Memorized action chunking with Transformers: Imitation learning for vision-based tissue surface scanning

Optical sensing technologies are emerging technologies used in cancer surgeries to ensure the complete removal of cancerous tissue. While point-wise assessment has many potential applications, incorporating automated large area scanning would enable holistic tissue sampling. However, such scanning tasks are challenging due to their long-horizon dependency and the requirement for fine-grained motion. To address these issues, we introduce Memorized Action Chunking with Transformers (MACT), an intuitive yet efficient imitation learning method for tissue surface scanning tasks. It utilizes a sequence of past images as historical information to predict near-future action sequences. In addition, hybrid temporal-spatial positional embeddings were employed to facilitate learning. In various simulation settings, MACT demonstrated significant improvements in contour scanning and area scanning over the baseline model. In real-world testing, with only 50 demonstration trajectories, MACT surpassed the baseline model by achieving a 60-80% success rate on all scanning tasks. Our findings suggest that MACT is a promising model for adaptive scanning in surgical settings.

SurgicalGS: Dynamic 3D Gaussian Splatting for Accurate Robotic-Assisted Surgical Scene Reconstruction

Accurate 3D reconstruction of dynamic surgical scenes from endoscopic video is essential for robotic-assisted surgery. While recent 3D Gaussian Splatting methods have shown promise in achieving high-quality reconstructions with fast rendering speeds, their use of inverse depth loss functions compresses depth variations. This can lead to a loss of fine geometric details, limiting their ability to capture precise 3D geometry and effectiveness in intraoperative application. To address these challenges, we present SurgicalGS, a dynamic 3D Gaussian Splatting framework specifically designed for surgical scene reconstruction with improved geometric accuracy. Our approach first initialises a Gaussian point cloud using depth priors, employing binary motion masks to identify pixels with significant depth variations and fusing point clouds from depth maps across frames for initialisation. We use the Flexible Deformation Model to represent dynamic scene and introduce a normalised depth regularisation loss along with an unsupervised depth smoothness constraint to ensure more accurate geometric reconstruction. Extensive experiments on two real surgical datasets demonstrate that SurgicalGS achieves state-of-the-art reconstruction quality, especially in terms of accurate geometry, advancing the usability of 3D Gaussian Splatting in robotic-assisted surgery.

Tracking Everything in Robotic-Assisted Surgery

Accurate tracking of tissues and instruments in videos is crucial for Robotic-Assisted Minimally Invasive Surgery (RAMIS), as it enables the robot to comprehend the surgical scene with precise locations and interactions of tissues and tools. Traditional keypoint-based sparse tracking is limited by featured points, while flow-based dense two-view matching suffers from long-term drifts. Recently, the Tracking Any Point (TAP) algorithm was proposed to overcome these limitations and achieve dense accurate long-term tracking. However, its efficacy in surgical scenarios remains untested, largely due to the lack of a comprehensive surgical tracking dataset for evaluation. To address this gap, we introduce a new annotated surgical tracking dataset for benchmarking tracking methods for surgical scenarios, comprising real-world surgical videos with complex tissue and instrument motions. We extensively evaluate state-of-the-art (SOTA) TAP-based algorithms on this dataset and reveal their limitations in challenging surgical scenarios, including fast instrument motion, severe occlusions, and motion blur, etc. Furthermore, we propose a new tracking method, namely SurgMotion, to solve the challenges and further improve the tracking performance. Our proposed method outperforms most TAP-based algorithms in surgical instruments tracking, and especially demonstrates significant improvements over baselines in challenging medical videos.

Detecting the Sensing Area of A Laparoscopic Probe in Minimally Invasive Cancer Surgery

In surgical oncology, it is challenging for surgeons to identify lymph nodes and completely resect cancer even with pre-operative imaging systems like PET and CT, because of the lack of reliable intraoperative visualization tools. Endoscopic radio-guided cancer detection and resection has recently been evaluated whereby a novel tethered laparoscopic gamma detector is used to localize a preoperatively injected radiotracer. This can both enhance the endoscopic imaging and complement preoperative nuclear imaging data. However, gamma activity visualization is challenging to present to the operator because the probe is non-imaging and it does not visibly indicate the activity origination on the tissue surface. Initial failed attempts used segmentation or geometric methods, but led to the discovery that it could be resolved by leveraging high-dimensional image features and probe position information. To demonstrate the effectiveness of this solution, we designed and implemented a simple regression network that successfully addressed the problem. To further validate the proposed solution, we acquired and publicly released two datasets captured using a custom-designed, portable stereo laparoscope system. Through intensive experimentation, we demonstrated that our method can successfully and effectively detect the sensing area, establishing a new performance benchmark. Code and data are available at https://github.com/br0202/Sensing_area_detection.git

Deep Imitation Learning for Automated Drop-In Gamma Probe Manipulation

The increasing prevalence of prostate cancer has led to the widespread adoption of Robotic-Assisted Surgery (RAS) as a treatment option. Sentinel lymph node biopsy (SLNB) is a crucial component of prostate cancer surgery and requires accurate diagnostic evidence. This procedure can be improved by using a drop-in gamma probe, SENSEI system, to distinguish cancerous tissue from normal tissue. However, manual control of the probe using live gamma level display and audible feedback could be challenging for inexperienced surgeons, leading to the potential for missed detections. In this study, a deep imitation training workflow was proposed to automate the radioactive node detection procedure. The proposed training workflow uses simulation data to train an end-to-end vision-based gamma probe manipulation agent. The evaluation results showed that the proposed approach was capable to predict the next-step action and holds promise for further improvement and extension to a hardware setup.

