Synergistic Bleeding Region and Point Detection in Surgical Videos

Intraoperative bleeding in laparoscopic surgery causes rapid obscuration of the operative field to hinder the surgical process. Intelligent detection of bleeding regions can quantify the blood loss to assist decision-making, while locating the bleeding point helps surgeons quickly identify the source of bleeding and achieve hemostasis in time. In this study, we first construct a real-world surgical bleeding detection dataset, named SurgBlood, comprising 5,330 frames from 95 surgical video clips with bleeding region and point annotations. Accordingly, we develop a dual-task synergistic online detector called BlooDet, designed to perform simultaneous detection of bleeding regions and points in surgical videos. Our framework embraces a dual-branch bidirectional guidance design based on Segment Anything Model 2 (SAM 2). The mask branch detects bleeding regions through adaptive edge and point prompt embeddings, while the point branch leverages mask memory to induce bleeding point memory modeling and captures the direction of bleed point movement through inter-frame optical flow. By interactive guidance and prompts, the two branches explore potential spatial-temporal relationships while leveraging memory modeling from previous frames to infer the current bleeding condition. Extensive experiments demonstrate that our approach outperforms other counterparts on SurgBlood in both bleeding region and point detection tasks, e.g., achieving 64.88% IoU for bleeding region detection and 83.69% PCK-10% for bleeding point detection.

Unconstrained Salient and Camouflaged Object Detection

Visual Salient Object Detection (SOD) and Camouflaged Object Detection (COD) are two interrelated yet distinct tasks. Both tasks model the human visual system's ability to perceive the presence of objects. The traditional SOD datasets and methods are designed for scenes where only salient objects are present, similarly, COD datasets and methods are designed for scenes where only camouflaged objects are present. However, scenes where both salient and camouflaged objects coexist, or where neither is present, are not considered. This simplifies the existing research on SOD and COD. In this paper, to explore a more generalized approach to SOD and COD, we introduce a benchmark called Unconstrained Salient and Camouflaged Object Detection (USCOD), which supports the simultaneous detection of salient and camouflaged objects in unconstrained scenes, regardless of their presence. Towards this, we construct a large-scale dataset, CS12K, that encompasses a variety of scenes, including four distinct types: only salient objects, only camouflaged objects, both, and neither. In our benchmark experiments, we identify a major challenge in USCOD: distinguishing between salient and camouflaged objects within the same scene. To address this challenge, we propose USCNet, a baseline model for USCOD that decouples the learning of attribute distinction from mask reconstruction. The model incorporates an APG module, which learns both sample-generic and sample-specific features to enhance the attribute differentiation between salient and camouflaged objects. Furthermore, to evaluate models' ability to distinguish between salient and camouflaged objects, we design a metric called Camouflage-Saliency Confusion Score (CSCS). The proposed method achieves state-of-the-art performance on the newly introduced USCOD task. The code and dataset will be publicly available.

Evaluation Study on SAM 2 for Class-agnostic Instance-level Segmentation

Segment Anything Model (SAM) has demonstrated powerful zero-shot segmentation performance in natural scenes. The recently released Segment Anything Model 2 (SAM2) has further heightened researchers' expectations towards image segmentation capabilities. To evaluate the performance of SAM2 on class-agnostic instance-level segmentation tasks, we adopt different prompt strategies for SAM2 to cope with instance-level tasks for three relevant scenarios: Salient Instance Segmentation (SIS), Camouflaged Instance Segmentation (CIS), and Shadow Instance Detection (SID). In addition, to further explore the effectiveness of SAM2 in segmenting granular object structures, we also conduct detailed tests on the high-resolution Dichotomous Image Segmentation (DIS) benchmark to assess the fine-grained segmentation capability. Qualitative and quantitative experimental results indicate that the performance of SAM2 varies significantly across different scenarios. Besides, SAM2 is not particularly sensitive to segmenting high-resolution fine details. We hope this technique report can drive the emergence of SAM2-based adapters, aiming to enhance the performance ceiling of large vision models on class-agnostic instance segmentation tasks.

