Jack H. Noble

Yike Zhang, Eduardo Davalos, Jack Noble

Accurate 6D pose estimation has gained more attention over the years for robotics-assisted tasks that require precise interaction with physical objects. This paper presents an interactive 3D-to-2D visualization and annotation tool to support the 6D pose estimation research community. To the best of our knowledge, the proposed work is the first tool that allows users to visualize and manipulate 3D objects interactively on a 2D real-world scene, along with a comprehensive user study. This system supports robust 6D camera pose annotation by providing both visual cues and spatial relationships to determine object position and orientation in various environments. The annotation feature in Vision6D is particularly helpful in scenarios where the transformation matrix between the camera and world objects is unknown, as it enables accurate annotation of these objects' poses using only the camera intrinsic matrix. This capability serves as a foundational step in developing and training advanced pose estimation models across various domains. We evaluate Vision6D's effectiveness by utilizing widely-used open-source pose estimation datasets Linemod and HANDAL through comparisons between the default ground-truth camera poses with manual annotations. A user study was performed to show that Vision6D generates accurate pose annotations via visual cues in an intuitive 3D user interface. This approach aims to bridge the gap between 2D scene projections and 3D scenes, offering an effective way for researchers and developers to solve 6D pose annotation related problems. The software is open-source and publicly available at https://github.com/InteractiveGL/vision6D.

Ange Lou, Kareem Tawfik, Xing Yao et al.

A common problem with segmentation of medical images using neural networks is the difficulty to obtain a significant number of pixel-level annotated data for training. To address this issue, we proposed a semi-supervised segmentation network based on contrastive learning. In contrast to the previous state-of-the-art, we introduce Min-Max Similarity (MMS), a contrastive learning form of dual-view training by employing classifiers and projectors to build all-negative, and positive and negative feature pairs, respectively, to formulate the learning as solving a MMS problem. The all-negative pairs are used to supervise the networks learning from different views and to capture general features, and the consistency of unlabeled predictions is measured by pixel-wise contrastive loss between positive and negative pairs. To quantitatively and qualitatively evaluate our proposed method, we test it on four public endoscopy surgical tool segmentation datasets and one cochlear implant surgery dataset, which we manually annotated. Results indicate that our proposed method consistently outperforms state-of-the-art semi-supervised and fully supervised segmentation algorithms. And our semi-supervised segmentation algorithm can successfully recognize unknown surgical tools and provide good predictions. Also, our MMS approach could achieve inference speeds of about 40 frames per second (fps) and is suitable to deal with the real-time video segmentation.

Ange Lou, Jack Noble

Depth estimation in surgical video plays a crucial role in many image-guided surgery procedures. However, it is difficult and time consuming to create depth map ground truth datasets in surgical videos due in part to inconsistent brightness and noise in the surgical scene. Therefore, building an accurate and robust self-supervised depth and camera ego-motion estimation system is gaining more attention from the computer vision community. Although several self-supervision methods alleviate the need for ground truth depth maps and poses, they still need known camera intrinsic parameters, which are often missing or not recorded. Moreover, the camera intrinsic prediction methods in existing works depend heavily on the quality of datasets. In this work, we aimed to build a self-supervised depth and ego-motion estimation system which can predict not only accurate depth maps and camera pose, but also camera intrinsic parameters. We proposed a cost-volume-based supervision manner to give the system auxiliary supervision for camera parameters prediction. The experimental results showed that the proposed method improved the accuracy of estimated camera parameters, ego-motion, and depth estimation.

Yike Zhang, Jack Noble

AI-assisted surgeries have drawn the attention of the medical image research community due to their real-world impact on improving surgery success rates. For image-guided surgeries, such as Cochlear Implants (CIs), accurate object segmentation can provide useful information for surgeons before an operation. Recently published image segmentation methods that leverage machine learning usually rely on a large number of manually predefined ground truth labels. However, it is a laborious and time-consuming task to prepare the dataset. This paper presents a novel technique using a self-supervised 3D-UNet that produces a dense deformation field between an atlas and a target image that can be used for atlas-based segmentation of the ossicles. Our results show that our method outperforms traditional image segmentation methods and generates a more accurate boundary around the ossicles based on Dice similarity coefficient and point-to-point error comparison. The mean Dice coefficient is improved by 8.51% with our proposed method.

Ange Lou, Yamin Li, Xing Yao et al.

