arXiv subjects

Runlong He

Publications and source records attributed to Runlong He.

8 recordsLinked to original sources

arXiv2026

CoRe-DA: Contrastive Regression for Unsupervised Domain Adaptation in Surgical Skill Assessment

Vision-based surgical skill assessment (SSA) enables objective and scalable evaluation of operative performance. Progress in this field is constrained by the high cost and time demands for manual annotation of quantitative skill scores, as well as the poor generalization of existing regression models to new surgical tasks and environments. Meanwhile, appreciable volumes of unlabeled video data are now available, motivating the development of unsupervised domain adaptation (UDA) methods for SSA. We introduce the first benchmark for UDA in SSA regression, spanning four datasets across dry-lab and clinical settings as well as open and robotic surgery. We evaluate eight representative models under challenging domain shifts and propose CoRe-DA, a novel contrastive regression-based adaptation framework. Our method learns domain-invariant representations through relative-score supervision and target-domain self-training. Comprehensive experiments across two UDA settings show that CoRe-DA is superior to state-of-the-art methods, achieving Spearman Correlation Coefficients of 0.46 and 0.41 on dry-lab and clinical target datasets, respectively, without using any labeled target data for training. Overall, CoRe-DA enables scalable SSA with reliable cross-domain generalization, where existing methods underperform. Our code and datasets will be released at https://github.com/anastadimi/CoRe-DA.

cs.CV↗

arXiv2026

A Unified Framework for Joint Detection of Lacunes and Enlarged Perivascular Spaces

Cerebral small vessel disease (CSVD) markers, specifically enlarged perivascular spaces (EPVS) and lacunae, present a unique challenge in medical image analysis due to their radiological mimicry. Standard segmentation networks struggle with feature interference and extreme class imbalance when handling these divergent targets simultaneously. To address these issues, we propose a morphology-decoupled framework where Zero-Initialized Gated Cross-Task Attention exploits dense EPVS context to guide sparse lacune detection. Furthermore, biological and topological consistency are enforced via a mixed-supervision strategy integrating Mutual Exclusion and Centerline Dice losses. Finally, we introduce an Anatomically-Informed Inference Calibration mechanism to dynamically suppress false positives based on tissue semantics. Extensive 5-folds cross-validation on the VALDO 2021 dataset (N=40) demonstrates state-of-the-art performance, notably surpassing task winners in lacunae detection precision (71.1%, p=0.01) and F1-score (62.6%, p=0.03). Furthermore, evaluation on the external EPAD cohort (N=1762) confirms the model's robustness for large-scale population studies. Code will be released upon acceptance.

cs.CV↗

arXiv2026

Depth Augmented and FE Free 3D/2D Liver Registration for Laparoscopic Liver AR

Augmented reality (AR) guidance in laparoscopic liver surgery requires accurate registration of preoperative 3D models to intraoperative 2D video, but remains challenging due to partial visibility, specularities, and tissue deformation. Existing methods often rely on contour-based rigid initialization and finite-element (FE) models for deformable registration, increasing modeling and engineering complexity. We present a depth-augmented, FE-free 3D--2D registration pipeline that combines robust rigid initialization with patient-specific non-rigid refinement. For rigid alignment, we adapt the RefineNet module of FoundationPose to laparoscopic liver scenes by using multi-class contour maps and monocular depth for relative pose refinement. For deformable alignment, we construct a patient-specific statistical deformation model from non-rigid ICP (NICP) correspondences and optimize pose and shape parameters using a coarse-to-fine L-BFGS-B strategy. On a public clinical laparoscopic liver dataset, the proposed method achieves a mean target registration error (TRE) of 14.73\,mm under a controlled manual-contour setting designed to isolate registration performance. Ablation studies show that monocular depth improves rigid initialization over contour-only inputs, while tumor-mapping analysis indicates that good surface alignment does not necessarily translate into lower target localization error. On an external dataset without ground truth, the method produces visually plausible overlays for qualitative assessment. These results suggest that depth-augmented pose refinement and FE-free statistical deformation modeling provide a promising alternative to FE-based pipelines for controlled 3D--2D liver registration in surgical AR.

cs.CV↗

arXiv2026

SurgFusion-Net: Diversified Adaptive Multimodal Fusion Network for Surgical Skill Assessment

