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Maxence Boels

Publications and source records attributed to Maxence Boels.

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Progressive Experience Fusion for Multi-Task World Model Control in Endovascular Navigation

Autonomous endovascular navigation could support the delivery of mechanical thrombectomy to underserved areas, but controllers must navigate long, multi-stage paths across varying vascular anatomies. This study investigates Progressive Experience Fusion (PEF) to train a multi-task TD-MPC2 controller. We additionally evaluate a heuristic that changes the Model Predictive Path Integral planning horizon using residual action-sequence dispersion, and fine-tuning in a patient-specific simulation. Across five subtasks in ten known training anatomies with held-out targets, PEF achieved a mean success rate of 74%, compared with 37% for Soft Actor-Critic (p < 0.001) and 65% for base TD-MPC2 (p = 0.053). A PEF controller with adaptive-horizon planning trained on 30 vasculatures achieved a mean success rate of 90% in ten held-out vasculatures. The PEF agent successfully transferred to an unseen in vitro stroke patient vasculature under fluoroscopy, achieving a mean path ratio improvement from 63% to 80% with fine-tuning (p < 0.001), following 40x103 fine-tuning steps (corresponding to approximately 107 min of clinical inter-hospital transfer time). This work represents a proof of concept for multi-vasculature training and patient-specific adaptation, while further validation is required before clinical deployment.

cs.RO

DARIL: When Imitation Learning outperforms Reinforcement Learning in Surgical Action Planning

Surgical action planning requires predicting future instrument-verb-target triplets for real-time assistance. While teleoperated robotic surgery provides natural expert demonstrations for imitation learning (IL), reinforcement learning (RL) could potentially discover superior strategies through self-exploration. We present the first comprehensive comparison of IL versus RL for surgical action planning on CholecT50. Our Dual-task Autoregressive Imitation Learning (DARIL) baseline achieves 34.6% action triplet recognition mAP and 33.6% next frame prediction mAP with smooth planning degradation to 29.2% at 10-second horizons. We evaluated three RL variants: world model-based RL, direct video RL, and inverse RL enhancement. Surprisingly, all RL approaches underperformed DARIL--world model RL dropped to 3.1% mAP at 10s while direct video RL achieved only 15.9%. Our analysis reveals that distribution matching on expert-annotated test sets systematically favors IL over potentially valid RL policies that differ from training demonstrations. This challenges assumptions about RL superiority in sequential decision making and provides crucial insights for surgical AI development.

cs.AI

UltraFlwr -- An Efficient Federated Surgical Object Detection Framework

Surgical object detection in laparoscopic videos enables real-time instrument identification for workflow analysis and skills assessment, but training robust models such as You Only Look Once (YOLO) is challenged by limited data, privacy constraints, and inter-institutional variability. Federated learning (FL) enables collaborative training without sharing raw data, yet practical support for modern YOLO pipelines under heterogeneous surgical data remains limited. We present UltraFlwr, an open-source, communication-efficient, and edge-deployable framework that integrates Ultralytics YOLO with the Flower FL platform and supports native Partial Aggregation (PA) of YOLO components (backbone, neck, head). Using two public laparoscopic surgical tool detection datasets, we conduct a systematic empirical study of federated YOLO training under Independent and Identically Distributed (IID) and multiple clinically motivated heterogeneous scenarios, including differences in data curation, video length, and label availability. Results show that standard FL aggregators (e.g., FedAvg) do not consistently match centralized training per client, but reduce inter-client performance variability. Aggregating both backbone and neck components achieves performance comparable to full aggregation with lower communication costs. Also, improving within-client data consistency can benefit FL even when it increases distribution shift across clients. These findings provide practical guidance for deploying federated YOLO-based object detection in heterogeneous surgical environments. UltraFlwr is publicly available at https://github.com/KCL-BMEIS/UltraFlwr.

cs.CV

SWAG: Long-term Surgical Workflow Prediction with Generative-based Anticipation

While existing approaches excel at recognising current surgical phases, they provide limited foresight and intraoperative guidance into future procedural steps. Similarly, current anticipation methods are constrained to predicting short-term and single events, neglecting the dense, repetitive, and long sequential nature of surgical workflows. To address these needs and limitations, we propose SWAG (Surgical Workflow Anticipative Generation), a framework that combines phase recognition and anticipation using a generative approach. This paper investigates two distinct decoding methods - single-pass (SP) and auto-regressive (AR) - to generate sequences of future surgical phases at minute intervals over long horizons. We propose a novel embedding approach using class transition probabilities to enhance the accuracy of phase anticipation. Additionally, we propose a generative framework using remaining time regression to classification (R2C). SWAG was evaluated on two publicly available datasets, Cholec80 and AutoLaparo21. Our single-pass model with class transition probability embeddings (SP*) achieves 32.1% and 41.3% F1 scores over 20 and 30 minutes on Cholec80 and AutoLaparo21, respectively. Moreover, our approach competes with existing methods on phase remaining time regression, achieving weighted mean absolute errors of 0.32 and 0.48 minutes for 2- and 3-minute horizons. SWAG demonstrates versatility across generative decoding frame works and classification and regression tasks to create temporal continuity between surgical workflow recognition and anticipation. Our method provides steps towards intraoperative surgical workflow generation for anticipation. Project: https://maxboels.com/research/swag.