The accurate reconstruction of surgical scenes from surgical videos is critical for various applications, including intraoperative navigation and image-guided robotic surgery automation. However, previous approaches, mainly relying on depth estimation, have limited effectiveness in reconstructing surgical scenes with moving surgical tools. To address this limitation and provide accurate 3D position prediction for surgical tools in all frames, we propose a novel approach called SAMSNeRF that combines Segment Anything Model (SAM) and Neural Radiance Field (NeRF) techniques. Our approach generates accurate segmentation masks of surgical tools using SAM, which guides the refinement of the dynamic surgical scene reconstruction by NeRF. Our experimental results on public endoscopy surgical videos demonstrate that our approach successfully reconstructs high-fidelity dynamic surgical scenes and accurately reflects the spatial information of surgical tools. Our proposed approach can significantly enhance surgical navigation and automation by providing surgeons with accurate 3D position information of surgical tools during surgery.The source code will be released soon.

Ange Lou, Xing Yao, Ziteng Liu et al.

Surgical instrument tracking is an active research area that can provide surgeons feedback about the location of their tools relative to anatomy. Recent tracking methods are mainly divided into two parts: segmentation and object detection. However, both can only predict 2D information, which is limiting for application to real-world surgery. An accurate 3D surgical instrument model is a prerequisite for precise predictions of the pose and depth of the instrument. Recent single-view 3D reconstruction methods are only used in natural object reconstruction and do not achieve satisfying reconstruction accuracy without 3D attribute-level supervision. Further, those methods are not suitable for the surgical instruments because of their elongated shapes. In this paper, we firstly propose an end-to-end surgical instrument reconstruction system -- Self-supervised Surgical Instrument Reconstruction (SSIR). With SSIR, we propose a multi-cycle-consistency strategy to help capture the texture information from a slim instrument while only requiring a binary instrument label map. Experiments demonstrate that our approach improves the reconstruction quality of surgical instruments compared to other self-supervised methods and achieves promising results.

Ange Lou, Yamin Li, Yike Zhang et al.

The Segment Anything Model 2 (SAM 2) is the latest generation foundation model for image and video segmentation. Trained on the expansive Segment Anything Video (SA-V) dataset, which comprises 35.5 million masks across 50.9K videos, SAM 2 advances its predecessor's capabilities by supporting zero-shot segmentation through various prompts (e.g., points, boxes, and masks). Its robust zero-shot performance and efficient memory usage make SAM 2 particularly appealing for surgical tool segmentation in videos, especially given the scarcity of labeled data and the diversity of surgical procedures. In this study, we evaluate the zero-shot video segmentation performance of the SAM 2 model across different types of surgeries, including endoscopy and microscopy. We also assess its performance on videos featuring single and multiple tools of varying lengths to demonstrate SAM 2's applicability and effectiveness in the surgical domain. We found that: 1) SAM 2 demonstrates a strong capability for segmenting various surgical videos; 2) When new tools enter the scene, additional prompts are necessary to maintain segmentation accuracy; and 3) Specific challenges inherent to surgical videos can impact the robustness of SAM 2.

Yike Zhang, Eduardo Davalos, Dingjie Su et al.

Cochlear Implant (CI) procedures require the insertion of an electrode array into the cochlea within the inner ear. To achieve this, mastoidectomy, a surgical procedure involving the removal of part of the mastoid region of the temporal bone using a high-speed drill provides safe access to the cochlea through the middle and inner ear. In this paper, we propose a novel Mamba-based method to synthesize the mastoidectomy volume using only preoperative Computed Tomography (CT) scans, where the mastoid remains intact. Our approach introduces a self-supervised learning framework designed to predict the mastoidectomy shape and reconstruct a 3D post-mastoidectomy surface directly from preoperative CT scans. This reconstruction aligns with intraoperative microscope views, enabling various downstream surgical applications. For training, we leverage postoperative CT scans to bypass manual data cleaning and labeling, even when the region removed during mastoidectomy is affected by challenges such as metal artifacts, low signal-to-noise ratio, or electrode wiring. Our method achieves a mean Dice score of 0.70 in estimating mastoidectomy regions, demonstrating its effectiveness for accurate and efficient surgical preoperative planning.

