arXiv subjects

Franziska Mathis-Ullrich

Publications and source records attributed to Franziska Mathis-Ullrich.

At least 19 recordsLinked to original sources

arXiv2026

Cross-Modal MRI Ovary Segmentation in Endometriosis Using Unpaired TVUS Prototype Priors

Transvaginal ultrasound (TVUS) and magnetic resonance imaging (MRI) provide complementary information for endometriosis image analysis, yet existing studies mainly focus on single-modality analysis or disease classification, leaving cross-modal ovarian segmentation largely unexplored. In this work, to tackle the increased difficulty of ovary segmentation in MRI due to ovaries' small target size and ambiguous boundaries with surrounding pelvic structures, we propose a dual branch framework for ovary segmentation across TVUS and MRI. More specifically, by adapting MedSAM3 with TVUS-derived prototype bank, we aim to align anatomically consistent feature representations across both modalities. Extensive experiments are conducted on endometriosis-related TVUS and MRI datasets. We observe quantitative and qualitative improvements of over 5 percentage points for the proposed dual-branch approach compared with multiple state-of-the-art methods. Furthermore, our ablation study shows the contribution of individual components such as the prototype bank and the importance of warm-up pretraining in the source TVUS domain.

cs.CV↗

arXiv2026

A Compact Top-Loading Robot for Endovascular Interventions: Design, Control and Evaluation

Robot-assisted endovascular intervention can potentially reduce radiation exposure, improve surgeon ergonomics, enable telesurgery, support active assistance and autonomy, and enhance procedural precision. However, existing systems often suffer from limited procedural coverage because constrained patient-side setups, restricted flexibility, and complex instrument exchange hinder clinical workflow integration. This work presents a compact robotic system for endovascular interventions that enables continuous translational and rotational manipulation of standard endovascular instruments. The system consists of two alternating carts with pneumatically actuated membrane grippers integrated into rotating gripper gears. Its top-loading design allows rapid exchange of instruments such as guidewires and catheters without changing the robotic setup. A leader-follower control strategy enables continuous motion despite the finite stroke of each cart. The system was evaluated in motion-tracking experiments with guidewires and catheters and in an in vitro vascular phantom. The motion-tracking experiments showed generally smooth translational and rotational motion profiles. Across all tested guidewire and catheter experiments, the mean relative tracking errors were 3.6% for translational motion and 4.1% for rotational motion. In the vascular phantom, robot-assisted navigation reached the target in most trials, demonstrating the feasibility of the proposed manipulation concept under in vitro conditions. The presented robotic system demonstrates technical feasibility for continuous manipulation of standard endovascular instruments in bench-top and in vitro experiments. The compact top-loading design may ease instrument exchange and clinical workflow integration. Future work will focus on improving gripping performance, actuation speed, force feedback, and evaluation in more clinically realistic settings.

cs.RO↗

arXiv2026

Comparing Commercial Depth Sensor Accuracy for Medical Applications

Depth estimation has numerous medical and surgical applications. We benchmark four depth sensors on a porcine bone specimen, a porcine belly specimen, and a silicone kidney phantom using stylus-sampled references. These objects contain several real-world challenges, including homogeneous surfaces, specular surfaces, and subsurface scattering. The comparison includes stereo, structured-light, and time-of-flight sensors at a distance of approximately 50 cm. Specifically, the Intel RealSense D405 (Intel RealSense, United States), PMD Flexx2 (pmdtechnologies, Germany), Stereolabs ZED 2i (Stereolabs, France), and Zivid 2M+ 60 (Zivid, Norway) are compared. The Zivid 2M+ 60 performed best across all objects and metrics considered in this work. The ZED ranked second for real tissue, but last on the phantom.

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arXiv2026

Point Cloud Segmentation for Autonomous Clip Positioning in Laparoscopic Cholecystectomy on a Phantom

High-risk applications in robotics, such as robot-assisted surgery, present unique challenges. These systems must be both highly precise and interpretable in order to be deployed in environments with very low tolerance for error or unsafe exploration. We present the first robotic system to demonstrate autonomous clip positioning on a physical phantom in laparoscopic surgery, one of the most common interventions in general surgery. After segmentation of a colorless point cloud from a single camera, target positions for the clips are extracted using spline interpolation, and can then be adjusted by the human operator. The segmentation model is trained on only 60 hand-labeled real point clouds, reflecting data scarcity in the surgical domain. We overcome this with a combination of pre-training on 128,000 synthetic point clouds and two novel data augmentation techniques. The motion of the end-effector to each target is visualized for the operator, satisfying the unique motion constraints of minimally-invasive surgery while ensuring that the robot's actions are verifiable and interpretable. In real robot experiments, our system localizes targets with the required precision of 0.75mm at a 95% success rate and executes autonomous clip positioning with a 100% success rate. We provide insights that are applicable to many other surgical and non-surgical tasks that require identifying and navigating to a precise target. Source code and project page: https://github.com/balazsgyenes/kirurc

