arXiv subjects

Jeffrey H. Siewerdsen

Publications and source records attributed to Jeffrey H. Siewerdsen.

8 recordsLinked to original sources

arXiv2026

Current validation practice undermines surgical AI development

Surgical data science (SDS) is rapidly advancing, yet clinical adoption of artificial intelligence (AI) in surgery remains limited, with inadequate validation as an important contributing factor. Existing validation practices often neglect the temporal and hierarchical structure of intraoperative videos, yielding misleading or clinically irrelevant results. We introduce a comprehensive catalogue of validation pitfalls in AI-based surgical video analysis, derived from a multi-stage Delphi process with 92 international experts. Pitfalls span three categories: (1) data, (2) metric selection/configuration, and (3) aggregation and reporting. A systematic review of surgical AI papers reveals that these pitfalls are widespread. Experiments on surgical video datasets show that ignoring temporal and hierarchical data structures can understate uncertainty, obscure critical failure modes, and alter algorithm rankings. To address these shortcomings, we provide consensus-based best practices compiled. Together, this work provides an evidence-based framework for rigorous validation of surgical video analysis algorithms, guiding benchmarking, reporting, regulatory review, and clinical translation.

q-bio.OT↗

arXiv2026

A Single-Fiber Optical Frequency Domain Reflectometry (OFDR)-Based Shape Sensing of Concentric Tube Steerable Drilling Robots

This paper introduces a novel shape-sensing approach for Concentric Tube Steerable Drilling Robots (CT-SDRs) based on Optical Frequency Domain Reflectometry (OFDR). Unlike traditional FBG-based methods, OFDR enables continuous strain measurement along the entire fiber length with enhanced spatial resolution. In the proposed method, a Shape Sensing Assembly (SSA) is first fabricated by integrating a single OFDR fiber with a flat NiTi wire. The calibrated SSA is then routed through and housed within the internal channel of a flexible drilling instrument, which is guided by the pre-shaped NiTi tube of the CT-SDR. In this configuration, the drilling instrument serves as a protective sheath for the SSA during drilling, eliminating the need for integration or adhesion to the instrument surface that is typical of conventional optical sensor approaches. The performance of the proposed SSA, integrated within the cannulated CT-SDR, was thoroughly evaluated under free-bending conditions and during drilling along multiple J-shaped trajectories in synthetic Sawbones phantoms. Results demonstrate accurate and reliable shape-sensing capability, confirming the feasibility and robustness of this integration strategy.

cs.RO↗

arXiv2026

Comparative Analysis of Autonomous Robotic and Manual Techniques for Ultrasonic Sacral Osteotomy: A Preliminary Study

In this paper, we introduce an autonomous Ultrasonic Sacral Osteotomy (USO) robotic system that integrates an ultrasonic osteotome with a seven-degree-of-freedom (DoF) robotic manipulator guided by an optical tracking system. To assess multi-directional control along both the surface trajectory and cutting depth of this system, we conducted quantitative comparisons between manual USO (MUSO) and robotic USO (RUSO) in Sawbones phantoms under identical osteotomy conditions. The RUSO system achieved sub-millimeter trajectory accuracy (0.11 mm RMSE), an order of magnitude improvement over MUSO (1.10 mm RMSE). Moreover, MUSO trials showed substantial over-penetration (16.0 mm achieved vs. 8.0 mm target), whereas the RUSO system maintained precise depth control (8.1 mm). These results demonstrate that robotic procedures can effectively overcome the critical limitations of manual osteotomy, establishing a foundation for safer and more precise sacral resections.

cs.RO↗

arXiv2025

Image-Guided Surgery: Technology, Quality, Innovation, and Opportunities for Medical Physics

The science and clinical practice of medical physics has been integral to the advancement of radiology and radiation therapy for over a century. In parallel, advances in surgery - including intraoperative imaging, registration, and other technologies within the expertise of medical physicists - have advanced primarily in connection to other disciplines, such as biomedical engineering and computer science, and via somewhat distinct translational paths. This review article briefly traces the parallel and convergent evolution of such scientific, engineering, and clinical domains with an eye to a potentially broader, more impactful role of medical physics in research and clinical practice of surgery. A review of image-guided surgery technologies is offered, including intraoperative imaging, tracking / navigation, image registration, visualization, and surgical robotics across a spectrum of surgical applications. Trends and drivers for research and innovation are traced, including federal funding and academic-industry partnership, and some of the major challenges to achieving major clinical impact are described. Opportunities for medical physicists to expand expertise and contribute to the advancement of surgery in the decade ahead are outlined, including research and innovation, data science approaches, improving efficiency through operations research and optimization, improving patient safety, and bringing rigorous quality assurance to technologies and processes in the circle of care for surgery. Challenges abound but appear tractable, including domain knowledge, professional qualifications, and the need for investment and clinical partnership.