Robotic-assisted surgery (RAS) is established in clinical practice, and automated surgical skill assessment utilizing multimodal data offers transformative potential for surgical analytics and education. However, developing effective multimodal methods remains challenging due to the task complexity, limited annotated datasets and insufficient techniques for cross-modal information fusion. Existing state-of-the-art relies exclusively on RGB video and only applies on dry-lab settings, failing to address the significant domain gap between controlled simulation and real clinical cases, where the surgical environment together with camera and tissue motion introduce substantial complexities. This work introduces SurgFusion-Net and Divergence Regulated Attention (DRA), an innovative fusion strategy for multimodal surgical skill assessment. We contribute two first-of-their-kind clinical datasets: the RAH-skill dataset containing 279,691 RGB frames from 37 videos of Robot-assisted Hysterectomy (RAH), and the RARP-skill dataset containing 70,661 RGB frames from 33 videos of Robot-Assisted Radical Prostatectomy (RARP). Both datasets include M-GEARS skill annotations, corresponding optical flow and tool segmentation masks. DRA incorporates adaptive dual attention and diversity-promoting multi-head attention to fuse multimodal information, from three modalities, based on surgical context, enhancing assessment accuracy and reliability. Validated on the JIGSAWS benchmark, RAH-skill, and RARP-skill datasets, our approach outperforms recent baselines with SCC improvements of 0.02 in LOSO, 0.04 in LOUO across JIGSAWS tasks, and 0.0538 and 0.0493 gains on RAH-skill and RARP-skill, respectively.

cs.RO↗

arXiv2025

SurgAnt-ViVQA: Learning to Anticipate Surgical Events through GRU-Driven Temporal Cross-Attention

Anticipating forthcoming surgical events is vital for real-time assistance in endonasal transsphenoidal pituitary surgery, where visibility is limited and workflow changes rapidly. Most visual question answering (VQA) systems reason on isolated frames with static vision language alignment, providing little support for forecasting next steps or instrument needs. Existing surgical VQA datasets likewise center on the current scene rather than the near future. We introduce PitVQA-Anticipation, the first VQA dataset designed for forward looking surgical reasoning. It comprises 33.5 hours of operative video and 734,769 question answer pairs built from temporally grouped clips and expert annotations across four tasks: predicting the future phase, next step, upcoming instrument, and remaining duration. We further propose SurgAnt-ViVQA, a video language model that adapts a large language model using a GRU Gated Temporal Cross-Attention module. A bidirectional GRU encodes frame to frame dynamics, while an adaptive gate injects visual context into the language stream at the token level. Parameter efficient fine tuning customizes the language backbone to the surgical domain. SurgAnt-ViVQA tested upon on PitVQA-Anticipation and EndoVis datasets, surpassing strong image and video based baselines. Ablations show that temporal recurrence and gated fusion drive most of the gains. A frame budget study indicates a trade-off: 8 frames maximize fluency, whereas 32 frames slightly reduce BLEU but improve numeric time estimation. By pairing a temporally aware encoder with fine grained gated cross-attention, SurgAnt-ViVQA advances surgical VQA from retrospective description to proactive anticipation. PitVQA-Anticipation offers a comprehensive benchmark for this setting and highlights the importance of targeted temporal modeling for reliable, future aware surgical assistance.

cs.CV↗

arXiv2025

Surgical AI Copilot: Energy-Based Fourier Gradient Low-Rank Adaptation for Surgical LLM Agent Reasoning and Planning