Surgical Workflow Recognition and Blocking Effectiveness Detection in Laparoscopic Liver Resections with Pringle Maneuver

Pringle maneuver (PM) in laparoscopic liver resection aims to reduce blood loss and provide a clear surgical view by intermittently blocking blood inflow of the liver, whereas prolonged PM may cause ischemic injury. To comprehensively monitor this surgical procedure and provide timely warnings of ineffective and prolonged blocking, we suggest two complementary AI-assisted surgical monitoring tasks: workflow recognition and blocking effectiveness detection in liver resections. The former presents challenges in real-time capturing of short-term PM, while the latter involves the intraoperative discrimination of long-term liver ischemia states. To address these challenges, we meticulously collect a novel dataset, called PmLR50, consisting of 25,037 video frames covering various surgical phases from 50 laparoscopic liver resection procedures. Additionally, we develop an online baseline for PmLR50, termed PmNet. This model embraces Masked Temporal Encoding (MTE) and Compressed Sequence Modeling (CSM) for efficient short-term and long-term temporal information modeling, and embeds Contrastive Prototype Separation (CPS) to enhance action discrimination between similar intraoperative operations. Experimental results demonstrate that PmNet outperforms existing state-of-the-art surgical workflow recognition methods on the PmLR50 benchmark. Our research offers potential clinical applications for the laparoscopic liver surgery community. Source code and data will be publicly available.

Depth-Driven Geometric Prompt Learning for Laparoscopic Liver Landmark Detection

Laparoscopic liver surgery poses a complex intraoperative dynamic environment for surgeons, where remains a significant challenge to distinguish critical or even hidden structures inside the liver. Liver anatomical landmarks, e.g., ridge and ligament, serve as important markers for 2D-3D alignment, which can significantly enhance the spatial perception of surgeons for precise surgery. To facilitate the detection of laparoscopic liver landmarks, we collect a novel dataset called L3D, which comprises 1,152 frames with elaborated landmark annotations from surgical videos of 39 patients across two medical sites. For benchmarking purposes, 12 mainstream detection methods are selected and comprehensively evaluated on L3D. Further, we propose a depth-driven geometric prompt learning network, namely D2GPLand. Specifically, we design a Depth-aware Prompt Embedding (DPE) module that is guided by self-supervised prompts and generates semantically relevant geometric information with the benefit of global depth cues extracted from SAM-based features. Additionally, a Semantic-specific Geometric Augmentation (SGA) scheme is introduced to efficiently merge RGB-D spatial and geometric information through reverse anatomic perception. The experimental results indicate that D2GPLand obtains state-of-the-art performance on L3D, with 63.52% DICE and 48.68% IoU scores. Together with 2D-3D fusion technology, our method can directly provide the surgeon with intuitive guidance information in laparoscopic scenarios.

Epicardium Prompt-guided Real-time Cardiac Ultrasound Frame-to-volume Registration

A comprehensive guidance view for cardiac interventional surgery can be provided by the real-time fusion of the intraoperative 2D images and preoperative 3D volume based on the ultrasound frame-to-volume registration. However, cardiac ultrasound images are characterized by a low signal-to-noise ratio and small differences between adjacent frames, coupled with significant dimension variations between 2D frames and 3D volumes to be registered, resulting in real-time and accurate cardiac ultrasound frame-to-volume registration being a very challenging task. This paper introduces a lightweight end-to-end Cardiac Ultrasound frame-to-volume Registration network, termed CU-Reg. Specifically, the proposed model leverages epicardium prompt-guided anatomical clues to reinforce the interaction of 2D sparse and 3D dense features, followed by a voxel-wise local-global aggregation of enhanced features, thereby boosting the cross-dimensional matching effectiveness of low-quality ultrasound modalities. We further embed an inter-frame discriminative regularization term within the hybrid supervised learning to increase the distinction between adjacent slices in the same ultrasound volume to ensure registration stability. Experimental results on the reprocessed CAMUS dataset demonstrate that our CU-Reg surpasses existing methods in terms of registration accuracy and efficiency, meeting the guidance requirements of clinical cardiac interventional surgery.

