Enhancing Bronchoscopy Depth Estimation through Synthetic-to-Real Domain Adaptation

Monocular depth estimation has shown promise in general imaging tasks, aiding in localization and 3D reconstruction. While effective in various domains, its application to bronchoscopic images is hindered by the lack of labeled data, challenging the use of supervised learning methods. In this work, we propose a transfer learning framework that leverages synthetic data with depth labels for training and adapts domain knowledge for accurate depth estimation in real bronchoscope data. Our network demonstrates improved depth prediction on real footage using domain adaptation compared to training solely on synthetic data, validating our approach.

Multi-Stage Airway Segmentation in Lung CT Based on Multi-scale Nested Residual UNet

Accurate and complete segmentation of airways in chest CT images is essential for the quantitative assessment of lung diseases and the facilitation of pulmonary interventional procedures. Although deep learning has led to significant advancements in medical image segmentation, maintaining airway continuity remains particularly challenging. This difficulty arises primarily from the small and dispersed nature of airway structures, as well as class imbalance in CT scans. To address these challenges, we designed a Multi-scale Nested Residual U-Net (MNR-UNet), incorporating multi-scale inputs and Residual Multi-scale Modules (RMM) into a nested residual framework to enhance information flow, effectively capturing the intricate details of small airways and mitigating gradient vanishing. Building on this, we developed a three-stage segmentation pipeline to optimize the training of the MNR-UNet. The first two stages prioritize high accuracy and sensitivity, while the third stage focuses on repairing airway breakages to balance topological completeness and correctness. To further address class imbalance, we introduced a weighted Breakage-Aware Loss (wBAL) to heighten focus on challenging samples, penalizing breakages and thereby extending the length of the airway tree. Additionally, we proposed a hierarchical evaluation framework to offer more clinically meaningful analysis. Validation on both in-house and public datasets demonstrates that our approach achieves superior performance in detecting more accurate airway voxels and identifying additional branches, significantly improving airway topological completeness. The code will be released publicly following the publication of the paper.

Making LLMs Vulnerable to Prompt Injection via Poisoning Alignment

In a prompt injection attack, an attacker injects a prompt into the original one, aiming to make the LLM follow the injected prompt and perform a task chosen by the attacker. Existing prompt injection attacks primarily focus on how to blend the injected prompt into the original prompt without altering the LLM itself. Our experiments show that these attacks achieve some success, but there is still significant room for improvement. In this work, we show that an attacker can boost the success of prompt injection attacks by poisoning the LLM's alignment process. Specifically, we propose PoisonedAlign, a method to strategically create poisoned alignment samples. When even a small fraction of the alignment data is poisoned using our method, the aligned LLM becomes more vulnerable to prompt injection while maintaining its foundational capabilities. The code is available at https://github.com/Sadcardation/PoisonedAlign

Automatically Generating Visual Hallucination Test Cases for Multimodal Large Language Models

Visual hallucination (VH) occurs when a multimodal large language model (MLLM) generates responses with incorrect visual details for prompts. Existing methods for generating VH test cases primarily rely on human annotations, typically in the form of triples: (image, question, answer). In this paper, we introduce VHExpansion, the first automated method for expanding VH test cases for MLLMs. Given an initial VH test case, VHExpansion automatically expands it by perturbing the question and answer through negation as well as modifying the image using both common and adversarial perturbations. Additionally, we propose a new evaluation metric, symmetric accuracy, which measures the proportion of correctly answered VH test-case pairs. Each pair consists of a test case and its negated counterpart. Our theoretical analysis shows that symmetric accuracy is an unbiased evaluation metric that remains unaffected by the imbalance of VH testing cases with varying answers when an MLLM is randomly guessing the answers, whereas traditional accuracy is prone to such imbalance. We apply VHExpansion to expand three VH datasets annotated manually and use these expanded datasets to benchmark seven MLLMs. Our evaluation shows that VHExpansion effectively identifies more VH test cases. Moreover, symmetric accuracy, being unbiased, leads to different conclusions about the vulnerability of MLLMs to VH compared to traditional accuracy metric. Finally, we show that fine-tuning MLLMs on the expanded VH dataset generated by VHExpansion mitigates VH more effectively than fine-tuning on the original, manually annotated dataset. Our code is available at: https://github.com/lycheeefish/VHExpansion.

Can DeepFake Speech be Reliably Detected?

Recent advances in text-to-speech (TTS) systems, particularly those with voice cloning capabilities, have made voice impersonation readily accessible, raising ethical and legal concerns due to potential misuse for malicious activities like misinformation campaigns and fraud. While synthetic speech detectors (SSDs) exist to combat this, they are vulnerable to ``test domain shift", exhibiting decreased performance when audio is altered through transcoding, playback, or background noise. This vulnerability is further exacerbated by deliberate manipulation of synthetic speech aimed at deceiving detectors. This work presents the first systematic study of such active malicious attacks against state-of-the-art open-source SSDs. White-box attacks, black-box attacks, and their transferability are studied from both attack effectiveness and stealthiness, using both hardcoded metrics and human ratings. The results highlight the urgent need for more robust detection methods in the face of evolving adversarial threats.