Self-Supervised Depth Estimation in Laparoscopic Image using 3D Geometric Consistency

Depth estimation is a crucial step for image-guided intervention in robotic surgery and laparoscopic imaging system. Since per-pixel depth ground truth is difficult to acquire for laparoscopic image data, it is rarely possible to apply supervised depth estimation to surgical applications. As an alternative, self-supervised methods have been introduced to train depth estimators using only synchronized stereo image pairs. However, most recent work focused on the left-right consistency in 2D and ignored valuable inherent 3D information on the object in real world coordinates, meaning that the left-right 3D geometric structural consistency is not fully utilized. To overcome this limitation, we present M3Depth, a self-supervised depth estimator to leverage 3D geometric structural information hidden in stereo pairs while keeping monocular inference. The method also removes the influence of border regions unseen in at least one of the stereo images via masking, to enhance the correspondences between left and right images in overlapping areas. Intensive experiments show that our method outperforms previous self-supervised approaches on both a public dataset and a newly acquired dataset by a large margin, indicating a good generalization across different samples and laparoscopes.

Self-Supervised Generative Adversarial Network for Depth Estimation in Laparoscopic Images

Dense depth estimation and 3D reconstruction of a surgical scene are crucial steps in computer assisted surgery. Recent work has shown that depth estimation from a stereo images pair could be solved with convolutional neural networks. However, most recent depth estimation models were trained on datasets with per-pixel ground truth. Such data is especially rare for laparoscopic imaging, making it hard to apply supervised depth estimation to real surgical applications. To overcome this limitation, we propose SADepth, a new self-supervised depth estimation method based on Generative Adversarial Networks. It consists of an encoder-decoder generator and a discriminator to incorporate geometry constraints during training. Multi-scale outputs from the generator help to solve the local minima caused by the photometric reprojection loss, while the adversarial learning improves the framework generation quality. Extensive experiments on two public datasets show that SADepth outperforms recent state-of-the-art unsupervised methods by a large margin, and reduces the gap between supervised and unsupervised depth estimation in laparoscopic images.

H-Net: Unsupervised Attention-based Stereo Depth Estimation Leveraging Epipolar Geometry

Depth estimation from a stereo image pair has become one of the most explored applications in computer vision, with most of the previous methods relying on fully supervised learning settings. However, due to the difficulty in acquiring accurate and scalable ground truth data, the training of fully supervised methods is challenging. As an alternative, self-supervised methods are becoming more popular to mitigate this challenge. In this paper, we introduce the H-Net, a deep-learning framework for unsupervised stereo depth estimation that leverages epipolar geometry to refine stereo matching. For the first time, a Siamese autoencoder architecture is used for depth estimation which allows mutual information between the rectified stereo images to be extracted. To enforce the epipolar constraint, the mutual epipolar attention mechanism has been designed which gives more emphasis to correspondences of features which lie on the same epipolar line while learning mutual information between the input stereo pair. Stereo correspondences are further enhanced by incorporating semantic information to the proposed attention mechanism. More specifically, the optimal transport algorithm is used to suppress attention and eliminate outliers in areas not visible in both cameras. Extensive experiments on KITTI2015 and Cityscapes show that our method outperforms the state-ofthe-art unsupervised stereo depth estimation methods while closing the gap with the fully supervised approaches.

Estimation of Tissue Oxygen Saturation from RGB images and Sparse Hyperspectral Signals based on Conditional Generative Adversarial Network

Purpose: Intra-operative measurement of tissue oxygen saturation (StO2) is important in the detection of ischemia, monitoring perfusion and identifying disease. Hyperspectral imaging (HSI) measures the optical reflectance spectrum of the tissue and uses this information to quantify its composition, including StO2. However, real-time monitoring is difficult due to the capture rate and data processing time. Methods: An endoscopic system based on a multi-fiber probe was previously developed to sparsely capture HSI data (sHSI). These were combined with RGB images, via a deep neural network, to generate high-resolution hypercubes and calculate StO2. To improve accuracy and processing speed, we propose a dual-input conditional generative adversarial network (cGAN), Dual2StO2, to directly estimate StO2 by fusing features from both RGB and sHSI. Results: Validation experiments were carried out on in vivo porcine bowel data, where the ground truth StO2 was generated from the HSI camera. The performance was also compared to our previous super-spectral-resolution network, SSRNet in terms of mean StO2 prediction accuracy and structural similarity metrics. Dual2StO2 was also tested using simulated probe data with varying fiber number. Conclusions: StO2 estimation by Dual2StO2 is visually closer to ground truth in general structure, achieves higher prediction accuracy and faster processing speed than SSRNet. Simulations showed that results improved when a greater number of fibers are used in the probe. Future work will include refinement of the network architecture, hardware optimization based on simulation results, and evaluation of the technique in clinical applications beyond StO2 estimation.

Estimation of Tissue Oxygen Saturation from RGB Images based on Pixel-level Image Translation

Intra-operative measurement of tissue oxygen saturation (StO2) has been widely explored by pulse oximetry or hyperspectral imaging (HSI) to assess the function and viability of tissue. In this paper we propose a pixel- level image-to-image translation approach based on conditional Generative Adversarial Networks (cGAN) to estimate tissue oxygen saturation (StO2) directly from RGB images. The real-time performance and non-reliance on additional hardware, enable a seamless integration of the proposed method into surgical and diagnostic workflows with standard endoscope systems. For validation, RGB images and StO2 ground truth were simulated and estimated from HSI images collected by a liquid crystal tuneable filter (LCTF) endoscope for three tissue types (porcine bowel, lamb uterus and rabbit uterus). The result show that the proposed method can achieve visually identical images with comparable accuracy.