Yike Zhang, Jack Noble

Cochlear Implant (CI) procedures involve performing an invasive mastoidectomy to insert an electrode array into the cochlea. In this paper, we introduce a novel pipeline that is capable of generating synthetic multi-view videos from a single CI microscope image. In our approach, we use a patient's pre-operative CT scan to predict the post-mastoidectomy surface using a method designed for this purpose. We manually align the surface with a selected microscope frame to obtain an accurate initial pose of the reconstructed CT mesh relative to the microscope. We then perform UV projection to transfer the colors from the frame to surface textures. Novel views of the textured surface can be used to generate a large dataset of synthetic frames with ground truth poses. We evaluated the quality of synthetic views rendered using Pytorch3D and PyVista. We found both rendering engines lead to similarly high-quality synthetic novel-view frames compared to ground truth with a structural similarity index for both methods averaging about 0.86. A large dataset of novel views with known poses is critical for ongoing training of a method to automatically estimate microscope pose for 2D to 3D registration with the pre-operative CT to facilitate augmented reality surgery. This dataset will empower various downstream tasks, such as integrating Augmented Reality (AR) in the OR, tracking surgical tools, and supporting other video analysis studies.

Ange Lou, Benjamin Planche, Zhongpai Gao et al.

Addressing the intricate challenge of modeling and re-rendering dynamic scenes, most recent approaches have sought to simplify these complexities using plane-based explicit representations, overcoming the slow training time issues associated with methods like Neural Radiance Fields (NeRF) and implicit representations. However, the straightforward decomposition of 4D dynamic scenes into multiple 2D plane-based representations proves insufficient for re-rendering high-fidelity scenes with complex motions. In response, we present a novel direction-aware representation (DaRe) approach that captures scene dynamics from six different directions. This learned representation undergoes an inverse dual-tree complex wavelet transformation (DTCWT) to recover plane-based information. DaReNeRF computes features for each space-time point by fusing vectors from these recovered planes. Combining DaReNeRF with a tiny MLP for color regression and leveraging volume rendering in training yield state-of-the-art performance in novel view synthesis for complex dynamic scenes. Notably, to address redundancy introduced by the six real and six imaginary direction-aware wavelet coefficients, we introduce a trainable masking approach, mitigating storage issues without significant performance decline. Moreover, DaReNeRF maintains a 2x reduction in training time compared to prior art while delivering superior performance.

Yike Zhang, Eduardo Davalos, Dingjie Su et al.

For those experiencing severe-to-profound sensorineural hearing loss, the cochlear implant (CI) is the preferred treatment. Augmented reality (AR) aided surgery can potentially improve CI procedures and hearing outcomes. Typically, AR solutions for image-guided surgery rely on optical tracking systems to register pre-operative planning information to the display so that hidden anatomy or other important information can be overlayed and co-registered with the view of the surgical scene. In this paper, our goal is to develop a method that permits direct 2D-to-3D registration of the microscope video to the pre-operative Computed Tomography (CT) scan without the need for external tracking equipment. Our proposed solution involves using surface mapping of a portion of the incus in surgical recordings and determining the pose of this structure relative to the surgical microscope by performing pose estimation via the perspective-n-point (PnP) algorithm. This registration can then be applied to pre-operative segmentations of other anatomy-of-interest, as well as the planned electrode insertion trajectory to co-register this information for the AR display. Our results demonstrate the accuracy with an average rotation error of less than 25 degrees and a translation error of less than 2 mm, 3 mm, and 0.55% for the x, y, and z axes, respectively. Our proposed method has the potential to be applicable and generalized to other surgical procedures while only needing a monocular microscope during intra-operation.

Yike Zhang, Eduardo Davalos, Jack Noble

Recent deep learning-based image completion methods, including both inpainting and outpainting, have demonstrated promising results in restoring corrupted images by effectively filling various missing regions. Among these, Generative Adversarial Networks (GANs) and Denoising Diffusion Probabilistic Models (DDPMs) have been employed as key generative image completion approaches, excelling in the field of generating high-quality restorations with reduced artifacts and improved fine details. In previous work, we developed a method aimed at synthesizing views from novel microscope positions for mastoidectomy surgeries; however, that approach did not have the ability to restore the surrounding surgical scene environment. In this paper, we propose an efficient method to complete the surgical scene of the synthetic postmastoidectomy dataset. Our approach leverages self-supervised learning on real surgical datasets to train a Single-Step Denoising Diffusion-GAN (SSDD-GAN), combining the advantages of diffusion models with the adversarial optimization of GANs for improved Structural Similarity results of 6%. The trained model is then directly applied to the synthetic postmastoidectomy dataset using a zero-shot approach, enabling the generation of realistic and complete surgical scenes without the need for explicit ground-truth labels from the synthetic postmastoidectomy dataset. This method addresses key limitations in previous work, offering a novel pathway for full surgical microscopy scene completion and enhancing the usability of the synthetic postmastoidectomy dataset in surgical preoperative planning and intraoperative navigation.

Ange Lou, Benjamin Planche, Zhongpai Gao et al.