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arXiv2026

A Position Statement on Endovascular Models and Effectiveness Metrics for Mechanical Thrombectomy Navigation, on behalf of the Stakeholder Taskforce for AI-assisted Robotic Thrombectomy (START)

While we are making progress in overcoming infectious diseases and cancer; one of the major medical challenges of the mid-21st century will be the rising prevalence of stroke. Large vessels occlusions are especially debilitating, yet effective treatment (needed within hours to achieve best outcomes) remains limited due to geography. One solution for improving timely access to mechanical thrombectomy in geographically diverse populations is the deployment of robotic surgical systems. Artificial intelligence (AI) assistance may enable the upskilling of operators in this emerging therapeutic delivery approach. Our aim was to establish consensus frameworks for developing and validating AI-assisted robots for thrombectomy. Objectives included standardizing effectiveness metrics and defining reference testbeds across in silico, in vitro, ex vivo, and in vivo environments. To achieve this, we convened experts in neurointervention, robotics, data science, health economics, policy, statistics, and patient advocacy. Consensus was built through an incubator day, a Delphi process, and a final Position Statement. We identified that the four essential testbed environments each had distinct validation roles. Realism requirements vary: simpler testbeds should include realistic vessel anatomy compatible with guidewire and catheter use, while standard testbeds should incorporate deformable vessels. More advanced testbeds should include blood flow, pulsatility, and disease features. There are two macro-classes of effectiveness metrics: one for in silico, in vitro, and ex vivo stages focusing on technical navigation, and another for in vivo stages, focused on clinical outcomes. Patient safety is central to this technology's development. One requisite patient safety task needed now is to correlate in vitro measurements to in vivo complications.

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arXiv2025

LUDO: Low-Latency Understanding of Deformable Objects using Point Cloud Occupancy Functions

Accurately determining the shape of deformable objects and the location of their internal structures is crucial for medical tasks that require precise targeting, such as robotic biopsies. We introduce LUDO, a method for accurate low-latency understanding of deformable objects. LUDO reconstructs objects in their deformed state, including their internal structures, from a single-view point cloud observation in under 30 ms using occupancy networks. LUDO provides uncertainty estimates for its predictions. Additionally, it provides explainability by highlighting key features in its input observations. Both uncertainty and explainability are important for safety-critical applications such as surgery. We evaluate LUDO in real-world robotic experiments, achieving a success rate of 98.9% for puncturing various regions of interest (ROIs) inside deformable objects. We compare LUDO to a popular baseline and show its superior ROI localization accuracy, training time, and memory requirements. LUDO demonstrates the potential to interact with deformable objects without the need for deformable registration methods.

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arXiv2025

LOOC: Localizing Organs using Occupancy Networks and Body Surface Depth Images

We introduce a novel approach for the precise localization of 67 anatomical structures from single depth images captured from the exterior of the human body. Our method uses a multi-class occupancy network, trained using segmented CT scans augmented with body-pose changes, and incorporates a specialized sampling strategy to handle densely packed internal organs. Our contributions include the application of occupancy networks for occluded structure localization, a robust method for estimating anatomical positions from depth images, and the creation of detailed, individualized 3D anatomical atlases. We outperform localization using template matching and provide qualitative real-world reconstructions. This method promises improvements in automated medical imaging and diagnostic procedures by offering accurate, non-invasive localization of critical anatomical structures.

cs.CV↗

arXiv2024

Ensemble Learning and 3D Pix2Pix for Comprehensive Brain Tumor Analysis in Multimodal MRI

