Determining the type of kidney stones allows urologists to prescribe a treatment to avoid recurrence of renal lithiasis. An automated in-vivo image-based classification method would be an important step towards an immediate identification of the kidney stone type required as a first phase of the diagnosis. In the literature it was shown on ex-vivo data (i.e., in very controlled scene and image acquisition conditions) that an automated kidney stone classification is indeed feasible. This pilot study compares the kidney stone recognition performances of six shallow machine learning methods and three deep-learning architectures which were tested with in-vivo images of the four most frequent urinary calculi types acquired with an endoscope during standard ureteroscopies. This contribution details the database construction and the design of the tested kidney stones classifiers. Even if the best results were obtained by the Inception v3 architecture (weighted precision, recall and F1-score of 0.97, 0.98 and 0.97, respectively), it is also shown that choosing an appropriate colour space and texture features allows a shallow machine learning method to approach closely the performances of the most promising deep-learning methods (the XGBoost classifier led to weighted precision, recall and F1-score values of 0.96). This paper is the first one that explores the most discriminant features to be extracted from images acquired during ureteroscopies.

This contribution presents a deep-learning method for extracting and fusing image information acquired from different viewpoints, with the aim to produce more discriminant object features for the identification of the type of kidney stones seen in endoscopic images. The model was further improved with a two-step transfer learning approach and by attention blocks to refine the learned feature maps. Deep feature fusion strategies improved the results of single view extraction backbone models by more than 6% in terms of accuracy of the kidney stones classification.

Several Deep Learning (DL) methods have recently been proposed for an automated identification of kidney stones during an ureteroscopy to enable rapid therapeutic decisions. Even if these DL approaches led to promising results, they are mainly appropriate for kidney stone types for which numerous labelled data are available. However, only few labelled images are available for some rare kidney stone types. This contribution exploits Deep Metric Learning (DML) methods i) to handle such classes with few samples, ii) to generalize well to out of distribution samples, and iii) to cope better with new classes which are added to the database. The proposed Guided Deep Metric Learning approach is based on a novel architecture which was designed to learn data representations in an improved way. The solution was inspired by Few-Shot Learning (FSL) and makes use of a teacher-student approach. The teacher model (GEMINI) generates a reduced hypothesis space based on prior knowledge from the labeled data, and is used it as a guide to a student model (i.e., ResNet50) through a Knowledge Distillation scheme. Extensive tests were first performed on two datasets separately used for the recognition, namely a set of images acquired for the surfaces of the kidney stone fragments, and a set of images of the fragment sections. The proposed DML-approach improved the identification accuracy by 10% and 12% in comparison to DL-methods and other DML-approaches, respectively. Moreover, model embeddings from the two dataset types were merged in an organized way through a multi-view scheme to simultaneously exploit the information of surface and section fragments. Test with the resulting mixed model improves the identification accuracy by at least 3% and up to 30% with respect to DL-models and shallow machine learning methods, respectively.

Few-shot learning is a challenging area of research that aims to learn new concepts with only a few labeled samples of data. Recent works based on metric-learning approaches leverage the meta-learning approach, which is encompassed by episodic tasks that make use a support (training) and query set (test) with the objective of learning a similarity comparison metric between those sets. Due to the lack of data, the learning process of the embedding network becomes an important part of the few-shot task. Previous works have addressed this problem using metric learning approaches, but the properties of the underlying latent space and the separability of the difference classes on it was not entirely enforced. In this work, we propose two different loss functions which consider the importance of the embedding vectors by looking at the intra-class and inter-class distance between the few data. The first loss function is the Proto-Triplet Loss, which is based on the original triplet loss with the modifications needed to better work on few-shot scenarios. The second loss function, which we dub ICNN loss is based on an inter and intra class nearest neighbors score, which help us to assess the quality of embeddings obtained from the trained network. Our results, obtained from a extensive experimental setup show a significant improvement in accuracy in the miniImagenNet benchmark compared to other metric-based few-shot learning methods by a margin of 2%, demonstrating the capability of these loss functions to allow the network to generalize better to previously unseen classes. In our experiments, we demonstrate competitive generalization capabilities to other domains, such as the Caltech CUB, Dogs and Cars datasets compared with the state of the art.