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How to ensure fairness is an important topic in federated learning (FL). Recent studies have investigated how to reward clients based on their contribution (collaboration fairness), and how to achieve uniformity of performance across clients (performance fairness). Despite achieving progress on either one, we argue that it is critical to consider them together, in order to engage and motivate more diverse clients joining FL to derive a high-quality global model. In this work, we propose a novel method to optimize both types of fairness simultaneously. Specifically, we propose to estimate client contribution in gradient and data space. In gradient space, we monitor the gradient direction differences of each client with respect to others. And in data space, we measure the prediction error on client data using an auxiliary model. Based on this contribution estimation, we propose a FL method, federated training via contribution estimation (FedCE), i.e., using estimation as global model aggregation weights. We have theoretically analyzed our method and empirically evaluated it on two real-world medical datasets. The effectiveness of our approach has been validated with significant performance improvements, better collaboration fairness, better performance fairness, and comprehensive analytical studies., Comment: Accepted at CVPR 2023

Semi-supervised learning (SSL) methods assume that labeled data, unlabeled data and test data are from the same distribution. Open-set semi-supervised learning (Open-set SSL) considers a more practical scenario, where unlabeled data and test data contain new categories (outliers) not observed in labeled data (inliers). Most previous works focused on outlier detection via binary classifiers, which suffer from insufficient scalability and inability to distinguish different types of uncertainty. In this paper, we propose a novel framework, Adaptive Negative Evidential Deep Learning (ANEDL) to tackle these limitations. Concretely, we first introduce evidential deep learning (EDL) as an outlier detector to quantify different types of uncertainty, and design different uncertainty metrics for self-training and inference. Furthermore, we propose a novel adaptive negative optimization strategy, making EDL more tailored to the unlabeled dataset containing both inliers and outliers. As demonstrated empirically, our proposed method outperforms existing state-of-the-art methods across four datasets., Comment: Accepted by AAAI2024

Video dehazing aims to recover haze-free frames with high visibility and contrast. This paper presents a novel framework to effectively explore the physical haze priors and aggregate temporal information. Specifically, we design a memory-based physical prior guidance module to encode the prior-related features into long-range memory. Besides, we formulate a multi-range scene radiance recovery module to capture space-time dependencies in multiple space-time ranges, which helps to effectively aggregate temporal information from adjacent frames. Moreover, we construct the first large-scale outdoor video dehazing benchmark dataset, which contains videos in various real-world scenarios. Experimental results on both synthetic and real conditions show the superiority of our proposed method., Comment: CVPR 2023; Code: https://github.com/jiaqixuac/MAP-Net

Needle picking is a challenging manipulation task in robot-assisted surgery due to the characteristics of small slender shapes of needles, needles' variations in shapes and sizes, and demands for millimeter-level control. Prior works, heavily relying on the prior of needles (e.g., geometric models), are hard to scale to unseen needles' variations. In this paper, we present the first end-to-end learning method to train deep visuomotor policy for needle picking. Concretely, we propose DreamerfD to maximally leverage demonstrations to improve the learning efficiency of a state-of-the-art model-based reinforcement learning method, DreamerV2; Since Variational Auto-Encoder (VAE) in DreamerV2 is difficult to scale to high-resolution images, we propose Dynamic Spotlight Adaptation to represent control-related visual signals in a low-resolution image space; Virtual Clutch is also proposed to reduce performance degradation due to significant error between prior and posterior encoded states at the beginning of a rollout. We conducted extensive experiments in simulation to evaluate the performance, robustness, in-domain variation adaptation, and effectiveness of individual components of our method. Our method, trained by 8k demonstration timesteps and 140k online policy timesteps, can achieve a remarkable success rate of 80%. Furthermore, our method effectively demonstrated its superiority in generalization to unseen in-domain variations including needle variations and image disturbance, highlighting its robustness and versatility. Codes and videos are available at https://sites.google.com/view/DreamerfD., Comment: Accepted by IROS 2023

This paper proposes a novel bin picking framework, two-stage grasping, aiming at precise grasping of cluttered small objects. Object density estimation and rough grasping are conducted in the first stage. Fine segmentation, detection, grasping, and pushing are performed in the second stage. A small object bin picking system has been realized to exhibit the concept of two-stage grasping. Experiments have shown the effectiveness of the proposed framework. Unlike traditional bin picking methods focusing on vision-based grasping planning using classic frameworks, the challenges of picking cluttered small objects can be solved by the proposed new framework with simple vision detection and planning., Comment: ICRA 2023

Recent advancements toward perception and decision-making of flexible endoscopes have shown great potential in computer-aided surgical interventions. However, owing to modeling uncertainty and inter-patient anatomical variation in flexible endoscopy, the challenge remains for efficient and safe navigation in patient-specific scenarios. This paper presents a novel data-driven framework with self-contained visual-shape fusion for autonomous intelligent navigation of flexible endoscopes requiring no priori knowledge of system models and global environments. A learning-based adaptive visual servoing controller is proposed to online update the eye-in-hand vision-motor configuration and steer the endoscope, which is guided by monocular depth estimation via a vision transformer (ViT). To prevent unnecessary and excessive interactions with surrounding anatomy, an energy-motivated shape planning algorithm is introduced through entire endoscope 3-D proprioception from embedded fiber Bragg grating (FBG) sensors. Furthermore, a model predictive control (MPC) strategy is developed to minimize the elastic potential energy flow and simultaneously optimize the steering policy. Dedicated navigation experiments on a robotic-assisted flexible endoscope with an FBG fiber in several phantom environments demonstrate the effectiveness and adaptability of the proposed framework., Comment: Accepted to ICRA 2023

