Abstract
PurposeUreteroscopy is an efficient endoscopic minimally invasive technique for the diagnosis and treatment of upper tract urothelial carcinoma. During ureteroscopy, the automatic segmentation of the hollow lumen is of primary importance, since it indicates the path that the endoscope should follow. In order to obtain an accurate segmentation of the hollow lumen, this paper presents an automatic method based on convolutional neural networks (CNNs).MethodsThe proposed method is based on an ensemble of 4 parallel CNNs to simultaneously process single and multi-frame information. Of these, two architectures are taken as core-models, namely U-Net based in residual blocks (m_1) and Mask-RCNN (m_2), which are fed with single still-frames I(t). The other two models (M_1, M_2) are modifications of the former ones consisting on the addition of a stage which makes use of 3D convolutions to process temporal information. M_1, M_2 are fed with triplets of frames (I(t-1), I(t), I(t+1)) to produce the segmentation for I(t).ResultsThe proposed method was evaluated using a custom dataset of 11 videos (2673 frames) which were collected and manually annotated from 6 patients. We obtain a Dice similarity coefficient of 0.80, outperforming previous state-of-the-art methods.ConclusionThe obtained results show that spatial-temporal information can be effectively exploited by the ensemble model to improve hollow lumen segmentation in ureteroscopic images. The method is effective also in the presence of poor visibility, occasional bleeding, or specular reflections.
Highlights
Upper tract urothelial cancer (UTUC) is a sub-type of urothelial cancer which arises in the renal pelvis and the ureter
In the case of spatiotemporal-based models, U-Net based on residual blocks (M1) performs 3% better than the one based on MaskRCNN (M2)
This might be due to the constraint of fitting the output of the 3D convolution into the layers of the backbone of Mask-RCNN
Summary
Upper tract urothelial cancer (UTUC) is a sub-type of urothelial cancer which arises in the renal pelvis and the ureter. Flexible ureteroscopy (URS) is nowadays the gold standard for UTUC diagnosis and conservative. URS is used to inspect the tissue in the urinary system, determine the presence and size of tumor [2] as well as for biopsy of suspicious lesions [3]. Navigation and diagnosis through the urinary tract are highly dependent upon the operator expertise [5]. For this reason, the current development of methods in computerassisted interventions (CAI) intends to support surgeons by providing them with relevant information during the procedure [6]. Within the endeavors of developing new tools for robotic ureteroscopy, a navigation system which relies on image information from the endoscopic camera is needed [7]
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