Motivated by the need for advanced solutions in the segmentation and inpainting of glioma-affected brain regions in multi-modal magnetic resonance imaging (MRI), this study presents an integrated approach leveraging the strengths of ensemble learning with hybrid transformer models and convolutional neural networks (CNNs), alongside the innovative application of 3D Pix2Pix Generative Adversarial Network (GAN). Our methodology combines robust tumor segmentation capabilities, utilizing axial attention and transformer encoders for enhanced spatial relationship modeling, with the ability to synthesize biologically plausible brain tissue through 3D Pix2Pix GAN. This integrated approach addresses the BraTS 2023 cluster challenges by offering precise segmentation and realistic inpainting, tailored for diverse tumor types and sub-regions. The results demonstrate outstanding performance, evidenced by quantitative evaluations such as the Dice Similarity Coefficient (DSC), Hausdorff Distance (HD95) for segmentation, and Structural Similarity Index Measure (SSIM), Peak Signal-to-Noise Ratio (PSNR), and Mean-Square Error (MSE) for inpainting. Qualitative assessments further validate the high-quality, clinically relevant outputs. In conclusion, this study underscores the potential of combining advanced machine learning techniques for comprehensive brain tumor analysis, promising significant advancements in clinical decision-making and patient care within the realm of medical imaging.

eess.IV↗

arXiv2024

Unified HT-CNNs Architecture: Transfer Learning for Segmenting Diverse Brain Tumors in MRI from Gliomas to Pediatric Tumors

Accurate segmentation of brain tumors from 3D multimodal MRI is vital for diagnosis and treatment planning across diverse brain tumors. This paper addresses the challenges posed by the BraTS 2023, presenting a unified transfer learning approach that applies to a broader spectrum of brain tumors. We introduce HT-CNNs, an ensemble of Hybrid Transformers and Convolutional Neural Networks optimized through transfer learning for varied brain tumor segmentation. This method captures spatial and contextual details from MRI data, fine-tuned on diverse datasets representing common tumor types. Through transfer learning, HT-CNNs utilize the learned representations from one task to improve generalization in another, harnessing the power of pre-trained models on large datasets and fine-tuning them on specific tumor types. We preprocess diverse datasets from multiple international distributions, ensuring representativeness for the most common brain tumors. Our rigorous evaluation employs standardized quantitative metrics across all tumor types, ensuring robustness and generalizability. The proposed ensemble model achieves superior segmentation results across the BraTS validation datasets over the previous winning methods. Comprehensive quantitative evaluations using the DSC and HD95 demonstrate the effectiveness of our approach. Qualitative segmentation predictions further validate the high-quality outputs produced by our model. Our findings underscore the potential of transfer learning and ensemble approaches in medical image segmentation, indicating a substantial enhancement in clinical decision-making and patient care. Despite facing challenges related to post-processing and domain gaps, our study sets a new precedent for future research for brain tumor segmentation. The docker image for the code and models has been made publicly available, https://hub.docker.com/r/razeineldin/ht-cnns.

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arXiv2024

Tracking Tumors under Deformation from Partial Point Clouds using Occupancy Networks

To track tumors during surgery, information from preoperative CT scans is used to determine their position. However, as the surgeon operates, the tumor may be deformed which presents a major hurdle for accurately resecting the tumor, and can lead to surgical inaccuracy, increased operation time, and excessive margins. This issue is particularly pronounced in robot-assisted partial nephrectomy (RAPN), where the kidney undergoes significant deformations during operation. Toward addressing this, we introduce a occupancy network-based method for the localization of tumors within kidney phantoms undergoing deformations at interactive speeds. We validate our method by introducing a 3D hydrogel kidney phantom embedded with exophytic and endophytic renal tumors. It closely mimics real tissue mechanics to simulate kidney deformation during in vivo surgery, providing excellent contrast and clear delineation of tumor margins to enable automatic threshold-based segmentation. Our findings indicate that the proposed method can localize tumors in moderately deforming kidneys with a margin of 6mm to 10mm, while providing essential volumetric 3D information at over 60Hz. This capability directly enables downstream tasks such as robotic resection.

cs.RO↗

arXiv2024

Learning-Based Autonomous Navigation, Benchmark Environments and Simulation Framework for Endovascular Interventions