Histopathological tissue classification is a fundamental task in computational pathology. Deep learning-based models have achieved superior performance but centralized training with data centralization suffers from the privacy leakage problem. Federated learning (FL) can safeguard privacy by keeping training samples locally, but existing FL-based frameworks require a large number of well-annotated training samples and numerous rounds of communication which hinder their practicability in the real-world clinical scenario. In this paper, we propose a universal and lightweight federated learning framework, named Federated Deep-Broad Learning (FedDBL), to achieve superior classification performance with limited training samples and only one-round communication. By simply associating a pre-trained deep learning feature extractor, a fast and lightweight broad learning inference system and a classical federated aggregation approach, FedDBL can dramatically reduce data dependency and improve communication efficiency. Five-fold cross-validation demonstrates that FedDBL greatly outperforms the competitors with only one-round communication and limited training samples, while it even achieves comparable performance with the ones under multiple-round communications. Furthermore, due to the lightweight design and one-round communication, FedDBL reduces the communication burden from 4.6GB to only 276.5KB per client using the ResNet-50 backbone at 50-round training. Since no data or deep model sharing across different clients, the privacy issue is well-solved and the model security is guaranteed with no model inversion attack risk. Code is available at https://github.com/tianpeng-deng/FedDBL.

Task automation of surgical robot has the potentials to improve surgical efficiency. Recent reinforcement learning (RL) based approaches provide scalable solutions to surgical automation, but typically require extensive data collection to solve a task if no prior knowledge is given. This issue is known as the exploration challenge, which can be alleviated by providing expert demonstrations to an RL agent. Yet, how to make effective use of demonstration data to improve exploration efficiency still remains an open challenge. In this work, we introduce Demonstration-guided EXploration (DEX), an efficient reinforcement learning algorithm that aims to overcome the exploration problem with expert demonstrations for surgical automation. To effectively exploit demonstrations, our method estimates expert-like behaviors with higher values to facilitate productive interactions, and adopts non-parametric regression to enable such guidance at states unobserved in demonstration data. Extensive experiments on $10$ surgical manipulation tasks from SurRoL, a comprehensive surgical simulation platform, demonstrate significant improvements in the exploration efficiency and task success rates of our method. Moreover, we also deploy the learned policies to the da Vinci Research Kit (dVRK) platform to show the effectiveness on the real robot. Code is available at https://github.com/med-air/DEX., Comment: Accepted to ICRA 2023

Radiance fields have gradually become a main representation of media. Although its appearance editing has been studied, how to achieve view-consistent recoloring in an efficient manner is still under explored. We present RecolorNeRF, a novel user-friendly color editing approach for the neural radiance fields. Our key idea is to decompose the scene into a set of pure-colored layers, forming a palette. By this means, color manipulation can be conducted by altering the color components of the palette directly. To support efficient palette-based editing, the color of each layer needs to be as representative as possible. In the end, the problem is formulated as an optimization problem, where the layers and their blending weights are jointly optimized with the NeRF itself. Extensive experiments show that our jointly-optimized layer decomposition can be used against multiple backbones and produce photo-realistic recolored novel-view renderings. We demonstrate that RecolorNeRF outperforms baseline methods both quantitatively and qualitatively for color editing even in complex real-world scenes., Comment: To appear in ACM Multimedia 2023. Project website is accessible at https://sites.google.com/view/recolornerf

Mitigating the discrimination of machine learning models has gained increasing attention in medical image analysis. However, rare works focus on fair treatments for patients with multiple sensitive demographic ones, which is a crucial yet challenging problem for real-world clinical applications. In this paper, we propose a novel method for fair representation learning with respect to multi-sensitive attributes. We pursue the independence between target and multi-sensitive representations by achieving orthogonality in the representation space. Concretely, we enforce the column space orthogonality by keeping target information on the complement of a low-rank sensitive space. Furthermore, in the row space, we encourage feature dimensions between target and sensitive representations to be orthogonal. The effectiveness of the proposed method is demonstrated with extensive experiments on the CheXpert dataset. To our best knowledge, this is the first work to mitigate unfairness with respect to multiple sensitive attributes in the field of medical imaging.

Surgical robot automation has attracted increasing research interest over the past decade, expecting its potential to benefit surgeons, nurses and patients. Recently, the learning paradigm of embodied intelligence has demonstrated promising ability to learn good control policies for various complex tasks, where embodied AI simulators play an essential role to facilitate relevant research. However, existing open-sourced simulators for surgical robot are still not sufficiently supporting human interactions through physical input devices, which further limits effective investigations on how the human demonstrations would affect policy learning. In this work, we study human-in-the-loop embodied intelligence with a new interactive simulation platform for surgical robot learning. Specifically, we establish our platform based on our previously released SurRoL simulator with several new features co-developed to allow high-quality human interaction via an input device. We showcase the improvement of our simulation environment with the designed new features, and validate effectiveness of incorporating human factors in embodied intelligence through the use of human demonstrations and reinforcement learning as a representative example. Promising results are obtained in terms of learning efficiency. Lastly, five new surgical robot training tasks are developed and released, with which we hope to pave the way for future research on surgical embodied intelligence. Our learning platform is publicly released and will be continuously updated in the website: https://med-air.github.io/SurRoL.

Brain midline shift (MLS) is one of the most critical factors to be considered for clinical diagnosis and treatment decision-making for intracranial hemorrhage. Existing computational methods on MLS quantification not only require intensive labeling in millimeter-level measurement but also suffer from poor performance due to their dependence on specific landmarks or simplified anatomical assumptions. In this paper, we propose a novel semi-supervised framework to accurately measure the scale of MLS from head CT scans. We formulate the MLS measurement task as a deformation estimation problem and solve it using a few MLS slices with sparse labels. Meanwhile, with the help of diffusion models, we are able to use a great number of unlabeled MLS data and 2793 non-MLS cases for representation learning and regularization. The extracted representation reflects how the image is different from a non-MLS image and regularization serves an important role in the sparse-to-dense refinement of the deformation field. Our experiment on a real clinical brain hemorrhage dataset has achieved state-of-the-art performance and can generate interpretable deformation fields., Comment: 12 pages, 5 figures

