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Register a new userVideo and Accelerometer-Based Motion Analysis for Automated Surgical Skills Assessment
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Aneeq Zia
Publication date
2017
fields
Informatics Engineering
and research's language is
English
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Purpose: Basic surgical skills of suturing and knot tying are an essential part of medical training. Having an automated system for surgical skills assessment could help save experts time and improve training efficiency. There have been some recent attempts at automated surgical skills assessment using either video analysis or acceleration data. In this paper, we present a novel approach for automated assessment of OSATS based surgical skills and provide an analysis of different features on multi-modal data (video and accelerometer data). Methods: We conduct the largest study, to the best of our knowledge, for basic surgical skills assessment on a dataset that contained video and accelerometer data for suturing and knot-tying tasks. We introduce entropy based features - Approximate Entropy (ApEn) and Cross-Approximate Entropy (XApEn), which quantify the amount of predictability and regularity of fluctuations in time-series data. The proposed features are compared to existing methods of Sequential Motion Texture (SMT), Discrete Cosine Transform (DCT) and Discrete Fourier Transform (DFT), for surgical skills assessment. Results: We report average performance of different features across all applicable OSATS criteria for suturing and knot tying tasks. Our analysis shows that the proposed entropy based features out-perform previous state-of-the-art methods using video data. For accelerometer data, our method performs better for suturing only. We also show that fusion of video and acceleration features can improve overall performance with the proposed entropy features achieving highest accuracy. Conclusions: Automated surgical skills assessment can be achieved with high accuracy using the proposed entropy features. Such a system can significantly improve the efficiency of surgical training in medical schools and teaching hospitals.
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Purpose: Manual feedback in basic RMIS training can consume a significant amount of time from expert surgeons schedule and is prone to subjectivity. While VR-based training tasks can generate automated score reports, there is no mechanism of generating automated feedback for surgeons performing basic surgical tasks in RMIS training. In this paper, we explore the usage of different holistic features for automated skill assessment using only robot kinematic data and propose a weighted feature fusion technique for improving score prediction performance. Methods: We perform our experiments on the publicly available JIGSAWS dataset and evaluate four different types of holistic features from robot kinematic data - Sequential Motion Texture (SMT), Discrete Fourier Transform (DFT), Discrete Cosine Transform (DCT) and Approximate Entropy (ApEn). The features are then used for skill classification and exact skill score prediction. Along with using these features individually, we also evaluate the performance using our proposed weighted combination technique. Results: Our results demonstrate that these holistic features outperform all previous HMM based state-of-the-art methods for skill classification on the JIGSAWS dataset. Also, our proposed feature fusion strategy significantly improves performance for skill score predictions achieving up to 0.61 average spearman correlation coefficient. Conclusions: Holistic features capturing global information from robot kinematic data can successfully be used for evaluating surgeon skill in basic surgical tasks on the da Vinci robot. Using the framework presented can potentially allow for real time score feedback in RMIS training.
Surgical training in medical school residency programs has followed the apprenticeship model. The learning and assessment process is inherently subjective and time-consuming. Thus, there is a need for objective methods to assess surgical skills. Here, we use the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to systematically survey the literature on the use of Deep Neural Networks for automated and objective surgical skill assessment, with a focus on kinematic data as putative markers of surgical competency. There is considerable recent interest in deep neural networks (DNN) due to the availability of powerful algorithms, multiple datasets, some of which are publicly available, as well as efficient computational hardware to train and host them. We have reviewed 530 papers, of which we selected 25 for this systematic review. Based on this review, we concluded that DNNs are powerful tools for automated, objective surgical skill assessment using both kinematic and video data. The field would benefit from large, publicly available, annotated datasets that are representative of the surgical trainee and expert demographics and multimodal data beyond kinematics and videos.
