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Lucas Luttner

Publications and source records attributed to Lucas Luttner.

5 recordsLinked to original sources

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

Challenging Vision-Language Models with Surgical Data: A New Dataset and Broad Benchmarking Study

While traditional computer vision models have historically struggled to generalize to endoscopic domains, the emergence of foundation models has shown promising cross-domain performance. In this work, we present the first large-scale study assessing the capabilities of Vision Language Models (VLMs) for endoscopic tasks with a specific focus on laparoscopic surgery. Using a diverse set of state-of-the-art models, multiple surgical datasets, and extensive human reference annotations, we address three key research questions: (1) Can current VLMs solve basic perception tasks on surgical images? (2) Can they handle advanced frame-based endoscopic scene understanding tasks? and (3) How do specialized medical VLMs compare to generalist models in this context? Our results reveal that VLMs can effectively perform basic surgical perception tasks, such as object counting and localization, with performance levels comparable to general domain tasks. However, their performance deteriorates significantly when the tasks require medical knowledge. Notably, we find that specialized medical VLMs currently underperform compared to generalist models across both basic and advanced surgical tasks, suggesting that they are not yet optimized for the complexity of surgical environments. These findings highlight the need for further advancements to enable VLMs to handle the unique challenges posed by surgery. Overall, our work provides important insights for the development of next-generation endoscopic AI systems and identifies key areas for improvement in medical visual language models.

cs.CV

Continual Domain Incremental Learning for Privacy-aware Digital Pathology

In recent years, there has been remarkable progress in the field of digital pathology, driven by the ability to model complex tissue patterns using advanced deep-learning algorithms. However, the robustness of these models is often severely compromised in the presence of data shifts (e.g., different stains, organs, centers, etc.). Alternatively, continual learning (CL) techniques aim to reduce the forgetting of past data when learning new data with distributional shift conditions. Specifically, rehearsal-based CL techniques, which store some past data in a buffer and then replay it with new data, have proven effective in medical image analysis tasks. However, privacy concerns arise as these approaches store past data, prompting the development of our novel Generative Latent Replay-based CL (GLRCL) approach. GLRCL captures the previous distribution through Gaussian Mixture Models instead of storing past samples, which are then utilized to generate features and perform latent replay with new data. We systematically evaluate our proposed framework under different shift conditions in histopathology data, including stain and organ shift. Our approach significantly outperforms popular buffer-free CL approaches and performs similarly to rehearsal-based CL approaches that require large buffers causing serious privacy violations.

eess.IV

Unsupervised Latent Stain Adaptation for Computational Pathology

In computational pathology, deep learning (DL) models for tasks such as segmentation or tissue classification are known to suffer from domain shifts due to different staining techniques. Stain adaptation aims to reduce the generalization error between different stains by training a model on source stains that generalizes to target stains. Despite the abundance of target stain data, a key challenge is the lack of annotations. To address this, we propose a joint training between artificially labeled and unlabeled data including all available stained images called Unsupervised Latent Stain Adaptation (ULSA). Our method uses stain translation to enrich labeled source images with synthetic target images in order to increase the supervised signals. Moreover, we leverage unlabeled target stain images using stain-invariant feature consistency learning. With ULSA we present a semi-supervised strategy for efficient stain adaptation without access to annotated target stain data. Remarkably, ULSA is task agnostic in patch-level analysis for whole slide images (WSIs). Through extensive evaluation on external datasets, we demonstrate that ULSA achieves state-of-the-art (SOTA) performance in kidney tissue segmentation and breast cancer classification across a spectrum of staining variations. Our findings suggest that ULSA is an important framework for stain adaptation in computational pathology.

eess.IV

Training of Neural Networks with Uncertain Data: A Mixture of Experts Approach

This paper introduces the "Uncertainty-aware Mixture of Experts" (uMoE), a novel solution aimed at addressing aleatoric uncertainty within Neural Network (NN) based predictive models. While existing methodologies primarily concentrate on managing uncertainty during inference, uMoE uniquely embeds uncertainty into the training phase. Employing a "Divide and Conquer" strategy, uMoE strategically partitions the uncertain input space into more manageable subspaces. It comprises Expert components, individually trained on their respective subspace uncertainties. Overarching the Experts, a Gating Unit, leveraging additional information regarding the distribution of uncertain in-puts across these subspaces, dynamically adjusts the weighting to minimize deviations from ground truth. Our findings demonstrate the superior performance of uMoE over baseline methods in effectively managing data uncertainty. Furthermore, through a comprehensive robustness analysis, we showcase its adaptability to varying uncertainty levels and propose optimal threshold parameters. This innovative approach boasts broad applicability across diverse da-ta-driven domains, including but not limited to biomedical signal processing, autonomous driving, and production quality control.

stat.ML