This paper introduces a novel pipeline designed to bring ultrasound (US) plane pose estimation closer to clinical use for more effective navigation to the standard planes (SPs) in the fetal brain. We propose a semi-supervised segmentation model utilizing both labeled SPs and unlabeled 3D US volume slices. Our model enables reliable segmentation across a diverse set of fetal brain images. Furthermore, the model incorporates a classification mechanism to identify the fetal brain precisely. Our model not only filters out frames lacking the brain but also generates masks for those containing it, enhancing the relevance of plane pose regression in clinical settings. We focus on fetal brain navigation from two-dimensional (2D) ultrasound (US) video analysis and combine this model with a US plane pose regression network to provide sensorless proximity detection to SPs and non-SPs planes; we emphasize the importance of proximity detection to SPs for guiding sonographers, offering a substantial advantage over traditional methods by allowing earlier and more precise adjustments during scanning. We demonstrate the practical applicability of our approach through validation on real fetal scan videos obtained from sonographers of varying expertise levels. Our findings demonstrate the potential of our approach to complement existing fetal US technologies and advance prenatal diagnostic practices.

In obstetric ultrasound (US) scanning, the learner's ability to mentally build a three-dimensional (3D) map of the fetus from a two-dimensional (2D) US image represents a significant challenge in skill acquisition. We aim to build a US plane localization system for 3D visualization, training, and guidance without integrating additional sensors. This work builds on top of our previous work, which predicts the six-dimensional (6D) pose of arbitrarily oriented US planes slicing the fetal brain with respect to a normalized reference frame using a convolutional neural network (CNN) regression network. Here, we analyze in detail the assumptions of the normalized fetal brain reference frame and quantify its accuracy with respect to the acquisition of transventricular (TV) standard plane (SP) for fetal biometry. We investigate the impact of registration quality in the training and testing data and its subsequent effect on trained models. Finally, we introduce data augmentations and larger training sets that improve the results of our previous work, achieving median errors of 2.97 mm and 6.63 degrees for translation and rotation, respectively.

This paper introduces the ``SurgT: Surgical Tracking" challenge which was organised in conjunction with MICCAI 2022. There were two purposes for the creation of this challenge: (1) the establishment of the first standardised benchmark for the research community to assess soft-tissue trackers; and (2) to encourage the development of unsupervised deep learning methods, given the lack of annotated data in surgery. A dataset of 157 stereo endoscopic videos from 20 clinical cases, along with stereo camera calibration parameters, have been provided. Participants were assigned the task of developing algorithms to track the movement of soft tissues, represented by bounding boxes, in stereo endoscopic videos. At the end of the challenge, the developed methods were assessed on a previously hidden test subset. This assessment uses benchmarking metrics that were purposely developed for this challenge, to verify the efficacy of unsupervised deep learning algorithms in tracking soft-tissue. The metric used for ranking the methods was the Expected Average Overlap (EAO) score, which measures the average overlap between a tracker's and the ground truth bounding boxes. Coming first in the challenge was the deep learning submission by ICVS-2Ai with a superior EAO score of 0.617. This method employs ARFlow to estimate unsupervised dense optical flow from cropped images, using photometric and regularization losses. Second, Jmees with an EAO of 0.583, uses deep learning for surgical tool segmentation on top of a non-deep learning baseline method: CSRT. CSRT by itself scores a similar EAO of 0.563. The results from this challenge show that currently, non-deep learning methods are still competitive. The dataset and benchmarking tool created for this challenge have been made publicly available at https://surgt.grand-challenge.org/.

Hand-eye calibration algorithms are mature and provide accurate transformation estimations for an effective camera-robot link but rely on a sufficiently wide range of calibration data to avoid errors and degenerate configurations. To solve the hand-eye problem in robotic-assisted minimally invasive surgery and also simplify the calibration procedure by using neural network method cooporating with the new objective function. We present a neural network-based solution that estimates the transformation from a sequence of images and kinematic data which significantly simplifies the calibration procedure. The network utilises the long short-term memory architecture to extract temporal information from the data and solve the hand-eye problem. The objective function is derived from the linear combination of remote centre of motion constraint, the re-projection error and its derivative to induce a small change in the hand-eye transformation. The method is validated with the data from da Vinci Si and the result shows that the estimated hand-eye matrix is able to re-project the end-effector from the robot coordinate to the camera coordinate within 10 to 20 pixels of accuracy in both testing dataset. The calibration performance is also superior to the previous neural network-based hand-eye method. The proposed algorithm shows that the calibration procedure can be simplified by using deep learning techniques and the performance is improved by the assumption of non-static hand-eye transformations.