Estimating precise metric depth and scene reconstruction from monocular endoscopy is a fundamental task for surgical navigation in robotic surgery. However, traditional stereo matching adopts binocular images to perceive the depth information, which is difficult to transfer to the soft robotics-based surgical systems due to the use of monocular endoscopy. In this paper, we present a novel framework that combines robot kinematics and monocular endoscope images with deep unsupervised learning into a single network for metric depth estimation and then achieve 3D reconstruction of complex anatomy. Specifically, we first obtain the relative depth maps of surgical scenes by leveraging a brightness-aware monocular depth estimation method. Then, the corresponding endoscope poses are computed based on non-linear optimization of geometric and photometric reprojection residuals. Afterwards, we develop a Depth-driven Sliding Optimization (DDSO) algorithm to extract the scaling coefficient from kinematics and calculated poses offline. By coupling the metric scale and relative depth data, we form a robust ensemble that represents the metric and consistent depth. Next, we treat the ensemble as supervisory labels to train a metric depth estimation network for surgeries (i.e., MetricDepthS-Net) that distills the embeddings from the robot kinematics, endoscopic videos, and poses. With accurate metric depth estimation, we utilize a dense visual reconstruction method to recover the 3D structure of the whole surgical site. We have extensively evaluated the proposed framework on public SCARED and achieved comparable performance with stereo-based depth estimation methods. Our results demonstrate the feasibility of the proposed approach to recover the metric depth and 3D structure with monocular inputs.

Most existing methods for category-level pose estimation rely on object point clouds. However, when considering transparent objects, depth cameras are usually not able to capture meaningful data, resulting in point clouds with severe artifacts. Without a high-quality point cloud, existing methods are not applicable to challenging transparent objects. To tackle this problem, we present StereoPose, a novel stereo image framework for category-level object pose estimation, ideally suited for transparent objects. For a robust estimation from pure stereo images, we develop a pipeline that decouples category-level pose estimation into object size estimation, initial pose estimation, and pose refinement. StereoPose then estimates object pose based on representation in the normalized object coordinate space~(NOCS). To address the issue of image content aliasing, we further define a back-view NOCS map for the transparent object. The back-view NOCS aims to reduce the network learning ambiguity caused by content aliasing, and leverage informative cues on the back of the transparent object for more accurate pose estimation. To further improve the performance of the stereo framework, StereoPose is equipped with a parallax attention module for stereo feature fusion and an epipolar loss for improving the stereo-view consistency of network predictions. Extensive experiments on the public TOD dataset demonstrate the superiority of the proposed StereoPose framework for category-level 6D transparent object pose estimation., Comment: 7 pages, 6 figures, Project homepage: https://appsrv.cse.cuhk.edu.hk/~kaichen/stereopose.html

Learning high-performance deep neural networks for dynamic modeling of high Degree-Of-Freedom (DOF) robots remains challenging due to the sampling complexity. Typical unknown system disturbance caused by unmodeled dynamics (such as internal compliance, cables) further exacerbates the problem. In this paper, a novel framework characterized by both high data efficiency and disturbance-adapting capability is proposed to address the problem of modeling gravitational dynamics using deep nets in feedforward gravity compensation control for high-DOF master manipulators with unknown disturbance. In particular, Feedforward Deep Neural Networks (FDNNs) are learned from both prior knowledge of an existing analytical model and observation of the robot system by Knowledge Distillation (KD). Through extensive experiments in high-DOF master manipulators with significant disturbance, we show that our method surpasses a standard Learning-from-Scratch (LfS) approach in terms of data efficiency and disturbance adaptation. Our initial feasibility study has demonstrated the potential of outperforming the analytical teacher model as the training data increases.

Domain generalization (DG) has been a hot topic in image recognition, with a goal to train a general model that can perform well on unseen domains. Recently, federated learning (FL), an emerging machine learning paradigm to train a global model from multiple decentralized clients without compromising data privacy, brings new challenges, also new possibilities, to DG. In the FL scenario, many existing state-of-the-art (SOTA) DG methods become ineffective, because they require the centralization of data from different domains during training. In this paper, we propose a novel domain generalization method for image recognition under federated learning through cross-client style transfer (CCST) without exchanging data samples. Our CCST method can lead to more uniform distributions of source clients, and thus make each local model learn to fit the image styles of all the clients to avoid the different model biases. Two types of style (single image style and overall domain style) with corresponding mechanisms are proposed to be chosen according to different scenarios. Our style representation is exceptionally lightweight and can hardly be used for the reconstruction of the dataset. The level of diversity is also flexible to be controlled with a hyper-parameter. Our method outperforms recent SOTA DG methods on two DG benchmarks (PACS, OfficeHome) and a large-scale medical image dataset (Camelyon17) in the FL setting. Last but not least, our method is orthogonal to many classic DG methods, achieving additive performance by combined utilization., Comment: Accepted by WACV 2023

In this paper, we present a novel and generic data-driven method to servo-control the 3-D shape of continuum and soft robots embedded with fiber Bragg grating (FBG) sensors. Developments of 3-D shape perception and control technologies are crucial for continuum robots to perform the tasks autonomously in surgical interventions. However, owing to the nonlinear properties of continuum robots, one main difficulty lies in the modeling of them, especially for soft robots with variable stiffness. To address this problem, we propose a versatile learning-based adaptive controller by leveraging FBG shape feedback that can online estimate the unknown model of continuum robot against unexpected disturbances and exhibit an adaptive behavior to the unmodeled system without priori data exploration. Based on a new composite adaptation algorithm, the asymptotic convergences of the closed-loop system with learning parameters have been proven by Lyapunov theory. To validate the proposed method, we present a comprehensive experimental study by using two continuum robots both integrated with multi-core FBGs, including a robotic-assisted colonoscope and multi-section extensible soft manipulators. The results demonstrate the feasibility, adaptability, and superiority of our controller in various unstructured environments as well as phantom experiments.

