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Theo Ruers

Publications and source records attributed to Theo Ruers.

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A Paired Point-of-Care Ultrasound Dataset for Image Quality Enhancement and Benchmarking via a cGAN Baseline

Purpose: We aim to enhance the image quality of point-of-care ultrasound (POCUS) devices using deep learning and a novel paired dataset of POCUS and high-end ultrasound images. Approach: We collected the first accurately paired dataset using a custom-built automated gantry system of low-end POCUS and high-end ultrasound images. A conditional generative adversarial network (cGAN) was utilized based on the pix2pix architecture, with a U-Net generator that incorporates both L1 and structural similarity index (SSIM) losses to improve perceptual quality. Pretraining on a simulation dataset further boosts performance. Evaluation was performed on 1064 paired ex vivo tissue and phantom ultrasound image sets. Results: Our approach improves the SSIM from 0.29 to 0.54 and PSNR from 19.16 dB to 22.41 dB. No-reference metrics also indicate substantial enhancement, with the Natural Image Quality Evaluator (NIQE) and Perception-based Image Quality Evaluator (PIQE) scores dropping from 7.95 to 4.44 and 31.12 to 19.99, respectively. Conclusions: This work presents the first publicly available accurately paired dataset of low-end POCUS to high end ultrasound images. Additionally, our results demonstrate the potential of the proposed framework to overcome hardware limitations of handheld POCUS, enhancing its diagnostic value in low-resource and point-of-care settings. The POCUS-IQ Dataset is publicly available at https://github.com/NKI-MedTech-AI/POCUS-IQ.

eess.IV

Navigated hepatic tumor resection using intraoperative ultrasound imaging

Purpose: This proof-of-concept study evaluates feasibility and accuracy of an ultrasound-based navigation system for open liver surgery. Unlike most conventional systems that rely on registration to preoperative imaging, the proposed system provides navigation-guided resection using 3D models generated from intraoperative ultrasound. Methods: A pilot study was conducted in 25 patients undergoing resection of liver metastases. The first five cases served to optimize the workflow. Intraoperatively, an electromagnetic sensor compensated for organ motion, after which an ultrasound volume was acquired. Vasculature was segmented automatically and tumors semi-automatically using region-growing (n=15) or a deep learning algorithm (n=5). The resulting 3D model was visualized alongside tracked surgical instruments. Accuracy was assessed by comparing the distance between surgical clips and tumors in the navigation software with the same distance on a postoperative CT of the resected specimen. Results: Navigation was successfully established in all 20 patients. However, four cases were excluded from accuracy assessment due to intraoperative sensor detachment (n=3) or incorrect data recording (n=1). The complete navigation workflow was operational within 5-10 minutes. In 16 evaluable patients, 78 clip-to-tumor distances were analyzed. The median navigation accuracy was 3.2 mm [IQR: 2.8-4.8 mm], and an R0 resection was achieved in 15/16 (93.8%) patients and one patient had an R1 vascular resection. Conclusion: Navigation based solely on intra-operative ultrasound is feasible and accurate for liver surgery. This registration-free approach paves the way for simpler and more accurate image guidance systems.

eess.IV

Unifying Scale-Aware Depth Prediction and Perceptual Priors for Monocular Endoscope Pose Estimation and Tissue Reconstruction

Accurate endoscope pose estimation and 3D tissue surface reconstruction significantly enhances monocular minimally invasive surgical procedures by enabling accurate navigation and improved spatial awareness. However, monocular endoscope pose estimation and tissue reconstruction face persistent challenges, including depth ambiguity, physiological tissue deformation, inconsistent endoscope motion, limited texture fidelity, and a restricted field of view. To overcome these limitations, a unified framework for monocular endoscopic tissue reconstruction that integrates scale-aware depth prediction with temporally-constrained perceptual refinement is presented. This framework incorporates a novel MAPIS-Depth module, which leverages Depth Pro for robust initialisation and Depth Anything for efficient per-frame depth prediction, in conjunction with L-BFGS-B optimisation, to generate pseudo-metric depth estimates. These estimates are temporally refined by computing pixel correspondences using RAFT and adaptively blending flow-warped frames based on LPIPS perceptual similarity, thereby reducing artefacts arising from physiological tissue deformation and motion. To ensure accurate registration of the synthesised pseudo-RGBD frames from MAPIS-Depth, a novel WEMA-RTDL module is integrated, optimising both rotation and translation. Finally, truncated signed distance function-based volumetric fusion and marching cubes are applied to extract a comprehensive 3D surface mesh. Evaluations on HEVD and SCARED, with ablation and comparative analyses, demonstrate the framework's robustness and superiority over state-of-the-art methods.

cs.CV