Numerous recent approaches to modeling and re-rendering dynamic scenes leverage plane-based explicit representations, addressing slow training times associated with models like neural radiance fields (NeRF) and Gaussian splatting (GS). However, merely decomposing 4D dynamic scenes into multiple 2D plane-based representations is insufficient for high-fidelity re-rendering of scenes with complex motions. In response, we present DaRePlane, a novel direction-aware representation approach that captures scene dynamics from six different directions. This learned representation undergoes an inverse dual-tree complex wavelet transformation (DTCWT) to recover plane-based information. Within NeRF pipelines, DaRePlane computes features for each space-time point by fusing vectors from these recovered planes, then passed to a tiny MLP for color regression. When applied to Gaussian splatting, DaRePlane computes the features of Gaussian points, followed by a tiny multi-head MLP for spatial-time deformation prediction. Notably, to address redundancy introduced by the six real and six imaginary direction-aware wavelet coefficients, we introduce a trainable masking approach, mitigating storage issues without significant performance decline. To demonstrate the generality and efficiency of DaRePlane, we test it on both regular and surgical dynamic scenes, for both NeRF and GS systems. Extensive experiments show that DaRePlane yields state-of-the-art performance in novel view synthesis for various complex dynamic scenes.

Hannah G. Mason, Jack H. Noble

Cochlear implants (CIs) are neural prosthetics used to treat patients with severe-to-profound hearing loss. Patient-specific modeling of CI stimulation of the auditory nerve fiber (ANFs) can help audiologists improve the CI programming. These models require localization of the ANFs relative to surrounding anatomy and the CI. Localization is challenging because the ANFs are so small they are not directly visible in clinical imaging. In this work, we hypothesize the position of the ANFs can be accurately inferred from the location of the internal auditory canal (IAC), which has high contrast in CT, since the ANFs pass through this canal between the cochlea and the brain. Inspired by VoxelMorph, in this paper we propose a deep atlas-based IAC segmentation network. We create a single atlas in which the IAC and ANFs are pre-localized. Our network is trained to produce deformation fields (DFs) mapping coordinates from the atlas to new target volumes and that accurately segment the IAC. We hypothesize that DFs that accurately segment the IAC in target images will also facilitate accurate atlas-based localization of the ANFs. As opposed to VoxelMorph, which aims to produce DFs that accurately register the entire volume, our novel contribution is an entirely self-supervised training scheme that aims to produce DFs that accurately segment the target structure. This self-supervision is facilitated using a regional level set (LS) inspired loss function. We call our method Deep Atlas Based Segmentation using Level Sets (DABS-LS). Results show that DABS-LS outperforms VoxelMorph for IAC segmentation. Tests with publicly available datasets for trachea and kidney segmentation also show significant improvement in segmentation accuracy, demonstrating the generalizability of the method.

Yike Zhang, Eduardo Davalos, Dingjie Su et al.

Cochlear Implant (CI) surgery treats severe hearing loss by inserting an electrode array into the cochlea to stimulate the auditory nerve. An important step in this procedure is mastoidectomy, which removes part of the mastoid region of the temporal bone to provide surgical access. Accurate mastoidectomy shape prediction from preoperative imaging improves pre-surgical planning, reduces risks, and enhances surgical outcomes. Despite its importance, there are limited deep-learning-based studies regarding this topic due to the challenges of acquiring ground-truth labels. We address this gap by investigating self-supervised and weakly-supervised learning models to predict the mastoidectomy region without human annotations. We propose a hybrid self-supervised and weakly-supervised learning framework to predict the mastoidectomy region directly from preoperative CT scans, where the mastoid remains intact. Our hybrid method achieves a mean Dice score of 0.72 when predicting the complex and boundary-less mastoidectomy shape, surpassing state-of-the-art approaches and demonstrating strong performance. The method provides groundwork for constructing 3D postmastoidectomy surfaces directly from the corresponding preoperative CT scans. To our knowledge, this is the first work that integrating self-supervised and weakly-supervised learning for mastoidectomy shape prediction, offering a robust and efficient solution for CI surgical planning while leveraging 3D T-distribution loss in weakly-supervised medical imaging.