Imaging markers of cerebral small vessel disease provide valuable information on brain health, but their manual assessment is time-consuming and hampered by substantial intra- and interrater variability. Automated rating may benefit biomedical research, as well as clinical assessment, but diagnostic reliability of existing algorithms is unknown. Here, we present the results of the \textit{VAscular Lesions DetectiOn and Segmentation} (\textit{Where is VALDO?}) challenge that was run as a satellite event at the international conference on Medical Image Computing and Computer Aided Intervention (MICCAI) 2021. This challenge aimed to promote the development of methods for automated detection and segmentation of small and sparse imaging markers of cerebral small vessel disease, namely enlarged perivascular spaces (EPVS) (Task 1), cerebral microbleeds (Task 2) and lacunes of presumed vascular origin (Task 3) while leveraging weak and noisy labels. Overall, 12 teams participated in the challenge proposing solutions for one or more tasks (4 for Task 1 - EPVS, 9 for Task 2 - Microbleeds and 6 for Task 3 - Lacunes). Multi-cohort data was used in both training and evaluation. Results showed a large variability in performance both across teams and across tasks, with promising results notably for Task 1 - EPVS and Task 2 - Microbleeds and not practically useful results yet for Task 3 - Lacunes. It also highlighted the performance inconsistency across cases that may deter use at an individual level, while still proving useful at a population level.

Computer-assisted minimally invasive surgery has great potential in benefiting modern operating theatres. The video data streamed from the endoscope provides rich information to support context-awareness for next-generation intelligent surgical systems. To achieve accurate perception and automatic manipulation during the procedure, learning based technique is a promising way, which enables advanced image analysis and scene understanding in recent years. However, learning such models highly relies on large-scale, high-quality, and multi-task labelled data. This is currently a bottleneck for the topic, as available public dataset is still extremely limited in the field of CAI. In this paper, we present and release the first integrated dataset (named AutoLaparo) with multiple image-based perception tasks to facilitate learning-based automation in hysterectomy surgery. Our AutoLaparo dataset is developed based on full-length videos of entire hysterectomy procedures. Specifically, three different yet highly correlated tasks are formulated in the dataset, including surgical workflow recognition, laparoscope motion prediction, and instrument and key anatomy segmentation. In addition, we provide experimental results with state-of-the-art models as reference benchmarks for further model developments and evaluations on this dataset. The dataset is available at https://autolaparo.github.io., Comment: Accepted at MICCAI 2022

Machine learning models fail to perform well on real-world applications when 1) the category distribution P(Y) of the training dataset suffers from long-tailed distribution and 2) the test data is drawn from different conditional distributions P(X|Y). Existing approaches cannot handle the scenario where both issues exist, which however is common for real-world applications. In this study, we took a step forward and looked into the problem of long-tailed classification under domain shifts. We designed three novel core functional blocks including Distribution Calibrated Classification Loss, Visual-Semantic Mapping and Semantic-Similarity Guided Augmentation. Furthermore, we adopted a meta-learning framework which integrates these three blocks to improve domain generalization on unseen target domains. Two new datasets were proposed for this problem, named AWA2-LTS and ImageNet-LTS. We evaluated our method on the two datasets and extensive experimental results demonstrate that our proposed method can achieve superior performance over state-of-the-art long-tailed/domain generalization approaches and the combinations. Source codes and datasets can be found at our project page https://xiaogu.site/LTDS., Comment: accepted to ECCV 2022

Surgical scene segmentation is fundamentally crucial for prompting cognitive assistance in robotic surgery. However, pixel-wise annotating surgical video in a frame-by-frame manner is expensive and time consuming. To greatly reduce the labeling burden, in this work, we study semi-supervised scene segmentation from robotic surgical video, which is practically essential yet rarely explored before. We consider a clinically suitable annotation situation under the equidistant sampling. We then propose PGV-CL, a novel pseudo-label guided cross-video contrast learning method to boost scene segmentation. It effectively leverages unlabeled data for a trusty and global model regularization that produces more discriminative feature representation. Concretely, for trusty representation learning, we propose to incorporate pseudo labels to instruct the pair selection, obtaining more reliable representation pairs for pixel contrast. Moreover, we expand the representation learning space from previous image-level to cross-video, which can capture the global semantics to benefit the learning process. We extensively evaluate our method on a public robotic surgery dataset EndoVis18 and a public cataract dataset CaDIS. Experimental results demonstrate the effectiveness of our method, consistently outperforming the state-of-the-art semi-supervised methods under different labeling ratios, and even surpassing fully supervised training on EndoVis18 with 10.1% labeling., Comment: Accepted by IROS 2022

Class distribution plays an important role in learning deep classifiers. When the proportion of each class in the test set differs from the training set, the performance of classification nets usually degrades. Such a label distribution shift problem is common in medical diagnosis since the prevalence of disease vary over location and time. In this paper, we propose the first method to tackle label shift for medical image classification, which effectively adapt the model learned from a single training label distribution to arbitrary unknown test label distribution. Our approach innovates distribution calibration to learn multiple representative classifiers, which are capable of handling different one-dominating-class distributions. When given a test image, the diverse classifiers are dynamically aggregated via the consistency-driven test-time adaptation, to deal with the unknown test label distribution. We validate our method on two important medical image classification tasks including liver fibrosis staging and COVID-19 severity prediction. Our experiments clearly show the decreased model performance under label shift. With our method, model performance significantly improves on all the test datasets with different label shifts for both medical image diagnosis tasks., Comment: This paper has been accepted by MICCAI 2022