Endovascular interventions are a life-saving treatment for many diseases, yet suffer from drawbacks such as radiation exposure and potential scarcity of proficient physicians. Robotic assistance during these interventions could be a promising support towards these problems. Research focusing on autonomous endovascular interventions utilizing artificial intelligence-based methodologies is gaining popularity. However, variability in assessment environments hinders the ability to compare and contrast the efficacy of different approaches, primarily due to each study employing a unique evaluation framework. In this study, we present deep reinforcement learning-based autonomous endovascular device navigation on three distinct digital benchmark interventions: BasicWireNav, ArchVariety, and DualDeviceNav. The benchmark interventions were implemented with our modular simulation framework stEVE (simulated EndoVascular Environment). Autonomous controllers were trained solely in simulation and evaluated in simulation and on physical test benches with camera and fluoroscopy feedback. Autonomous control for BasicWireNav and ArchVariety reached high success rates and was successfully transferred from the simulated training environment to the physical test benches, while autonomous control for DualDeviceNav reached a moderate success rate. The experiments demonstrate the feasibility of stEVE and its potential for transferring controllers trained in simulation to real-world scenarios. Nevertheless, they also reveal areas that offer opportunities for future research. This study demonstrates the transferability of autonomous controllers from simulation to the real world in endovascular navigation and lowers the entry barriers and increases the comparability of research on endovascular assistance systems by providing open-source training scripts, benchmarks and the stEVE framework.

cs.RO↗

arXiv2024

Interactive Surgical Liver Phantom for Cholecystectomy Training

Training and prototype development in robot-assisted surgery requires appropriate and safe environments for the execution of surgical procedures. Current dry lab laparoscopy phantoms often lack the ability to mimic complex, interactive surgical tasks. This work presents an interactive surgical phantom for the cholecystectomy. The phantom enables the removal of the gallbladder during cholecystectomy by allowing manipulations and cutting interactions with the synthetic tissue. The force-displacement behavior of the gallbladder is modelled based on retraction demonstrations. The force model is compared to the force model of ex-vivo porcine gallbladders and evaluated on its ability to estimate retraction forces.

cs.RO↗

arXiv2024

Sim-To-Real Transfer for Visual Reinforcement Learning of Deformable Object Manipulation for Robot-Assisted Surgery

Automation holds the potential to assist surgeons in robotic interventions, shifting their mental work load from visuomotor control to high level decision making. Reinforcement learning has shown promising results in learning complex visuomotor policies, especially in simulation environments where many samples can be collected at low cost. A core challenge is learning policies in simulation that can be deployed in the real world, thereby overcoming the sim-to-real gap. In this work, we bridge the visual sim-to-real gap with an image-based reinforcement learning pipeline based on pixel-level domain adaptation and demonstrate its effectiveness on an image-based task in deformable object manipulation. We choose a tissue retraction task because of its importance in clinical reality of precise cancer surgery. After training in simulation on domain-translated images, our policy requires no retraining to perform tissue retraction with a 50% success rate on the real robotic system using raw RGB images. Furthermore, our sim-to-real transfer method makes no assumptions on the task itself and requires no paired images. This work introduces the first successful application of visual sim-to-real transfer for robotic manipulation of deformable objects in the surgical field, which represents a notable step towards the clinical translation of cognitive surgical robotics.

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arXiv2024

Movement Primitive Diffusion: Learning Gentle Robotic Manipulation of Deformable Objects

Policy learning in robot-assisted surgery (RAS) lacks data efficient and versatile methods that exhibit the desired motion quality for delicate surgical interventions. To this end, we introduce Movement Primitive Diffusion (MPD), a novel method for imitation learning (IL) in RAS that focuses on gentle manipulation of deformable objects. The approach combines the versatility of diffusion-based imitation learning (DIL) with the high-quality motion generation capabilities of Probabilistic Dynamic Movement Primitives (ProDMPs). This combination enables MPD to achieve gentle manipulation of deformable objects, while maintaining data efficiency critical for RAS applications where demonstration data is scarce. We evaluate MPD across various simulated and real world robotic tasks on both state and image observations. MPD outperforms state-of-the-art DIL methods in success rate, motion quality, and data efficiency. Project page: https://scheiklp.github.io/movement-primitive-diffusion/

cs.RO↗

arXiv2024

The Brain Tumor Sequence Registration (BraTS-Reg) Challenge: Establishing Correspondence Between Pre-Operative and Follow-up MRI Scans of Diffuse Glioma Patients