Image-guided surgery demands adaptive, real-time decision support, yet static AI models struggle with structured task planning and providing interactive guidance. Large language models (LLMs)-powered agents offer a promising solution by enabling dynamic task planning and predictive decision support. Despite recent advances, the absence of surgical agent datasets and robust parameter-efficient fine-tuning techniques limits the development of LLM agents capable of complex intraoperative reasoning. In this paper, we introduce Surgical AI Copilot, an LLM agent for image-guided pituitary surgery, capable of conversation, planning, and task execution in response to queries involving tasks such as MRI tumor segmentation, endoscope anatomy segmentation, overlaying preoperative imaging with intraoperative views, instrument tracking, and surgical visual question answering (VQA). To enable structured agent planning, we develop the PitAgent dataset, a surgical context-aware planning dataset covering surgical tasks like workflow analysis, instrument localization, anatomical segmentation, and query-based reasoning. Additionally, we propose DEFT-GaLore, a Deterministic Energy-based Fourier Transform (DEFT) gradient projection technique for efficient low-rank adaptation of recent LLMs (e.g., LLaMA 3.2, Qwen 2.5), enabling their use as surgical agent planners. We extensively validate our agent's performance and the proposed adaptation technique against other state-of-the-art low-rank adaptation methods on agent planning and prompt generation tasks, including a zero-shot surgical VQA benchmark, demonstrating the significant potential for truly efficient and scalable surgical LLM agents in real-time operative settings.

cs.CV↗

arXiv2025

PitVQA++: Vector Matrix-Low-Rank Adaptation for Open-Ended Visual Question Answering in Pituitary Surgery

Vision-Language Models (VLMs) in visual question answering (VQA) offer a unique opportunity to enhance intra-operative decision-making, promote intuitive interactions, and significantly advancing surgical education. However, the development of VLMs for surgical VQA is challenging due to limited datasets and the risk of overfitting and catastrophic forgetting during full fine-tuning of pretrained weights. While parameter-efficient techniques like Low-Rank Adaptation (LoRA) and Matrix of Rank Adaptation (MoRA) address adaptation challenges, their uniform parameter distribution overlooks the feature hierarchy in deep networks, where earlier layers, that learn general features, require more parameters than later ones. This work introduces PitVQA++ with an open-ended PitVQA dataset and vector matrix-low-rank adaptation (Vector-MoLoRA), an innovative VLM fine-tuning approach for adapting GPT-2 to pituitary surgery. Open-Ended PitVQA comprises around 101,803 frames from 25 procedural videos with 745,972 question-answer sentence pairs, covering key surgical elements such as phase and step recognition, context understanding, tool detection, localization, and interactions recognition. Vector-MoLoRA incorporates the principles of LoRA and MoRA to develop a matrix-low-rank adaptation strategy that employs vector ranking to allocate more parameters to earlier layers, gradually reducing them in the later layers. Our approach, validated on the Open-Ended PitVQA and EndoVis18-VQA datasets, effectively mitigates catastrophic forgetting while significantly enhancing performance over recent baselines. Furthermore, our risk-coverage analysis highlights its enhanced reliability and trustworthiness in handling uncertain predictions. Our source code and dataset is available at~\url{https://github.com/HRL-Mike/PitVQA-Plus}.

cs.CV↗

arXiv2024

PitVQA: Image-grounded Text Embedding LLM for Visual Question Answering in Pituitary Surgery

Visual Question Answering (VQA) within the surgical domain, utilizing Large Language Models (LLMs), offers a distinct opportunity to improve intra-operative decision-making and facilitate intuitive surgeon-AI interaction. However, the development of LLMs for surgical VQA is hindered by the scarcity of diverse and extensive datasets with complex reasoning tasks. Moreover, contextual fusion of the image and text modalities remains an open research challenge due to the inherent differences between these two types of information and the complexity involved in aligning them. This paper introduces PitVQA, a novel dataset specifically designed for VQA in endonasal pituitary surgery and PitVQA-Net, an adaptation of the GPT2 with a novel image-grounded text embedding for surgical VQA. PitVQA comprises 25 procedural videos and a rich collection of question-answer pairs spanning crucial surgical aspects such as phase and step recognition, context understanding, tool detection and localization, and tool-tissue interactions. PitVQA-Net consists of a novel image-grounded text embedding that projects image and text features into a shared embedding space and GPT2 Backbone with an excitation block classification head to generate contextually relevant answers within the complex domain of endonasal pituitary surgery. Our image-grounded text embedding leverages joint embedding, cross-attention and contextual representation to understand the contextual relationship between questions and surgical images. We demonstrate the effectiveness of PitVQA-Net on both the PitVQA and the publicly available EndoVis18-VQA dataset, achieving improvements in balanced accuracy of 8% and 9% over the most recent baselines, respectively. Our code and dataset is available at https://github.com/mobarakol/PitVQA.

cs.CV↗