Towards computer-assisted TTTS: Laser ablation detection for workflow segmentation from fetoscopic video

Int J Comput Assist Radiol Surg. 2018 Oct;13(10):1661-1670. doi: 10.1007/s11548-018-1813-8. Epub 2018 Jun 27.

Abstract

Purpose: Intrauterine foetal surgery is the treatment option for several congenital malformations. For twin-to-twin transfusion syndrome (TTTS), interventions involve the use of laser fibre to ablate vessels in a shared placenta. The procedure presents a number of challenges for the surgeon, and computer-assisted technologies can potentially be a significant support. Vision-based sensing is the primary source of information from the intrauterine environment, and hence, vision approaches present an appealing approach for extracting higher level information from the surgical site.

Methods: In this paper, we propose a framework to detect one of the key steps during TTTS interventions-ablation. We adopt a deep learning approach, specifically the ResNet101 architecture, for classification of different surgical actions performed during laser ablation therapy.

Results: We perform a two-fold cross-validation using almost 50 k frames from five different TTTS ablation procedures. Our results show that deep learning methods are a promising approach for ablation detection.

Conclusion: To our knowledge, this is the first attempt at automating photocoagulation detection using video and our technique can be an important component of a larger assistive framework for enhanced foetal therapies. The current implementation does not include semantic segmentation or localisation of the ablation site, and this would be a natural extension in future work.

Keywords: Deep learning; Endoscopy; Twin-to-twin transfusion syndrome (TTTS); Workflow segmentation.

MeSH terms

  • Algorithms
  • Diagnosis, Computer-Assisted*
  • False Positive Reactions
  • Female
  • Fetofetal Transfusion / diagnostic imaging*
  • Fetoscopy*
  • Humans
  • Image Processing, Computer-Assisted
  • Laser Therapy*
  • Lasers*
  • Placenta / diagnostic imaging
  • Pregnancy
  • Pregnancy Complications / diagnostic imaging
  • Reproducibility of Results
  • Support Vector Machine
  • Video Recording
  • Workflow