Yike Zhang, Eduardo Davalos Anaya, Jack H. Noble

This paper presents a novel method for monocular patient-to-image intraoperative registration, specifically designed to operate without any external hardware tracking equipment or fiducial point markers. Leveraging a synthetic microscopy surgical scene dataset with a wide range of transformations, our approach directly maps preoperative CT scans to 2D intraoperative surgical frames through a lightweight neural network for real-time cochlear implant surgery guidance via a zero-shot learning approach. Unlike traditional methods, our framework seamlessly integrates with monocular surgical microscopes, making it highly practical for clinical use without additional hardware dependencies and requirements. Our method estimates camera poses, which include a rotation matrix and a translation vector, by learning from the synthetic dataset, enabling accurate and efficient intraoperative registration. The proposed framework was evaluated on nine clinical cases using a patient-specific and cross-patient validation strategy. Our results suggest that our approach achieves clinically relevant accuracy in predicting 6D camera poses for registering 3D preoperative CT scans to 2D surgical scenes with an angular error within 10 degrees in most cases, while also addressing limitations of traditional methods, such as reliance on external tracking systems or fiducial markers.

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].

Jianing Wang, Dingjie Su, Yubo Fan et al.

We propose an atlas-based method to segment the intracochlear anatomy (ICA) in the post-implantation CT (Post-CT) images of cochlear implant (CI) recipients that preserves the point-to-point correspondence between the meshes in the atlas and the segmented volumes. To solve this problem, which is challenging because of the strong artifacts produced by the implant, we use a pair of co-trained deep networks that generate dense deformation fields (DDFs) in opposite directions. One network is tasked with registering an atlas image to the Post-CT images and the other network is tasked with registering the Post-CT images to the atlas image. The networks are trained using loss functions based on voxel-wise labels, image content, fiducial registration error, and cycle-consistency constraint. The segmentation of the ICA in the Post-CT images is subsequently obtained by transferring the predefined segmentation meshes of the ICA in the atlas image to the Post-CT images using the corresponding DDFs generated by the trained registration networks. Our model can learn the underlying geometric features of the ICA even though they are obscured by the metal artifacts. We show that our end-to-end network produces results that are comparable to the current state of the art (SOTA) that relies on a two-steps approach that first uses conditional generative adversarial networks to synthesize artifact-free images from the Post-CT images and then uses an active shape model-based method to segment the ICA in the synthetic images. Our method requires a fraction of the time needed by the SOTA, which is important for end-user acceptance.

Yiyuan Zhao, Jianing Wang, Rui Li et al.

Cochlear implants (CIs) are a standard treatment for patients who experience severe to profound hearing loss. Recent studies have shown that hearing outcome is correlated with intra-cochlear anatomy and electrode placement. Our group has developed image-guided CI programming (IGCIP) techniques that use image analysis methods to both segment the inner ear structures in pre- or post-implantation CT images and localize the CI electrodes in post-implantation CT images. This permits to assist audiologists with CI programming by suggesting which among the contacts should be deactivated to reduce electrode interaction that is known to affect outcomes. Clinical studies have shown that IGCIP can improve hearing outcomes for CI recipients. However, the sensitivity of IGCIP with respect to the accuracy of the two major steps: electrode localization and intra-cochlear anatomy segmentation, is unknown. In this article, we create a ground truth dataset with conventional CT and micro-CT images of 35 temporal bone specimens to both rigorously characterize the accuracy of these two steps and assess how inaccuracies in these steps affect the overall results. Our study results show that when clinical pre- and post-implantation CTs are available, IGCIP produces results that are comparable to those obtained with the corresponding ground truth in 86.7% of the subjects tested. When only post-implantation CTs are available, this number is 83.3%. These results suggest that our current method is robust to errors in segmentation and localization but also that it can be improved upon. Keywords: cochlear implant, ground truth, segmentation, validation

Dongqing Zhang, Jianing Wang, Jack H. Noble et al.

Cochlear implants (CIs) are neural prosthetics which are used to treat patients with hearing loss. CIs use an array of electrodes which are surgically inserted into the cochlea to stimulate the auditory nerve endings. After surgery, CIs need to be programmed. Studies have shown that the spatial relationship between the intra-cochlear anatomy and electrodes derived from medical images can guide CI programming and lead to significant improvement in hearing outcomes. However, clinical head CT images are usually obtained from scanners of different brands with different protocols. The field of view thus varies greatly and visual inspection is needed to document their content prior to applying algorithms for electrode localization and intra-cochlear anatomy segmentation. In this work, to determine the presence/absence of inner ears and to accurately localize them in head CTs, we use a volume-to-volume convolutional neural network which can be trained end-to-end to map a raw CT volume to probability maps which indicate inner ear positions. We incorporate a false positive suppression strategy in training and apply a shape-based constraint. We achieve a labeling accuracy of 98.59% and a localization error of 2.45mm. The localization error is significantly smaller than a random forest-based approach that has been proposed recently to perform the same task.