Postoperative wound complications are a significant cause of expense for hospitals, doctors, and patients. Hence, an effective method to diagnose the onset of wound complications is strongly desired. Algorithmically classifying wound images is a difficult task due to the variability in the appearance of wound sites. Convolutional neural networks (CNNs), a subgroup of artificial neural networks that have shown great promise in analyzing visual imagery, can be leveraged to categorize surgical wounds. We present a multi-label CNN ensemble, Deepwound, trained to classify wound images using only image pixels and corresponding labels as inputs. Our final computational model can accurately identify the presence of nine labels: drainage, fibrinous exudate, granulation tissue, surgical site infection, open wound, staples, steri strips, and sutures. Our model achieves receiver operating curve (ROC) area under curve (AUC) scores, sensitivity, specificity, and F1 scores superior to prior work in this area. Smartphones provide a means to deliver accessible wound care due to their increasing ubiquity. Paired with deep neural networks, they offer the capability to provide clinical insight to assist surgeons during postoperative care. We also present a mobile application frontend to Deepwound that assists patients in tracking their wound and surgical recovery from the comfort of their home.
Surgical tool presence detection and surgical phase recognition are two fundamental yet challenging tasks in surgical video analysis and also very essential components in various applications in modern operating rooms. While these two analysis tasks are highly correlated in clinical practice as the surgical process is well-defined, most previous methods tackled them separately, without making full use of their relatedness. In this paper, we present a novel method by developing a multi-task recurrent convolutional network with correlation loss (MTRCNet-CL) to exploit their relatedness to simultaneously boost the performance of both tasks. Specifically, our proposed MTRCNet-CL model has an end-to-end architecture with two branches, which share earlier feature encoders to extract general visual features while holding respective higher layers targeting for specific tasks. Given that temporal information is crucial for phase recognition, long-short term memory (LSTM) is explored to model the sequential dependencies in the phase recognition branch. More importantly, a novel and effective correlation loss is designed to model the relatedness between tool presence and phase identification of each video frame, by minimizing the divergence of predictions from the two branches. Mutually leveraging both low-level feature sharing and high-level prediction correlating, our MTRCNet-CL method can encourage the interactions between the two tasks to a large extent, and hence can bring about benefits to each other. Extensive experiments on a large surgical video dataset (Cholec80) demonstrate outstanding performance of our proposed method, consistently exceeding the state-of-the-art methods by a large margin (e.g., 89.1% v.s. 81.0% for the mAP in tool presence detection and 87.4% v.s. 84.5% for F1 score in phase recognition). The code can be found on our project website.
Background: Maintaining a healthy diet is vital to avoid health-related issues, e.g., undernutrition, obesity and many non-communicable diseases. An indispensable part of the health diet is dietary assessment. Traditional manual recording methods are burdensome and contain substantial biases and errors. Recent advances in Artificial Intelligence, especially computer vision technologies, have made it possible to develop automatic dietary assessment solutions, which are more convenient, less time-consuming and even more accurate to monitor daily food intake. Scope and approach: This review presents one unified Vision-Based Dietary Assessment (VBDA) framework, which generally consists of three stages: food image analysis, volume estimation and nutrient derivation. Vision-based food analysis methods, including food recognition, detection and segmentation, are systematically summarized, and methods of volume estimation and nutrient derivation are also given. The prosperity of deep learning makes VBDA gradually move to an end-to-end implementation, which applies food images to a single network to directly estimate the nutrition. The recently proposed end-to-end methods are also discussed. We further analyze existing dietary assessment datasets, indicating that one large-scale benchmark is urgently needed, and finally highlight key challenges and future trends for VBDA. Key findings and conclusions: After thorough exploration, we find that multi-task end-to-end deep learning approaches are one important trend of VBDA. Despite considerable research progress, many challenges remain for VBDA due to the meal complexity. We also provide the latest ideas for future development of VBDA, e.g., fine-grained food analysis and accurate volume estimation. This survey aims to encourage researchers to propose more practical solutions for VBDA.
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