Registration of longitudinal brain MRI scans containing pathologies is challenging due to dramatic changes in tissue appearance. Although there has been progress in developing general-purpose medical image registration techniques, they have not yet attained the requisite precision and reliability for this task, highlighting its inherent complexity. Here we describe the Brain Tumor Sequence Registration (BraTS-Reg) challenge, as the first public benchmark environment for deformable registration algorithms focusing on estimating correspondences between pre-operative and follow-up scans of the same patient diagnosed with a diffuse brain glioma. The BraTS-Reg data comprise de-identified multi-institutional multi-parametric MRI (mpMRI) scans, curated for size and resolution according to a canonical anatomical template, and divided into training, validation, and testing sets. Clinical experts annotated ground truth (GT) landmark points of anatomical locations distinct across the temporal domain. Quantitative evaluation and ranking were based on the Median Euclidean Error (MEE), Robustness, and the determinant of the Jacobian of the displacement field. The top-ranked methodologies yielded similar performance across all evaluation metrics and shared several methodological commonalities, including pre-alignment, deep neural networks, inverse consistency analysis, and test-time instance optimization per-case basis as a post-processing step. The top-ranked method attained the MEE at or below that of the inter-rater variability for approximately 60% of the evaluated landmarks, underscoring the scope for further accuracy and robustness improvements, especially relative to human experts. The aim of BraTS-Reg is to continue to serve as an active resource for research, with the data and online evaluation tools accessible at https://bratsreg.github.io/.

eess.IV↗

arXiv2023

Registered and Segmented Deformable Object Reconstruction from a Single View Point Cloud

In deformable object manipulation, we often want to interact with specific segments of an object that are only defined in non-deformed models of the object. We thus require a system that can recognize and locate these segments in sensor data of deformed real world objects. This is normally done using deformable object registration, which is problem specific and complex to tune. Recent methods utilize neural occupancy functions to improve deformable object registration by registering to an object reconstruction. Going one step further, we propose a system that in addition to reconstruction learns segmentation of the reconstructed object. As the resulting output already contains the information about the segments, we can skip the registration process. Tested on a variety of deformable objects in simulation and the real world, we demonstrate that our method learns to robustly find these segments. We also introduce a simple sampling algorithm to generate better training data for occupancy learning.

cs.CV↗

arXiv2023

Grounding Graph Network Simulators using Physical Sensor Observations

Physical simulations that accurately model reality are crucial for many engineering disciplines such as mechanical engineering and robotic motion planning. In recent years, learned Graph Network Simulators produced accurate mesh-based simulations while requiring only a fraction of the computational cost of traditional simulators. Yet, the resulting predictors are confined to learning from data generated by existing mesh-based simulators and thus cannot include real world sensory information such as point cloud data. As these predictors have to simulate complex physical systems from only an initial state, they exhibit a high error accumulation for long-term predictions. In this work, we integrate sensory information to ground Graph Network Simulators on real world observations. In particular, we predict the mesh state of deformable objects by utilizing point cloud data. The resulting model allows for accurate predictions over longer time horizons, even under uncertainties in the simulation, such as unknown material properties. Since point clouds are usually not available for every time step, especially in online settings, we employ an imputation-based model. The model can make use of such additional information only when provided, and resorts to a standard Graph Network Simulator, otherwise. We experimentally validate our approach on a suite of prediction tasks for mesh-based interactions between soft and rigid bodies. Our method results in utilization of additional point cloud information to accurately predict stable simulations where existing Graph Network Simulators fail.

cs.LG↗

arXiv2023

LapGym -- An Open Source Framework for Reinforcement Learning in Robot-Assisted Laparoscopic Surgery

Recent advances in reinforcement learning (RL) have increased the promise of introducing cognitive assistance and automation to robot-assisted laparoscopic surgery (RALS). However, progress in algorithms and methods depends on the availability of standardized learning environments that represent skills relevant to RALS. We present LapGym, a framework for building RL environments for RALS that models the challenges posed by surgical tasks, and sofa_env, a diverse suite of 12 environments. Motivated by surgical training, these environments are organized into 4 tracks: Spatial Reasoning, Deformable Object Manipulation & Grasping, Dissection, and Thread Manipulation. Each environment is highly parametrizable for increasing difficulty, resulting in a high performance ceiling for new algorithms. We use Proximal Policy Optimization (PPO) to establish a baseline for model-free RL algorithms, investigating the effect of several environment parameters on task difficulty. Finally, we show that many environments and parameter configurations reflect well-known, open problems in RL research, allowing researchers to continue exploring these fundamental problems in a surgical context. We aim to provide a challenging, standard environment suite for further development of RL for RALS, ultimately helping to realize the full potential of cognitive surgical robotics. LapGym is publicly accessible through GitHub (https://github.com/ScheiklP/lap_gym).

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