Reconstruction of the soft tissues in robotic surgery from endoscopic stereo videos is important for many applications such as intra-operative navigation and image-guided robotic surgery automation. Previous works on this task mainly rely on SLAM-based approaches, which struggle to handle complex surgical scenes. Inspired by recent progress in neural rendering, we present a novel framework for deformable tissue reconstruction from binocular captures in robotic surgery under the single-viewpoint setting. Our framework adopts dynamic neural radiance fields to represent deformable surgical scenes in MLPs and optimize shapes and deformations in a learning-based manner. In addition to non-rigid deformations, tool occlusion and poor 3D clues from a single viewpoint are also particular challenges in soft tissue reconstruction. To overcome these difficulties, we present a series of strategies of tool mask-guided ray casting, stereo depth-cueing ray marching and stereo depth-supervised optimization. With experiments on DaVinci robotic surgery videos, our method significantly outperforms the current state-of-the-art reconstruction method for handling various complex non-rigid deformations. To our best knowledge, this is the first work leveraging neural rendering for surgical scene 3D reconstruction with remarkable potential demonstrated. Code is available at: https://github.com/med-air/EndoNeRF., Comment: 11 pages, 4 figures, conference

Domain generalization typically requires data from multiple source domains for model learning. However, such strong assumption may not always hold in practice, especially in medical field where the data sharing is highly concerned and sometimes prohibitive due to privacy issue. This paper studies the important yet challenging single domain generalization problem, in which a model is learned under the worst-case scenario with only one source domain to directly generalize to different unseen target domains. We present a novel approach to address this problem in medical image segmentation, which extracts and integrates the semantic shape prior information of segmentation that are invariant across domains and can be well-captured even from single domain data to facilitate segmentation under distribution shifts. Besides, a test-time adaptation strategy with dual-consistency regularization is further devised to promote dynamic incorporation of these shape priors under each unseen domain to improve model generalizability. Extensive experiments on two medical image segmentation tasks demonstrate the consistent improvements of our method across various unseen domains, as well as its superiority over state-of-the-art approaches in addressing domain generalization under the worst-case scenario., Comment: Accepted to AAAI 2022

Despite recent progress on semi-supervised federated learning (FL) for medical image diagnosis, the problem of imbalanced class distributions among unlabeled clients is still unsolved for real-world use. In this paper, we study a practical yet challenging problem of class imbalanced semi-supervised FL (imFed-Semi), which allows all clients to have only unlabeled data while the server just has a small amount of labeled data. This imFed-Semi problem is addressed by a novel dynamic bank learning scheme, which improves client training by exploiting class proportion information. This scheme consists of two parts, i.e., the dynamic bank construction to distill various class proportions for each local client, and the sub-bank classification to impose the local model to learn different class proportions. We evaluate our approach on two public real-world medical datasets, including the intracranial hemorrhage diagnosis with 25,000 CT slices and skin lesion diagnosis with 10,015 dermoscopy images. The effectiveness of our method has been validated with significant performance improvements (7.61% and 4.69%) compared with the second-best on the accuracy, as well as comprehensive analytical studies. Code is available at https://github.com/med-air/imFedSemi., Comment: Early accepted by 25th International Conference on Medical Image Computing and Computer Assisted Intervention (MICCAI'22)

Test-time adaptation (TTA) has increasingly been an important topic to efficiently tackle the cross-domain distribution shift at test time for medical images from different institutions. Previous TTA methods have a common limitation of using a fixed learning rate for all the test samples. Such a practice would be sub-optimal for TTA, because test data may arrive sequentially therefore the scale of distribution shift would change frequently. To address this problem, we propose a novel dynamic learning rate adjustment method for test-time adaptation, called DLTTA, which dynamically modulates the amount of weights update for each test image to account for the differences in their distribution shift. Specifically, our DLTTA is equipped with a memory bank based estimation scheme to effectively measure the discrepancy of a given test sample. Based on this estimated discrepancy, a dynamic learning rate adjustment strategy is then developed to achieve a suitable degree of adaptation for each test sample. The effectiveness and general applicability of our DLTTA is extensively demonstrated on three tasks including retinal optical coherence tomography (OCT) segmentation, histopathological image classification, and prostate 3D MRI segmentation. Our method achieves effective and fast test-time adaptation with consistent performance improvement over current state-of-the-art test-time adaptation methods. Code is available at: https://github.com/med-air/DLTTA.

Deep neural networks have achieved remarkable success in a wide variety of natural image and medical image computing tasks. However, these achievements indispensably rely on accurately annotated training data. If encountering some noisy-labeled images, the network training procedure would suffer from difficulties, leading to a sub-optimal classifier. This problem is even more severe in the medical image analysis field, as the annotation quality of medical images heavily relies on the expertise and experience of annotators. In this paper, we propose a novel collaborative training paradigm with global and local representation learning for robust medical image classification from noisy-labeled data to combat the lack of high quality annotated medical data. Specifically, we employ the self-ensemble model with a noisy label filter to efficiently select the clean and noisy samples. Then, the clean samples are trained by a collaborative training strategy to eliminate the disturbance from imperfect labeled samples. Notably, we further design a novel global and local representation learning scheme to implicitly regularize the networks to utilize noisy samples in a self-supervised manner. We evaluated our proposed robust learning strategy on four public medical image classification datasets with three types of label noise,ie,random noise, computer-generated label noise, and inter-observer variability noise. Our method outperforms other learning from noisy label methods and we also conducted extensive experiments to analyze each component of our method.

Although machine learning (ML) has shown promise in numerous domains, there are concerns about generalizability to out-of-sample data. This is currently addressed by centrally sharing ample, and importantly diverse, data from multiple sites. However, such centralization is challenging to scale (or even not feasible) due to various limitations. Federated ML (FL) provides an alternative to train accurate and generalizable ML models, by only sharing numerical model updates. Here we present findings from the largest FL study to-date, involving data from 71 healthcare institutions across 6 continents, to generate an automatic tumor boundary detector for the rare disease of glioblastoma, utilizing the largest dataset of such patients ever used in the literature (25,256 MRI scans from 6,314 patients). We demonstrate a 33% improvement over a publicly trained model to delineate the surgically targetable tumor, and 23% improvement over the tumor's entire extent. We anticipate our study to: 1) enable more studies in healthcare informed by large and diverse data, ensuring meaningful results for rare diseases and underrepresented populations, 2) facilitate further quantitative analyses for glioblastoma via performance optimization of our consensus model for eventual public release, and 3) demonstrate the effectiveness of FL at such scale and task complexity as a paradigm shift for multi-site collaborations, alleviating the need for data sharing., Comment: federated learning, deep learning, convolutional neural network, segmentation, brain tumor, glioma, glioblastoma, FeTS, BraTS