Fetoscopy laser photocoagulation is a widely adopted procedure for treating Twin-to-Twin Transfusion Syndrome (TTTS). The procedure involves photocoagulation pathological anastomoses to regulate blood exchange among twins. The procedure is particularly challenging due to the limited field of view, poor manoeuvrability of the fetoscope, poor visibility, and variability in illumination. These challenges may lead to increased surgery time and incomplete ablation. Computer-assisted intervention (CAI) can provide surgeons with decision support and context awareness by identifying key structures in the scene and expanding the fetoscopic field of view through video mosaicking. Research in this domain has been hampered by the lack of high-quality data to design, develop and test CAI algorithms. Through the Fetoscopic Placental Vessel Segmentation and Registration (FetReg2021) challenge, which was organized as part of the MICCAI2021 Endoscopic Vision challenge, we released the first largescale multicentre TTTS dataset for the development of generalized and robust semantic segmentation and video mosaicking algorithms. For this challenge, we released a dataset of 2060 images, pixel-annotated for vessels, tool, fetus and background classes, from 18 in-vivo TTTS fetoscopy procedures and 18 short video clips. Seven teams participated in this challenge and their model performance was assessed on an unseen test dataset of 658 pixel-annotated images from 6 fetoscopic procedures and 6 short clips. The challenge provided an opportunity for creating generalized solutions for fetoscopic scene understanding and mosaicking. In this paper, we present the findings of the FetReg2021 challenge alongside reporting a detailed literature review for CAI in TTTS fetoscopy. Through this challenge, its analysis and the release of multi-centre fetoscopic data, we provide a benchmark for future research in this field.

Fetoscopy laser photocoagulation is a widely used procedure for the treatment of Twin-to-Twin Transfusion Syndrome (TTTS), that occur in mono-chorionic multiple pregnancies due to placental vascular anastomoses. This procedure is particularly challenging due to limited field of view, poor manoeuvrability of the fetoscope, poor visibility due to fluid turbidity, variability in light source, and unusual position of the placenta. This may lead to increased procedural time and incomplete ablation, resulting in persistent TTTS. Computer-assisted intervention may help overcome these challenges by expanding the fetoscopic field of view through video mosaicking and providing better visualization of the vessel network. However, the research and development in this domain remain limited due to unavailability of high-quality data to encode the intra- and inter-procedure variability. Through the \textit{Fetoscopic Placental Vessel Segmentation and Registration (FetReg)} challenge, we present a large-scale multi-centre dataset for the development of generalized and robust semantic segmentation and video mosaicking algorithms for the fetal environment with a focus on creating drift-free mosaics from long duration fetoscopy videos. In this paper, we provide an overview of the FetReg dataset, challenge tasks, evaluation metrics and baseline methods for both segmentation and registration. Baseline methods results on the FetReg dataset shows that our dataset poses interesting challenges, offering large opportunity for the creation of novel methods and models through a community effort initiative guided by the FetReg challenge.

Twin-to-twin transfusion syndrome treatment requires fetoscopic laser photocoagulation of placental vascular anastomoses to regulate blood flow to both fetuses. Limited field-of-view (FoV) and low visual quality during fetoscopy make it challenging to identify all vascular connections. Mosaicking can align multiple overlapping images to generate an image with increased FoV, however, existing techniques apply poorly to fetoscopy due to the low visual quality, texture paucity, and hence fail in longer sequences due to the drift accumulated over time. Deep learning techniques can facilitate in overcoming these challenges. Therefore, we present a new generalized Deep Sequential Mosaicking (DSM) framework for fetoscopic videos captured from different settings such as simulation, phantom, and real environments. DSM extends an existing deep image-based homography model to sequential data by proposing controlled data augmentation and outlier rejection methods. Unlike existing methods, DSM can handle visual variations due to specular highlights and reflection across adjacent frames, hence reducing the accumulated drift. We perform experimental validation and comparison using 5 diverse fetoscopic videos to demonstrate the robustness of our framework.