Tri-modal Confluence with Temporal Dynamics for Scene Graph Generation in Operating Rooms

A comprehensive understanding of surgical scenes allows for monitoring of the surgical process, reducing the occurrence of accidents and enhancing efficiency for medical professionals. Semantic modeling within operating rooms, as a scene graph generation (SGG) task, is challenging since it involves consecutive recognition of subtle surgical actions over prolonged periods. To address this challenge, we propose a Tri-modal (i.e., images, point clouds, and language) confluence with Temporal dynamics framework, termed TriTemp-OR. Diverging from previous approaches that integrated temporal information via memory graphs, our method embraces two advantages: 1) we directly exploit bi-modal temporal information from the video streaming for hierarchical feature interaction, and 2) the prior knowledge from Large Language Models (LLMs) is embedded to alleviate the class-imbalance problem in the operating theatre. Specifically, our model performs temporal interactions across 2D frames and 3D point clouds, including a scale-adaptive multi-view temporal interaction (ViewTemp) and a geometric-temporal point aggregation (PointTemp). Furthermore, we transfer knowledge from the biomedical LLM, LLaVA-Med, to deepen the comprehension of intraoperative relations. The proposed TriTemp-OR enables the aggregation of tri-modal features through relation-aware unification to predict relations so as to generate scene graphs. Experimental results on the 4D-OR benchmark demonstrate the superior performance of our model for long-term OR streaming.

S^2Former-OR: Single-Stage Bimodal Transformer for Scene Graph Generation in OR

Scene graph generation (SGG) of surgical procedures is crucial in enhancing holistically cognitive intelligence in the operating room (OR). However, previous works have primarily relied on the multi-stage learning that generates semantic scene graphs dependent on intermediate processes with pose estimation and object detection, which may compromise model efficiency and efficacy, also impose extra annotation burden. In this study, we introduce a novel single-stage bimodal transformer framework for SGG in the OR, termed S^2Former-OR, aimed to complementally leverage multi-view 2D scenes and 3D point clouds for SGG in an end-to-end manner. Concretely, our model embraces a View-Sync Transfusion scheme to encourage multi-view visual information interaction. Concurrently, a Geometry-Visual Cohesion operation is designed to integrate the synergic 2D semantic features into 3D point cloud features. Moreover, based on the augmented feature, we propose a novel relation-sensitive transformer decoder that embeds dynamic entity-pair queries and relational trait priors, which enables the direct prediction of entity-pair relations for graph generation without intermediate steps. Extensive experiments have validated the superior SGG performance and lower computational cost of S^2Former-OR on 4D-OR benchmark, compared with current OR-SGG methods, e.g., 3% Precision increase and 24.2M reduction in model parameters. We further compared our method with generic single-stage SGG methods with broader metrics for a comprehensive evaluation, with consistently better performance achieved. The code will be made available.

A Unified Query-based Paradigm for Camouflaged Instance Segmentation

Due to the high similarity between camouflaged instances and the background, the recently proposed camouflaged instance segmentation (CIS) faces challenges in accurate localization and instance segmentation. To this end, inspired by query-based transformers, we propose a unified query-based multi-task learning framework for camouflaged instance segmentation, termed UQFormer, which builds a set of mask queries and a set of boundary queries to learn a shared composed query representation and efficiently integrates global camouflaged object region and boundary cues, for simultaneous instance segmentation and instance boundary detection in camouflaged scenarios. Specifically, we design a composed query learning paradigm that learns a shared representation to capture object region and boundary features by the cross-attention interaction of mask queries and boundary queries in the designed multi-scale unified learning transformer decoder. Then, we present a transformer-based multi-task learning framework for simultaneous camouflaged instance segmentation and camouflaged instance boundary detection based on the learned composed query representation, which also forces the model to learn a strong instance-level query representation. Notably, our model views the instance segmentation as a query-based direct set prediction problem, without other post-processing such as non-maximal suppression. Compared with 14 state-of-the-art approaches, our UQFormer significantly improves the performance of camouflaged instance segmentation. Our code will be available at https://github.com/dongbo811/UQFormer.

Partitioned Saliency Ranking with Dense Pyramid Transformers

In recent years, saliency ranking has emerged as a challenging task focusing on assessing the degree of saliency at instance-level. Being subjective, even humans struggle to identify the precise order of all salient instances. Previous approaches undertake the saliency ranking by directly sorting the rank scores of salient instances, which have not explicitly resolved the inherent ambiguities. To overcome this limitation, we propose the ranking by partition paradigm, which segments unordered salient instances into partitions and then ranks them based on the correlations among these partitions. The ranking by partition paradigm alleviates ranking ambiguities in a general sense, as it consistently improves the performance of other saliency ranking models. Additionally, we introduce the Dense Pyramid Transformer (DPT) to enable global cross-scale interactions, which significantly enhances feature interactions with reduced computational burden. Extensive experiments demonstrate that our approach outperforms all existing methods. The code for our method is available at \url{https://github.com/ssecv/PSR}.