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Register a new userSurgical Activity Recognition in Robot-Assisted Radical Prostatectomy using Deep Learning
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Added by
Aneeq Zia
Publication date
2018
fields
Informatics Engineering
and research's language is
English
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Adverse surgical outcomes are costly to patients and hospitals. Approaches to benchmark surgical care are often limited to gross measures across the entire procedure despite the performance of particular tasks being largely responsible for undesirable outcomes. In order to produce metrics from tasks as opposed to the whole procedure, methods to recognize automatically individual surgical tasks are needed. In this paper, we propose several approaches to recognize surgical activities in robot-assisted minimally invasive surgery using deep learning. We collected a clinical dataset of 100 robot-assisted radical prostatectomies (RARP) with 12 tasks each and propose `RP-Net, a modified version of InceptionV3 model, for image based surgical activity recognition. We achieve an average precision of 80.9% and average recall of 76.7% across all tasks using RP-Net which out-performs all other RNN and CNN based models explored in this paper. Our results suggest that automatic surgical activity recognition during RARP is feasible and can be the foundation for advanced analytics.
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Purpose: Surgical task-based metrics (rather than entire procedure metrics) can be used to improve surgeon training and, ultimately, patient care through focused training interventions. Machine learning models to automatically recognize individual tasks or activities are needed to overcome the otherwise manual effort of video review. Traditionally, these models have been evaluated using frame-level accuracy. Here, we propose evaluating surgical activity recognition models by their effect on task-based efficiency metrics. In this way, we can determine when models have achieved adequate performance for providing surgeon feedback via metrics from individual tasks. Methods: We propose a new CNN-LSTM model, RP-Net-V2, to recognize the 12 steps of robotic-assisted radical prostatectomies (RARP). We evaluated our model both in terms of conventional methods (e.g. Jaccard Index, task boundary accuracy) as well as novel ways, such as the accuracy of efficiency metrics computed from instrument movements and system events. Results: Our proposed model achieves a Jaccard Index of 0.85 thereby outperforming previous models on robotic-assisted radical prostatectomies. Additionally, we show that metrics computed from tasks automatically identified using RP-Net-V2 correlate well with metrics from tasks labeled by clinical experts. Conclusions: We demonstrate that metrics-based evaluation of surgical activity recognition models is a viable approach to determine when models can be used to quantify surgical efficiencies. We believe this approach and our results illustrate the potential for fully automated, post-operative efficiency reports.
Sensor-based human activity recognition (HAR) is now a research hotspot in multiple application areas. With the rise of smart wearable devices equipped with inertial measurement units (IMUs), researchers begin to utilize IMU data for HAR. By employing machine learning algorithms, early IMU-based research for HAR can achieve accurate classification results on traditional classical HAR datasets, containing only simple and repetitive daily activities. However, these datasets rarely display a rich diversity of information in real-scene. In this paper, we propose a novel method based on deep learning for complex HAR in the real-scene. Specially, in the off-line training stage, the AMASS dataset, containing abundant human poses and virtual IMU data, is innovatively adopted for enhancing the variety and diversity. Moreover, a deep convolutional neural network with an unsupervised penalty is proposed to automatically extract the features of AMASS and improve the robustness. In the on-line testing stage, by leveraging advantages of the transfer learning, we obtain the final result by fine-tuning the partial neural network (optimizing the parameters in the fully-connected layers) using the real IMU data. The experimental results show that the proposed method can surprisingly converge in a few iterations and achieve an accuracy of 91.15% on a real IMU dataset, demonstrating the efficiency and effectiveness of the proposed method.
For many applications in the field of computer assisted surgery, such as providing the position of a tumor, specifying the most probable tool required next by the surgeon or determining the remaining duration of surgery, methods for surgical workflow analysis are a prerequisite. Often machine learning based approaches serve as basis for surgical workflow analysis. In general machine learning algorithms, such as convolutional neural networks (CNN), require large amounts of labeled data. While data is often available in abundance, many tasks in surgical workflow analysis need data annotated by domain experts, making it difficult to obtain a sufficient amount of annotations. The aim of using active learning to train a machine learning model is to reduce the annotation effort. Active learning methods determine which unlabeled data points would provide the most information according to some metric, such as prediction uncertainty. Experts will then be asked to only annotate these data points. The model is then retrained with the new data and used to select further data for annotation. Recently, active learning has been applied to CNN by means of Deep Bayesian Networks (DBN). These networks make it possible to assign uncertainties to predictions. In this paper, we present a DBN-based active learning approach adapted for image-based surgical workflow analysis task. Furthermore, by using a recurrent architecture, we extend this network to video-based surgical workflow analysis. We evaluate these approaches on the Cholec80 dataset by performing instrument presence detection and surgical phase segmentation. Here we are able to show that using a DBN-based active learning approach for selecting what data points to annotate next outperforms a baseline based on randomly selecting data points.
Knowledge of interaction forces during teleoperated robot-assisted surgery could be used to enable force feedback to human operators and evaluate tissue handling skill. However, direct force sensing at the end-effector is challenging because it requires biocompatible, sterilizable, and cost-effective sensors. Vision-based deep learning using convolutional neural networks is a promising approach for providing useful force estimates, though questions remain about generalization to new scenarios and real-time inference. We present a force estimation neural network that uses RGB images and robot state as inputs. Using a self-collected dataset, we compared the network to variants that included only a single input type, and evaluated how they generalized to new viewpoints, workspace positions, materials, and tools. We found that vision-based networks were sensitive to shifts in viewpoints, while state-only networks were robust to changes in workspace. The network with both state and vision inputs had the highest accuracy for an unseen tool, and was moderately robust to changes in viewpoints. Through feature removal studies, we found that using only position features produced better accuracy than using only force features as input. The network with both state and vision inputs outperformed a physics-based baseline model in accuracy. It showed comparable accuracy but faster computation times than a baseline recurrent neural network, making it better suited for real-time applications.
Magnetic resonance imaging (MRI) has great potential to improve prostate cancer diagnosis. It can spare men with a normal exam from undergoing invasive biopsy while making biopsies more accurate in men with lesions suspicious for cancer. Yet, the subtle differences between cancer and confounding conditions, render the interpretation of MRI challenging. The tissue collected from patients that undergo pre-surgical MRI and radical prostatectomy provides a unique opportunity to correlate histopathology images of the entire prostate with MRI in order to accurately map the extent of prostate cancer onto MRI. Here, we introduce the RAPSODI (framework for the registration of radiology and pathology images. RAPSODI relies on a three-step procedure that first reconstructs in 3D the resected tissue using the serial whole-mount histopathology slices, then registers corresponding histopathology and MRI slices, and finally maps the cancer outlines from the histopathology slices onto MRI. We tested RAPSODI in a phantom study where we simulated various conditions, e.g., tissue specimen rotation upon mounting on glass slides, tissue shrinkage during fixation, or imperfect slice-to-slice correspondences between histology and MRI. Our experiments showed that RAPSODI can reliably correct for rotations within $pm15^{circ}$ and shrinkage up to 10%. We also evaluated RAPSODI in 89 patients from two institutions that underwent radical prostatectomy, yielding 543 histopathology slices that were registered to corresponding T2 weighted MRI slices. We found a Dice coefficient of 0.98$ pm $0.01 for the prostate, prostate boundary Hausdorff distance of 1.71$ pm $0.48 mm, a urethra deviation of 2.91$ pm $1.25 mm, and a landmark deviation of 2.88$ pm $0.70 mm between registered histopathology images and MRI. Our robust framework successfully mapped the extent of disease from histopathology slices onto MRI.
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