cs.CV

SuPRA: Surgical Phase Recognition and Anticipation for Intra-Operative Planning

Intra-operative recognition of surgical phases holds significant potential for enhancing real-time contextual awareness in the operating room. However, we argue that online recognition, while beneficial, primarily lends itself to post-operative video analysis due to its limited direct impact on the actual surgical decisions and actions during ongoing procedures. In contrast, we contend that the prediction and anticipation of surgical phases are inherently more valuable for intra-operative assistance, as they can meaningfully influence a surgeon's immediate and long-term planning by providing foresight into future steps. To address this gap, we propose a dual approach that simultaneously recognises the current surgical phase and predicts upcoming ones, thus offering comprehensive intra-operative assistance and guidance on the expected remaining workflow. Our novel method, Surgical Phase Recognition and Anticipation (SuPRA), leverages past and current information for accurate intra-operative phase recognition while using future segments for phase prediction. This unified approach challenges conventional frameworks that treat these objectives separately. We have validated SuPRA on two reputed datasets, Cholec80 and AutoLaparo21, where it demonstrated state-of-the-art performance with recognition accuracies of 91.8% and 79.3%, respectively. Additionally, we introduce and evaluate our model using new segment-level evaluation metrics, namely Edit and F1 Overlap scores, for a more temporal assessment of segment classification. In conclusion, SuPRA presents a new multi-task approach that paves the way for improved intra-operative assistance through surgical phase recognition and prediction of future events.

cs.CV

SAR-RARP50: Segmentation of surgical instrumentation and Action Recognition on Robot-Assisted Radical Prostatectomy Challenge

Surgical tool segmentation and action recognition are fundamental building blocks in many computer-assisted intervention applications, ranging from surgical skills assessment to decision support systems. Nowadays, learning-based action recognition and segmentation approaches outperform classical methods, relying, however, on large, annotated datasets. Furthermore, action recognition and tool segmentation algorithms are often trained and make predictions in isolation from each other, without exploiting potential cross-task relationships. With the EndoVis 2022 SAR-RARP50 challenge, we release the first multimodal, publicly available, in-vivo, dataset for surgical action recognition and semantic instrumentation segmentation, containing 50 suturing video segments of Robotic Assisted Radical Prostatectomy (RARP). The aim of the challenge is twofold. First, to enable researchers to leverage the scale of the provided dataset and develop robust and highly accurate single-task action recognition and tool segmentation approaches in the surgical domain. Second, to further explore the potential of multitask-based learning approaches and determine their comparative advantage against their single-task counterparts. A total of 12 teams participated in the challenge, contributing 7 action recognition methods, 9 instrument segmentation techniques, and 4 multitask approaches that integrated both action recognition and instrument segmentation. The complete SAR-RARP50 dataset is available at: https://rdr.ucl.ac.uk/projects/SARRARP50_Segmentation_of_surgical_instrumentation_and_Action_Recognition_on_Robot-Assisted_Radical_Prostatectomy_Challenge/191091

cs.CV

LoViT: Long Video Transformer for Surgical Phase Recognition

Online surgical phase recognition plays a significant role towards building contextual tools that could quantify performance and oversee the execution of surgical workflows. Current approaches are limited since they train spatial feature extractors using frame-level supervision that could lead to incorrect predictions due to similar frames appearing at different phases, and poorly fuse local and global features due to computational constraints which can affect the analysis of long videos commonly encountered in surgical interventions. In this paper, we present a two-stage method, called Long Video Transformer (LoViT) for fusing short- and long-term temporal information that combines a temporally-rich spatial feature extractor and a multi-scale temporal aggregator consisting of two cascaded L-Trans modules based on self-attention, followed by a G-Informer module based on ProbSparse self-attention for processing global temporal information. The multi-scale temporal head then combines local and global features and classifies surgical phases using phase transition-aware supervision. Our approach outperforms state-of-the-art methods on the Cholec80 and AutoLaparo datasets consistently. Compared to Trans-SVNet, LoViT achieves a 2.4 pp (percentage point) improvement in video-level accuracy on Cholec80 and a 3.1 pp improvement on AutoLaparo. Moreover, it achieves a 5.3 pp improvement in phase-level Jaccard on AutoLaparo and a 1.55 pp improvement on Cholec80. Our results demonstrate the effectiveness of our approach in achieving state-of-the-art performance of surgical phase recognition on two datasets of different surgical procedures and temporal sequencing characteristics whilst introducing mechanisms that cope with long videos.

cs.CV

MAPPING: Model Average with Post-processing for Stroke Lesion Segmentation

Accurate stroke lesion segmentation plays a pivotal role in stroke rehabilitation research, to provide lesion shape and size information which can be used for quantification of the extent of the stroke and to assess treatment efficacy. Recently, automatic segmentation algorithms using deep learning techniques have been developed and achieved promising results. In this report, we present our stroke lesion segmentation model based on nnU-Net framework, and apply it to the Anatomical Tracings of Lesions After Stroke (ATLAS v2.0) dataset. Furthermore, we describe an effective post-processing strategy that can improve some segmentation metrics. Our method took the first place in the 2022 MICCAI ATLAS Challenge with an average Dice score of 0.6667, Lesion-wise F1 score of 0.5643, Simple Lesion Count score of 4.5367, and Volume Difference score of 8804.9102. Our code and trained model weights are publicly available at https://github.com/King-HAW/ATLAS-R2-Docker-Submission.

eess.IV