EndoOmni: Zero-Shot Cross-Dataset Depth Estimation in Endoscopy by Robust Self-Learning from Noisy Labels

Single-image depth estimation is essential for endoscopy tasks such as localization, reconstruction, and augmented reality. Most existing methods in surgical scenes focus on in-domain depth estimation, limiting their real-world applicability. This constraint stems from the scarcity and inferior labeling quality of medical data for training. In this work, we present EndoOmni, the first foundation model for zero-shot cross-domain depth estimation for endoscopy. To harness the potential of diverse training data, we refine the advanced self-learning paradigm that employs a teacher model to generate pseudo-labels, guiding a student model trained on large-scale labeled and unlabeled data. To address training disturbance caused by inherent noise in depth labels, we propose a robust training framework that leverages both depth labels and estimated confidence from the teacher model to jointly guide the student model training. Moreover, we propose a weighted scale-and-shift invariant loss to adaptively adjust learning weights based on label confidence, thus imposing learning bias towards cleaner label pixels while reducing the influence of highly noisy pixels. Experiments on zero-shot relative depth estimation show that our EndoOmni improves state-of-the-art methods in medical imaging for 41\% and existing foundation models for 25\% in terms of absolute relative error on specific dataset. Furthermore, our model provides strong initialization for fine-tuning to metric depth estimation, maintaining superior performance in both in-domain and out-of-domain scenarios. The source code will be publicly available.

SurgTrack: CAD-Free 3D Tracking of Real-world Surgical Instruments

Vision-based surgical navigation has received increasing attention due to its non-invasive, cost-effective, and flexible advantages. In particular, a critical element of the vision-based navigation system is tracking surgical instruments. Compared with 2D instrument tracking methods, 3D instrument tracking has broader value in clinical practice, but is also more challenging due to weak texture, occlusion, and lack of Computer-Aided Design (CAD) models for 3D registration. To solve these challenges, we propose the SurgTrack, a two-stage 3D instrument tracking method for CAD-free and robust real-world applications. In the first registration stage, we incorporate an Instrument Signed Distance Field (SDF) modeling the 3D representation of instruments, achieving CAD-freed 3D registration. Due to this, we can obtain the location and orientation of instruments in the 3D space by matching the video stream with the registered SDF model. In the second tracking stage, we devise a posture graph optimization module, leveraging the historical tracking results of the posture memory pool to optimize the tracking results and improve the occlusion robustness. Furthermore, we collect the Instrument3D dataset to comprehensively evaluate the 3D tracking of surgical instruments. The extensive experiments validate the superiority and scalability of our SurgTrack, by outperforming the state-of-the-arts with a remarkable improvement. The code and dataset are available at https://github.com/wenwucode/SurgTrack.

CathAction: A Benchmark for Endovascular Intervention Understanding

Real-time visual feedback from catheterization analysis is crucial for enhancing surgical safety and efficiency during endovascular interventions. However, existing datasets are often limited to specific tasks, small scale, and lack the comprehensive annotations necessary for broader endovascular intervention understanding. To tackle these limitations, we introduce CathAction, a large-scale dataset for catheterization understanding. Our CathAction dataset encompasses approximately 500,000 annotated frames for catheterization action understanding and collision detection, and 25,000 ground truth masks for catheter and guidewire segmentation. For each task, we benchmark recent related works in the field. We further discuss the challenges of endovascular intentions compared to traditional computer vision tasks and point out open research questions. We hope that CathAction will facilitate the development of endovascular intervention understanding methods that can be applied to real-world applications. The dataset is available at https://airvlab.github.io/cathdata/.

Force Sensing Guided Artery-Vein Segmentation via Sequential Ultrasound Images

Accurate identification of arteries and veins in ultrasound images is crucial for vascular examinations and interventions in robotics-assisted surgeries. However, current methods for ultrasound vessel segmentation face challenges in distinguishing between arteries and veins due to their morphological similarities. To address this challenge, this study introduces a novel force sensing guided segmentation approach to enhance artery-vein segmentation accuracy by leveraging their distinct deformability. Our proposed method utilizes force magnitude to identify key frames with the most significant vascular deformation in a sequence of ultrasound images. These key frames are then integrated with the current frame through attention mechanisms, with weights assigned in accordance with force magnitude. Our proposed force sensing guided framework can be seamlessly integrated into various segmentation networks and achieves significant performance improvements in multiple U-shaped networks such as U-Net, Swin-unet and Transunet. Furthermore, we contribute the first multimodal ultrasound artery-vein segmentation dataset, Mus-V, which encompasses both force and image data simultaneously. The dataset comprises 3114 ultrasound images of carotid and femoral vessels extracted from 105 videos, with corresponding force data recorded by the force sensor mounted on the US probe. Our code and dataset will be publicly available.

ASI-Seg: Audio-Driven Surgical Instrument Segmentation with Surgeon Intention Understanding

Surgical instrument segmentation is crucial in surgical scene understanding, thereby facilitating surgical safety. Existing algorithms directly detected all instruments of pre-defined categories in the input image, lacking the capability to segment specific instruments according to the surgeon's intention. During different stages of surgery, surgeons exhibit varying preferences and focus toward different surgical instruments. Therefore, an instrument segmentation algorithm that adheres to the surgeon's intention can minimize distractions from irrelevant instruments and assist surgeons to a great extent. The recent Segment Anything Model (SAM) reveals the capability to segment objects following prompts, but the manual annotations for prompts are impractical during the surgery. To address these limitations in operating rooms, we propose an audio-driven surgical instrument segmentation framework, named ASI-Seg, to accurately segment the required surgical instruments by parsing the audio commands of surgeons. Specifically, we propose an intention-oriented multimodal fusion to interpret the segmentation intention from audio commands and retrieve relevant instrument details to facilitate segmentation. Moreover, to guide our ASI-Seg segment of the required surgical instruments, we devise a contrastive learning prompt encoder to effectively distinguish the required instruments from the irrelevant ones. Therefore, our ASI-Seg promotes the workflow in the operating rooms, thereby providing targeted support and reducing the cognitive load on surgeons. Extensive experiments are performed to validate the ASI-Seg framework, which reveals remarkable advantages over classical state-of-the-art and medical SAMs in both semantic segmentation and intention-oriented segmentation. The source code is available at https://github.com/Zonmgin-Zhang/ASI-Seg.