing approaches remain limited by artifacts, occlusions, and low contrast, and often fail to support real-time continuous insertion. To overcome these challenges, this study introduces a robust real-time framework for continuous needle detection. Methods: We present ConVibNet, an extension of VibNet for detecting needles with significantly reduced visibility, addressing real-time, continuous needle tracking during insertion. ConVibNet leverages temporal dependencies across successive ultrasound frames to enable continuous estimation of both needle tip position and shaft angle in dynamic scenarios. To strengthen temporal awareness of needle-tip motion, we introduce a novel intersection-and-difference loss that explicitly leverages motion correlations across consecutive frames. In addition, we curated a dedicated dataset for model development and evaluation. Results: The performance of the proposed ConVibNet model was evaluated on our dataset, demonstrating superior accuracy compared to the baseline VibNet and UNet-LSTM models. Specifically, ConVibNet achieved a tip error of 2.80+-2.42 mm and an angle error of 1.69+-2.00 deg. These results represent a 0.75 mm improvement in tip localization accuracy over the best-performing baseline, while preserving real-time inference capability. Conclusion: ConVibNet advances real-time needle detection in ultrasound-guided interventions by integrating temporal correlation modeling with a novel intersection-and-difference loss, thereby improving accuracy and robustness and demonstrating high potential for integration into autonomous insertion systems.

Yihua Shao, Kang Chen, Feng Xue et al.

In operating rooms (OR), world-scale multi-view 3D tracking supports downstream applications such as surgeon behavior recognition, where physically meaningful quantities such as distances and motion statistics must be measured in meters. However, real clinical deployments rarely satisfy the geometric prerequisites for stable multi-view fusion and tracking: camera calibration and RGB-D registration are always unreliable, leading to cross-view geometric inconsistency that produces "ghosting" during fusion and degrades 3D trajectories in a shared OR coordinate frame. To address this, we introduce Geometry OR Tracker, a two-stage pipeline that first rectifies imprecise calibration into a scaleconsistent and geometrically consistent camera setup with a single global scale via a Multi-view Metric Geometry Rectification module, and then performs Occlusion-Robust 3D Point Tracking directly in the unified OR world frame. On the MM-OR benchmark, improved geometric consistency translates into tracking gains: our rectification front-end reduces cross-view depth disagreement by more than 30$\times$ compared to raw calibration. Ablation studies further demonstrate the relationship between calibration quality and tracking accuracy, showing that improved geometric consistency yields stronger world-frame tracking.