physics.med-ph↗

arXiv2020

Optimized Spatial-Spectral CT for Multi-Material Decomposition

Spectral CT is an emerging modality that uses a data acquisition scheme with varied spectral responses to provide enhanced material discrimination in addition to the structural information of conventional CT. Existing clinical and preclinical designs with this capability include kV-switching, split-filtration, and dual-layer detector systems to provide two spectral channels of projection data. In this work, we examine an alternate design based on a spatial-spectral filter. This source-side filter is made up a linear array of materials that divide the incident x-ray beam into spectrally varied beamlets. This design allows for any number of spectral channels; however, each individual channel is sparse in the projection domain. Model-based iterative reconstruction methods can accommodate such sparse spatial-spectral sampling patterns and allow for the incorporation of advanced regularization. With the goal of an optimized physical design, we characterize the effects of design parameters including filter tile order and filter tile width and their impact on material decomposition performance. We present results of numerical simulations that characterize the impact of each design parameter using a realistic CT geometry and noise model to demonstrate feasibility. Results for filter tile order show little change indicating that filter order is a low-priority design consideration. We observe improved performance for narrower filter widths; however, the performance drop-off is relatively flat indicating that wider filter widths are also feasible designs.

physics.med-ph↗

arXiv2018

High-Fidelity Modeling of Detector Lag and Gantry Motion in CT Reconstruction

Detector lag and gantry motion during x-ray exposure and integration both result in azimuthal blurring in CT reconstructions. These effects can degrade image quality both for high-resolution features as well as low-contrast details. In this work we consider a forward model for model-based iterative reconstruction (MBIR) that is sufficiently general to accommodate both of these physical effects. We integrate this forward model in a penalized, weighted, nonlinear least-square style objective function for joint reconstruction and correction of these blur effects. We show that modeling detector lag can reduce/remove the characteristic lag artifacts in head imaging in both a simulation study and physical experiments. Similarly, we show that azimuthal blur ordinarily introduced by gantry motion can be mitigated with proper reconstruction models. In particular, we find the largest image quality improvement at the periphery of the field-of-view where gantry motion artifacts are most pronounced. These experiments illustrate the generality of the underlying forward model, suggesting the potential application in modeling a number of physical effects that are traditionally ignored or mitigated through pre-corrections to measurement data.

physics.med-ph↗

arXiv2017

Model-based Iterative Reconstruction for Flat-Panel Cone-Beam CT with Focal Spot Blur, Detector Blur, and Correlated Noise

While model-based reconstruction methods have been successfully applied to flat-panel cone-beam CT (FP-CBCT) systems, typical implementations ignore both spatial correlations in the projection data as well as system blurs due to the detector and focal spot in the x-ray source. In this work, we develop a forward model for flat-panel-based systems that includes blur and noise correlation associated with finite focal spot size and an indirect detector (e.g., scintillator). This forward model is used to develop a staged reconstruction framework where projection data are deconvolved and log-transformed, followed by a generalized least-squares reconstruction that utilizes a non-diagonal statistical weighting to account for the correlation that arises from the acquisition and data processing chain. We investigate the performance of this novel reconstruction approach in both simulated data and in CBCT test-bench data. In comparison to traditional filtered backprojection and model-based methods that ignore noise correlation, the proposed approach yields a superior noise-resolution tradeoff. For example, for a system with 0.34 mm FWHM scintillator blur and 0.70 FWHM focal spot blur, using the a correlated noise model instead of an uncorrelated noise model increased resolution by 42% (with variance matched at 6.9 x 10^-8 mm^-2 ). While this advantage holds across a wide range of systems with differing blur characteristics, the improvements are greatest for systems where source blur is larger than detector blur.

physics.med-ph↗

arXiv2016

Modeling shift-variant X-ray focal spot blur for high-resolution flat-panel cone-beam CT

Flat-panel cone-beam CT (CBCT) has been applied clinically in a number of high-resolution applications. Increasing geometric magnification can potentially improve resolution, but also increases blur due to an extended x-ray focal-spot. We present a shift-variant focal-spot blur model and incorporate it into a model-based iterative-reconstruction algorithm. We apply this algorithm to simulation and CBCT test-bench data. In a trabecular bone simulation study, we find traditional reconstruction approaches without a blur model exhibit shift-variant resolution properties that depend greatly on the acquisition protocol (e.g. short vs. full scans) and the anode angles of the rays used to reconstruct a particular region. For physical CBCT experiments focal spot blur was characterized and a spatial resolution phantom was scanned and reconstructed. In both experiments image quality using the shift-variant model was significantly improved over approaches that modeled no blur or only a shift-invariant blur, suggesting a potential means to overcome traditional CBCT spatial resolution and system design limitations.

physics.med-ph↗