Automatic Extraction of Central Tendon of Rectus Femoris (CT-RF) in Ultrasound Images Using a New Intensity-Compensated Free-Form Deformation-Based Tracking Algorithm With Local Shape Refinement

Robust tracking of deformable anatomical structures with severe occlusions using deformable geometrical primitives

BACKGROUND AND OBJECTIVE

Surgical robotics tends to develop cognitive control architectures to provide certain degree of autonomy to improve patient safety and surgery outcomes, while decreasing the required surgeons' cognitive load dedicated to low level decisions. Cognition needs workspace perception, which is an essential step towards automatic decision-making and task planning capabilities. Robust and accurate detection and tracking in minimally invasive surgery suffers from limited visibility, occlusions, anatomy deformations and camera movements.

METHOD

This paper develops a robust methodology to detect and track anatomical structures in real time to be used in automatic control of robotic systems and augmented reality. The work focuses on the experimental validation in highly challenging surgery: fetoscopic repair of Open Spina Bifida. The proposed method is based on two sequential steps: first, selection of relevant points (contour) using a Convolutional Neural Network and, second, reconstruction of the anatomical shape by means of deformable geometric primitives.

RESULTS

The methodology performance was validated with different scenarios. Synthetic scenario tests, designed for extreme validation conditions, demonstrate the safety margin offered by the methodology with respect to the nominal conditions during surgery. Real scenario experiments have demonstrated the validity of the method in terms of accuracy, robustness and computational efficiency.

CONCLUSIONS

This paper presents a robust anatomical structure detection in present of abrupt camera movements, severe occlusions and deformations. Even though the paper focuses on a case study, Open Spina Bifida, the methodology is applicable in all anatomies which contours can be approximated by geometric primitives. The methodology is designed to provide effective inputs to cognitive robotic control and augmented reality systems that require accurate tracking of sensitive anatomies.

MDF-Net: A Multi-Scale Dynamic Fusion Network for Breast Tumor Segmentation of Ultrasound Images

Breast tumor segmentation of ultrasound images provides valuable information of tumors for early detection and diagnosis. Accurate segmentation is challenging due to low image contrast between areas of interest; speckle noises, and large inter-subject variations in tumor shape and size. This paper proposes a novel Multi-scale Dynamic Fusion Network (MDF-Net) for breast ultrasound tumor segmentation. It employs a two-stage end-to-end architecture with a trunk sub-network for multiscale feature selection and a structurally optimized refinement sub-network for mitigating impairments such as noise and inter-subject variation via better feature exploration and fusion. The trunk network is extended from UNet++ with a simplified skip pathway structure to connect the features between adjacent scales. Moreover, deep supervision at all scales, instead of at the finest scale in UNet++, is proposed to extract more discriminative features and mitigate errors from speckle noise via a hybrid loss function. Unlike previous works, the first stage is linked to a loss function of the second stage so that both the preliminary segmentations and refinement subnetworks can be refined together at training. The refinement sub-network utilizes a structurally optimized MDF mechanism to integrate preliminary segmentation information (capturing general tumor shape and size) at coarse scales and explores inter-subject variation information at finer scales. Experimental results from two public datasets show that the proposed method achieves better Dice and other scores over state-of-the-art methods. Qualitative analysis also indicates that our proposed network is more robust to tumor size/shapes, speckle noise and heavy posterior shadows along tumor boundaries. An optional post-processing step is also proposed to facilitate users in mitigating segmentation artifacts. The efficiency of the proposed network is also illustrated on the "Electron Microscopy neural structures segmentation dataset". It outperforms a state-of-the-art algorithm based on UNet-2022 with simpler settings. This indicates the advantages of our MDF-Nets in other challenging image segmentation tasks with small to medium data sizes.

Automatic Muscle Fiber Orientation Tracking in Ultrasound Images Using a New Adaptive Fading Bayesian Kalman Smoother

This paper proposes a new algorithm for automatic estimation of muscle fiber orientation (MFO) in musculoskeletal ultrasound images, which is commonly used for both diagnosis and rehabilitation assessment of patients. The algorithm is based on a novel adaptive fading Bayesian Kalman filter (AF-BKF) and an automatic region of interest (ROI) extraction method. The ROI is first enhanced by the Gabor filter (GF) and extracted automatically using the revoting constrained Radon transform (RCRT) approach. The dominant MFO in the ROI is then detected by the RT and tracked by the proposed AF-BKF, which employs simplified Gaussian mixtures to approximate the non-Gaussian state densities and a new adaptive fading method to update the mixture parameters. An AF-BK smoother (AF-BKS) is also proposed by extending the AF-BKF using the concept of Rauch-Tung-Striebel smoother for further smoothing the fascicle orientations. The experimental results and comparisons show that: 1) the maximum segmentation error of the proposed RCRT is below nine pixels, which is sufficiently small for MFO tracking; 2) the accuracy of MFO gauged by RT in the ROI enhanced by the GF is comparable to that of using multiscale vessel enhancement filter-based method and better than those of local RT and revoting Hough transform approaches; and 3) the proposed AF-BKS algorithm outperforms the other tested approaches and achieves a performance close to those obtained by experienced operators (the overall covariance obtained by the AF-BKS is 3.19, which is rather close to that of the operators, 2.86). It, thus, serves as a valuable tool for automatic estimation of fascicle orientations and possibly for other applications in musculoskeletal ultrasound images.

Gear Shifting of Quadriceps during Isometric Knee Extension Disclosed Using Ultrasonography

Ultrasonography has been widely employed to estimate the morphological changes of muscle during contraction. To further investigate the motion pattern of quadriceps during isometric knee extensions, we studied the relative motion pattern between femur and quadriceps under ultrasonography. An interesting observation is that although the force of isometric knee extension can be controlled to change almost linearly, femur in the simultaneously captured ultrasound video sequences has several different piecewise moving patterns. This phenomenon is like quadriceps having several forward gear ratios like a car starting from rest towards maximal voluntary contraction (MVC) and then returning to rest. Therefore, to verify this assumption, we captured several ultrasound video sequences of isometric knee extension and collected the torque/force signal simultaneously. Then we extract the shapes of femur from these ultrasound video sequences using video processing techniques and study the motion pattern both qualitatively and quantitatively. The phenomenon can be seen easier via a comparison between the torque signal and relative spatial distance between femur and quadriceps. Furthermore, we use cluster analysis techniques to study the process and the clustering results also provided preliminary support to the conclusion that, during both ramp increasing and decreasing phases, quadriceps contraction may have several forward gear ratios relative to femur.