Federated learning (FL) allows multiple medical institutions to collaboratively learn a global model without centralizing client data. It is difficult, if possible at all, for such a global model to commonly achieve optimal performance for each individual client, due to the heterogeneity of medical images from various scanners and patient demographics. This problem becomes even more significant when deploying the global model to unseen clients outside the FL with unseen distributions not presented during federated training. To optimize the prediction accuracy of each individual client for medical imaging tasks, we propose a novel unified framework for both \textit{Inside and Outside model Personalization in FL} (IOP-FL). Our inside personalization uses a lightweight gradient-based approach that exploits the local adapted model for each client, by accumulating both the global gradients for common knowledge and the local gradients for client-specific optimization. Moreover, and importantly, the obtained local personalized models and the global model can form a diverse and informative routing space to personalize an adapted model for outside FL clients. Hence, we design a new test-time routing scheme using the consistency loss with a shape constraint to dynamically incorporate the models, given the distribution information conveyed by the test data. Our extensive experimental results on two medical image segmentation tasks present significant improvements over SOTA methods on both inside and outside personalization, demonstrating the potential of our IOP-FL scheme for clinical practice., Comment: Accepted by IEEE TMI special issue on federated learning for medical imaging

In this paper, we propose an iterative self-training framework for sim-to-real 6D object pose estimation to facilitate cost-effective robotic grasping. Given a bin-picking scenario, we establish a photo-realistic simulator to synthesize abundant virtual data, and use this to train an initial pose estimation network. This network then takes the role of a teacher model, which generates pose predictions for unlabeled real data. With these predictions, we further design a comprehensive adaptive selection scheme to distinguish reliable results, and leverage them as pseudo labels to update a student model for pose estimation on real data. To continuously improve the quality of pseudo labels, we iterate the above steps by taking the trained student model as a new teacher and re-label real data using the refined teacher model. We evaluate our method on a public benchmark and our newly-released dataset, achieving an ADD(-S) improvement of 11.49% and 22.62% respectively. Our method is also able to improve robotic bin-picking success by 19.54%, demonstrating the potential of iterative sim-to-real solutions for robotic applications., Comment: Accepted to ECCV 2022

Despite the remarkable success on medical image analysis with deep learning, it is still under exploration regarding how to rapidly transfer AI models from one dataset to another for clinical applications. This paper presents a novel and generic human-in-the-loop scheme for efficiently transferring a segmentation model from a small-scale labelled dataset to a larger-scale unlabelled dataset for multi-organ segmentation in CT. To achieve this, we propose to use an igniter network which can learn from a small-scale labelled dataset and generate coarse annotations to start the process of human-machine interaction. Then, we use a sustainer network for our larger-scale dataset, and iteratively updated it on the new annotated data. Moreover, we propose a flexible labelling strategy for the annotator to reduce the initial annotation workload. The model performance and the time cost of annotation in each subject evaluated on our private dataset are reported and analysed. The results show that our scheme can not only improve the performance by 19.7% on Dice, but also expedite the cost time of manual labelling from 13.87 min to 1.51 min per CT volume during the model transfer, demonstrating the clinical usefulness with promising potentials.

With the growing popularity of robotic surgery, education becomes increasingly important and urgently needed for the sake of patient safety. However, experienced surgeons have limited accessibility due to their busy clinical schedule or working in a distant city, thus can hardly provide sufficient education resources for novices. Remote mentoring, as an effective way, can help solve this problem, but traditional methods are limited to plain text, audio, or 2D video, which are not intuitive nor vivid. Augmented reality (AR), a thriving technique being widely used for various education scenarios, is promising to offer new possibilities of visual experience and interactive teaching. In this paper, we propose a novel AR-based robotic surgery remote mentoring system with efficient 3D scene visualization and natural 3D hand interaction. Using a head-mounted display (i.e., HoloLens), the mentor can remotely monitor the procedure streamed from the trainee's operation side. The mentor can also provide feedback directly with hand gestures, which is in-turn transmitted to the trainee and viewed in surgical console as guidance. We comprehensively validate the system on both real surgery stereo videos and ex-vivo scenarios of common robotic training tasks (i.e., peg-transfer and suturing). Promising results are demonstrated regarding the fidelity of streamed scene visualization, the accuracy of feedback with hand interaction, and the low-latency of each component in the entire remote mentoring system. This work showcases the feasibility of leveraging AR technology for reliable, flexible and low-cost solutions to robotic surgical education, and holds great potential for clinical applications.

Supervised federated learning (FL) enables multiple clients to share the trained model without sharing their labeled data. However, potential clients might even be reluctant to label their own data, which could limit the applicability of FL in practice. In this paper, we show the possibility of unsupervised FL whose model is still a classifier for predicting class labels, if the class-prior probabilities are shifted while the class-conditional distributions are shared among the unlabeled data owned by the clients. We propose federation of unsupervised learning (FedUL), where the unlabeled data are transformed into surrogate labeled data for each of the clients, a modified model is trained by supervised FL, and the wanted model is recovered from the modified model. FedUL is a very general solution to unsupervised FL: it is compatible with many supervised FL methods, and the recovery of the wanted model can be theoretically guaranteed as if the data have been labeled. Experiments on benchmark and real-world datasets demonstrate the effectiveness of FedUL. Code is available at https://github.com/lunanbit/FedUL., Comment: ICLR 2022 camera-ready version

