Instrument-tissue Interaction Detection Framework for Surgical Video Understanding

Instrument-tissue interaction detection task, which helps understand surgical activities, is vital for constructing computer-assisted surgery systems but with many challenges. Firstly, most models represent instrument-tissue interaction in a coarse-grained way which only focuses on classification and lacks the ability to automatically detect instruments and tissues. Secondly, existing works do not fully consider relations between intra- and inter-frame of instruments and tissues. In the paper, we propose to represent instrument-tissue interaction as <instrument class, instrument bounding box, tissue class, tissue bounding box, action class> quintuple and present an Instrument-Tissue Interaction Detection Network (ITIDNet) to detect the quintuple for surgery videos understanding. Specifically, we propose a Snippet Consecutive Feature (SCF) Layer to enhance features by modeling relationships of proposals in the current frame using global context information in the video snippet. We also propose a Spatial Corresponding Attention (SCA) Layer to incorporate features of proposals between adjacent frames through spatial encoding. To reason relationships between instruments and tissues, a Temporal Graph (TG) Layer is proposed with intra-frame connections to exploit relationships between instruments and tissues in the same frame and inter-frame connections to model the temporal information for the same instance. For evaluation, we build a cataract surgery video (PhacoQ) dataset and a cholecystectomy surgery video (CholecQ) dataset. Experimental results demonstrate the promising performance of our model, which outperforms other state-of-the-art models on both datasets.

ACT-Net: Anchor-context Action Detection in Surgery Videos

Recognition and localization of surgical detailed actions is an essential component of developing a context-aware decision support system. However, most existing detection algorithms fail to provide high-accuracy action classes even having their locations, as they do not consider the surgery procedure's regularity in the whole video. This limitation hinders their application. Moreover, implementing the predictions in clinical applications seriously needs to convey model confidence to earn entrustment, which is unexplored in surgical action prediction. In this paper, to accurately detect fine-grained actions that happen at every moment, we propose an anchor-context action detection network (ACTNet), including an anchor-context detection (ACD) module and a class conditional diffusion (CCD) module, to answer the following questions: 1) where the actions happen; 2) what actions are; 3) how confidence predictions are. Specifically, the proposed ACD module spatially and temporally highlights the regions interacting with the extracted anchor in surgery video, which outputs action location and its class distribution based on anchor-context interactions. Considering the full distribution of action classes in videos, the CCD module adopts a denoising diffusion-based generative model conditioned on our ACD estimator to further reconstruct accurately the action predictions. Moreover, we utilize the stochastic nature of the diffusion model outputs to access model confidence for each prediction. Our method reports the state-of-the-art performance, with improvements of 4.0% mAP against baseline on the surgical video dataset.

MIcro-Surgical Anastomose Workflow recognition challenge report

The "MIcro-Surgical Anastomose Workflow recognition on training sessions" (MISAW) challenge provided a data set of 27 sequences of micro-surgical anastomosis on artificial blood vessels. This data set was composed of videos, kinematics, and workflow annotations described at three different granularity levels: phase, step, and activity. The participants were given the option to use kinematic data and videos to develop workflow recognition models. Four tasks were proposed to the participants: three of them were related to the recognition of surgical workflow at three different granularity levels, while the last one addressed the recognition of all granularity levels in the same model. One ranking was made for each task. We used the average application-dependent balanced accuracy (AD-Accuracy) as the evaluation metric. This takes unbalanced classes into account and it is more clinically relevant than a frame-by-frame score. Six teams, including a non-competing team, participated in at least one task. All models employed deep learning models, such as CNN or RNN. The best models achieved more than 95% AD-Accuracy for phase recognition, 80% for step recognition, 60% for activity recognition, and 75% for all granularity levels. For high levels of granularity (i.e., phases and steps), the best models had a recognition rate that may be sufficient for applications such as prediction of remaining surgical time or resource management. However, for activities, the recognition rate was still low for applications that can be employed clinically. The MISAW data set is publicly available to encourage further research in surgical workflow recognition. It can be found at www.synapse.org/MISAW