Medical endoscopy remains a challenging application for simultaneous localization and mapping (SLAM) due to the sparsity of image features and size constraints that prevent direct depth-sensing. We present a SLAM approach that incorporates depth predictions made by an adversarially-trained convolutional neural network (CNN) applied to monocular endoscopy images. The depth network is trained with synthetic images of a simple colon model, and then fine-tuned with domain-randomized, photorealistic images rendered from computed tomography measurements of human colons. Each image is paired with an error-free depth map for supervised adversarial learning. Monocular RGB images are then fused with corresponding depth predictions, enabling dense reconstruction and mosaicing as an endoscope is advanced through the gastrointestinal tract. Our preliminary results demonstrate that incorporating monocular depth estimation into a SLAM architecture can enable dense reconstruction of endoscopic scenes.
While data-driven approaches excel at many image analysis tasks, the performance of these approaches is often limited by a shortage of annotated data available for training. Recent work in semi-supervised learning has shown that meaningful representations of images can be obtained from training with large quantities of unlabeled data, and that these representations can improve the performance of supervised tasks. Here, we demonstrate that an unsupervised jigsaw learning task, in combination with supervised training, results in up to a 9.8% improvement in correctly classifying lesions in colonoscopy images when compared to a fully-supervised baseline. We additionally benchmark improvements in domain adaptation and out-of-distribution detection, and demonstrate that semi-supervised learning outperforms supervised learning in both cases. In colonoscopy applications, these metrics are important given the skill required for endoscopic assessment of lesions, the wide variety of endoscopy systems in use, and the homogeneity that is typical of labeled datasets.
Speckle artifacts degrade image quality in virtually all modalities that utilize coherent energy, including optical coherence tomography, reflectance confocal microscopy, ultrasound, and widefield imaging with laser illumination. We present an adversarial deep learning framework for laser speckle reduction, called DeepLSR (https://durr.jhu.edu/DeepLSR), that transforms images from a source domain of coherent illumination to a target domain of speckle-free, incoherent illumination. We apply this method to widefield images of objects and tissues illuminated with a multi-wavelength laser, using light emitting diode-illuminated images as ground truth. In images of gastrointestinal tissues, DeepLSR reduces laser speckle noise by 6.4 dB, compared to a 2.9 dB reduction from optimized non-local means processing, a 3.0 dB reduction from BM3D, and a 3.7 dB reduction from an optical speckle reducer utilizing an oscillating diffuser. Further, DeepLSR can be combined with optical speckle reduction to reduce speckle noise by 9.4 dB. This dramatic reduction in speckle noise may enable the use of coherent light sources in applications that require small illumination sources and high-quality imaging, including medical endoscopy.
Transarterial embolization (TAE) is a standard-of-care treatment for tumors in which embolic particles are locally injected via a catheter to occlude blood flow and induce ischemia in the target tissue. Physicians currently rely on subjective visual cues from fluoroscopy in order to determine the procedural endpoint relative to the injection site. This contributes to highly variable treatment outcomes, including the accumulation of embolic particles in healthy tissue, called off-target embolization. To address this concern, we describe a novel, multi-lumen catheter that 1) measures real-time pressure upstream of the tumor site during TAE injection; and 2) associates that measurement with the volume of embolic particles injected. Using an in vitro silicon vascular model, we characterize the relationship between blood flow, intravascular pressure, and injection pressure. Furthermore, we identify a predictive pressure curve based on the volume of embolic particles injected. This approach has the potential to standardize and optimize TAE, reducing the likelihood of incomplete or off-target embolization, and improving patient outcomes.
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