Automatic laparoscope motion control is fundamentally important for surgeons to efficiently perform operations. However, its traditional control methods based on tool tracking without considering information hidden in surgical scenes are not intelligent enough, while the latest supervised imitation learning (IL)-based methods require expensive sensor data and suffer from distribution mismatch issues caused by limited demonstrations. In this paper, we propose a novel Imitation Learning framework for Laparoscope Control (ILLC) with reinforcement learning (RL), which can efficiently learn the control policy from limited surgical video clips. Specially, we first extract surgical laparoscope trajectories from unlabeled videos as the demonstrations and reconstruct the corresponding surgical scenes. To fully learn from limited motion trajectory demonstrations, we propose Shape Preserving Trajectory Augmentation (SPTA) to augment these data, and build a simulation environment that supports parallel RGB-D rendering to reinforce the RL policy for interacting with the environment efficiently. With adversarial training for IL, we obtain the laparoscope control policy based on the generated rollouts and surgical demonstrations. Extensive experiments are conducted in unseen reconstructed surgical scenes, and our method outperforms the previous IL methods, which proves the feasibility of our unified learning-based framework for laparoscope control., Comment: 7 pages, 7 figures, 2022 IEEE International Conference on Robotics and Automation (ICRA)

Magnetic resonance imaging (MRI) can present multi-contrast images of the same anatomical structures, enabling multi-contrast super-resolution (SR) techniques. Compared with SR reconstruction using a single-contrast, multi-contrast SR reconstruction is promising to yield SR images with higher quality by leveraging diverse yet complementary information embedded in different imaging modalities. However, existing methods still have two shortcomings: (1) they neglect that the multi-contrast features at different scales contain different anatomical details and hence lack effective mechanisms to match and fuse these features for better reconstruction; and (2) they are still deficient in capturing long-range dependencies, which are essential for the regions with complicated anatomical structures. We propose a novel network to comprehensively address these problems by developing a set of innovative Transformer-empowered multi-scale contextual matching and aggregation techniques; we call it McMRSR. Firstly, we tame transformers to model long-range dependencies in both reference and target images. Then, a new multi-scale contextual matching method is proposed to capture corresponding contexts from reference features at different scales. Furthermore, we introduce a multi-scale aggregation mechanism to gradually and interactively aggregate multi-scale matched features for reconstructing the target SR MR image. Extensive experiments demonstrate that our network outperforms state-of-the-art approaches and has great potential to be applied in clinical practice. Codes are available at https://github.com/XAIMI-Lab/McMRSR., Comment: CVPR 2022 accepted

Industrial bin picking is a challenging task that requires accurate and robust segmentation of individual object instances. Particularly, industrial objects can have irregular shapes, that is, thin and concave, whereas in bin-picking scenarios, objects are often closely packed with strong occlusion. To address these challenges, we formulate a novel part-aware instance segmentation pipeline. The key idea is to decompose industrial objects into correlated approximate convex parts and enhance the object-level segmentation with part-level segmentation. We design a part-aware network to predict part masks and part-to-part offsets, followed by a part aggregation module to assemble the recognized parts into instances. To guide the network learning, we also propose an automatic label decoupling scheme to generate ground-truth part-level labels from instance-level labels. Finally, we contribute the first instance segmentation dataset, which contains a variety of industrial objects that are thin and have non-trivial shapes. Extensive experimental results on various industrial objects demonstrate that our method can achieve the best segmentation results compared with the state-of-the-art approaches., Comment: 6 pages

This paper presents the design and results of the "PEg TRAnsfert Workflow recognition" (PETRAW) challenge whose objective was to develop surgical workflow recognition methods based on one or several modalities, among video, kinematic, and segmentation data, in order to study their added value. The PETRAW challenge provided a data set of 150 peg transfer sequences performed on a virtual simulator. This data set was composed of videos, kinematics, semantic segmentation, and workflow annotations which described the sequences at three different granularity levels: phase, step, and activity. Five tasks were proposed to the participants: three of them were related to the recognition of all granularities with one of the available modalities, while the others addressed the recognition with a combination of modalities. Average application-dependent balanced accuracy (AD-Accuracy) was used as evaluation metric to take unbalanced classes into account and because it is more clinically relevant than a frame-by-frame score. Seven teams participated in at least one task and four of them in all tasks. Best results are obtained with the use of the video and the kinematics data with an AD-Accuracy between 93% and 90% for the four teams who participated in all tasks. The improvement between video/kinematic-based methods and the uni-modality ones was significant for all of the teams. However, the difference in testing execution time between the video/kinematic-based and the kinematic-based methods has to be taken into consideration. Is it relevant to spend 20 to 200 times more computing time for less than 3% of improvement? The PETRAW data set is publicly available at www.synapse.org/PETRAW to encourage further research in surgical workflow recognition., Comment: Challenge report doi.org/10.1016/j.cmpb.2023.107561

Robot-assisted surgery has become progressively more and more popular due to its clinical advantages. In the meanwhile, the artificial intelligence and augmented reality in robotic surgery are developing rapidly and receive lots of attention. However, current methods have not discussed the coherent integration of AI and AR in robotic surgery. In this paper, we develop a novel system by seamlessly merging artificial intelligence module and augmented reality visualization to automatically generate the surgical guidance for robotic surgery education. Specifically, we first leverage reinforcement leaning to learn from expert demonstration and then generate 3D guidance trajectory, providing prior context information of the surgical procedure. Along with other information such as text hint, the 3D trajectory is then overlaid in the stereo view of dVRK, where the user can perceive the 3D guidance and learn the procedure. The proposed system is evaluated through a preliminary experiment on surgical education task peg-transfer, which proves its feasibility and potential as the next generation of robot-assisted surgery education solution.

Multiple medical institutions collaboratively training a model using federated learning (FL) has become a promising solution for maximizing the potential of data-driven models, yet the non-independent and identically distributed (non-iid) data in medical images is still an outstanding challenge in real-world practice. The feature heterogeneity caused by diverse scanners or protocols introduces a drift in the learning process, in both local (client) and global (server) optimizations, which harms the convergence as well as model performance. Many previous works have attempted to address the non-iid issue by tackling the drift locally or globally, but how to jointly solve the two essentially coupled drifts is still unclear. In this work, we concentrate on handling both local and global drifts and introduce a new harmonizing framework called HarmoFL. First, we propose to mitigate the local update drift by normalizing amplitudes of images transformed into the frequency domain to mimic a unified imaging setting, in order to generate a harmonized feature space across local clients. Second, based on harmonized features, we design a client weight perturbation guiding each local model to reach a flat optimum, where a neighborhood area of the local optimal solution has a uniformly low loss. Without any extra communication cost, the perturbation assists the global model to optimize towards a converged optimal solution by aggregating several local flat optima. We have theoretically analyzed the proposed method and empirically conducted extensive experiments on three medical image classification and segmentation tasks, showing that HarmoFL outperforms a set of recent state-of-the-art methods with promising convergence behavior. Code is available at https://github.com/med-air/HarmoFL., Comment: Accepted at AAAI 2022

How to tackle non-iid data is a crucial topic in federated learning. This challenging problem not only affects training process, but also harms performance of clients not participating in training. Existing literature mainly focuses on either side, yet still lacks a unified solution to handle these two types (internal and external) of clients in a joint way. In this work, we propose a unified framework to tackle the non-iid issues for internal and external clients together. Firstly, we propose to use client-specific batch normalization in either internal or external clients to alleviate feature distribution shifts incurred by non-iid data. Then we present theoretical analysis to demonstrate the benefits of client-specific batch normalization. Specifically, we show that our approach promotes convergence speed for federated training and yields lower generalization error bound for external clients. Furthermore, we use causal reasoning to form a causal view to explain the advantages of our framework. At last, we conduct extensive experiments on natural and medical images to evaluate our method, where our method achieves state-of-the-art performance, faster convergence, and shows good compatibility. We also performed comprehensive analytical studies on a real-world medical dataset to demonstrate the effectiveness.

Objective: The computation of anatomical information and laparoscope position is a fundamental block of surgical navigation in Minimally Invasive Surgery (MIS). Recovering a dense 3D structure of surgical scene using visual cues remains a challenge, and the online laparoscopic tracking primarily relies on external sensors, which increases system complexity. Methods: Here, we propose a learning-driven framework, in which an image-guided laparoscopic localization with 3D reconstructions of complex anatomical structures is obtained. To reconstruct the 3D structure of the whole surgical environment, we first fine-tune a learning-based stereoscopic depth perception method, which is robust to the texture-less and variant soft tissues, for depth estimation. Then, we develop a dense visual reconstruction algorithm to represent the scene by surfels, estimate the laparoscope poses and fuse the depth maps into a unified reference coordinate for tissue reconstruction. To estimate poses of new laparoscope views, we achieve a coarse-to-fine localization method, which incorporates our reconstructed 3D model. Results: We evaluate the reconstruction method and the localization module on three datasets, namely, the stereo correspondence and reconstruction of endoscopic data (SCARED), the ex-vivo phantom and tissue data collected with Universal Robot (UR) and Karl Storz Laparoscope, and the in-vivo DaVinci robotic surgery dataset, where the reconstructed 3D structures have rich details of surface texture with an accuracy error under 1.71 mm and the localization module can accurately track the laparoscope with only images as input. Conclusions: Experimental results demonstrate the superior performance of the proposed method in 3D anatomy reconstruction and laparoscopic localization. Significance: The proposed framework can be potentially extended to the current surgical navigation system.

PURPOSE: Surgical workflow and skill analysis are key technologies for the next generation of cognitive surgical assistance systems. These systems could increase the safety of the operation through context-sensitive warnings and semi-autonomous robotic assistance or improve training of surgeons via data-driven feedback. In surgical workflow analysis up to 91% average precision has been reported for phase recognition on an open data single-center dataset. In this work we investigated the generalizability of phase recognition algorithms in a multi-center setting including more difficult recognition tasks such as surgical action and surgical skill. METHODS: To achieve this goal, a dataset with 33 laparoscopic cholecystectomy videos from three surgical centers with a total operation time of 22 hours was created. Labels included annotation of seven surgical phases with 250 phase transitions, 5514 occurences of four surgical actions, 6980 occurences of 21 surgical instruments from seven instrument categories and 495 skill classifications in five skill dimensions. The dataset was used in the 2019 Endoscopic Vision challenge, sub-challenge for surgical workflow and skill analysis. Here, 12 teams submitted their machine learning algorithms for recognition of phase, action, instrument and/or skill assessment. RESULTS: F1-scores were achieved for phase recognition between 23.9% and 67.7% (n=9 teams), for instrument presence detection between 38.5% and 63.8% (n=8 teams), but for action recognition only between 21.8% and 23.3% (n=5 teams). The average absolute error for skill assessment was 0.78 (n=1 team). CONCLUSION: Surgical workflow and skill analysis are promising technologies to support the surgical team, but are not solved yet, as shown by our comparison of algorithms. This novel benchmark can be used for comparable evaluation and validation of future work.

Domain adaptation typically requires to access source domain data to utilize their distribution information for domain alignment with the target data. However, in many real-world scenarios, the source data may not be accessible during the model adaptation in the target domain due to privacy issue. This paper studies the practical yet challenging source-free unsupervised domain adaptation problem, in which only an existing source model and the unlabeled target data are available for model adaptation. We present a novel denoised pseudo-labeling method for this problem, which effectively makes use of the source model and unlabeled target data to promote model self-adaptation from pseudo labels. Importantly, considering that the pseudo labels generated from source model are inevitably noisy due to domain shift, we further introduce two complementary pixel-level and class-level denoising schemes with uncertainty estimation and prototype estimation to reduce noisy pseudo labels and select reliable ones to enhance the pseudo-labeling efficacy. Experimental results on cross-domain fundus image segmentation show that without using any source images or altering source training, our approach achieves comparable or even higher performance than state-of-the-art source-dependent unsupervised domain adaptation methods., Comment: Accepted to MICCAI 2021