arXiv subjects

Tom Vercauteren

Publications and source records attributed to Tom Vercauteren.

At least 19 recordsLinked to original sources

arXiv2026

Spatial Feature-wise Linear Modulation (SpFiLM) for Contrast Agent-Aware Brain Parcellation

Most automated brain parcellation tools are developed and validated on T1-weighted (T1w) MRI. Yet, some clinical workflows for which parcellation is relevant only use contrast-enhanced T1w (T1ce) MRI, on which T1w-trained models are less accurate. We present a unified network that parcellates both pre- and post-contrast agent T1w MRI reliably, trained on a combination of the two with conditioning that spatially modulates its response differently for each. Feature-wise Linear Modulation (FiLM) is a known approach for input-based modulation in networks. It applies a per-channel scale and shift uniformly across the input. However, the appearance change between pre- and post-contrast varies locally across the brain, making FiLM suboptimal for our use case. In this work, we introduce Spatial FiLM (SpFiLM), a conditioning layer whose modulation varies spatially, assembling a voxel-wise scale and shift from image-derived spatial patterns. Using a cohort of 134 patients with paired T1w and T1ce MRI parcellated into 106 classes, the addition of SpFiLM layers in a UNet increased the mean Dice on the test set of 25 patients from 80.2% to 84.1%, a 4.9% relative improvement. Adding SpFiLM layers led to the best performance on both pre- and post-contrast MRI, even when controlling for network parameter counts.

eess.IV↗

arXiv2026

SinkSLOT: Sinkhorn via Sparse Lifted Optimal Transport

Entropic optimal transport (EOT) has been shown to offer a computationally tractable approximation to exact optimal transport. However, the standard Sinkhorn-Knopp algorithm has two main limitations. First, given discrete measures with $N$ points, each iteration requires $O(N^2)$ operations, which restricts its use on large-scale datasets (e.g. $N\geq10^4$). Second, it uses the independent coupling as a reference measure for regularisation. This assigns mass to high-cost transport edges at moderate regularisation strengths. We propose SinkSLOT, which addresses both limitations by putting forth the expected sliced lifted transport plan as a natural way to sparsify the Gibbs kernel with a non-independent prior coupling. We prove that: 1) SinkSLOT converges; 2) with $L$ slices, each resulting sparse Sinkhorn iteration costs $O(LN)$; and 3) the resulting objective is a divergence requiring no debiasing. Experiments on synthetic benchmarks show that SinkSLOT delivers substantial speedups over state-of-the-art dense and sparse EOT methods. We also demonstrate the applicability of the proposed divergence in a gradient flow experiment. The code is publicly available at https://github.com/cai4cai/SinkSLOT.

cs.LG↗

arXiv2026

Streamlining stereo differentiable rendering for marker-free real-time tracking of surgical robots

Purpose: Marker-based tracking of surgical robots is occlusion-prone in cluttered operating rooms. We evaluate stereo differentiable rendering for marker-free, real-time robot pose tracking, potentially improving safety, reducing setup time, and enabling multi-robot interaction. Methods: We extend the markerless pose estimation framework roboreg to online dynamic tracking via (i) sequential optimisation that propagates pose estimates across frames with motion-adaptive hyperparameter tuning, and (ii) CUDA stream parallelisation of segmentation and optimisation, combined with CUDA-graph accelerated segmentation. We evaluate on 38 unobstructed and 5 occluded displacement sequences with static start/end ground-truth calibrations and dynamic marker-based reference tracking. Results: We achieve real-time 1080p tracking at 30 fps (up from 14 fps for vanilla roboreg), matching the camera frame rate. Accuracy reaches 1.7 cm / 0.6 deg against static ground truth and 1.2 cm mean 3D error over 27,460 frames against the marker-based reference (1.53 cm over 1,242 occluded frames). Our method outperforms FoundationPose by 11% in dynamic estimation (63% under occlusion) and 250% in static estimation, with 6x faster inference. Conclusions: Stereo differentiable rendering enables real-time, high-resolution marker-free surgical robot tracking, on par with marker-based approaches and surpassing foundation-model baselines.

cs.RO↗

arXiv2026

Interpretable Probabilistic Medical Image Segmentation via Gaussian Process with Explicit Modelling of Annotation Bias and Variability

Deep learning-based medical image segmentation models are trained using annotations that exhibit systematic bias and variability across raters. While probabilistic multi-rater approaches can emulate annotator-specific delineations, annotator characteristics are typically encoded implicitly in deep latent feature space, making direct analysis of their influence on predictive distributions less straightforward. We propose a logit-space probabilistic segmentation framework based on stochastic variational Gaussian Process that explicitly decomposes predictions into an image-dependent reference logit distribution and annotator specific perturbations parameterised by bias and variance. This formulation enables more explicit analysis on how intra- and inter-rater variability propagate to predictive distributions. We evaluate the method on a multi-annotator medical image dataset, which shows that explicitly modelling annotator specific perturbations improves uncertainty calibration while maintaining comparable segmentation accuracy, compared with state-of-the-art multi-rater probabilistic segmentation method. The learned bias and variance parameters quantitatively reflect annotator-specific behaviour. Furthermore, controlled perturbation experiments over bias and variance demonstrate how changes in annotator parameters systematically influence predictive performance. The code used in this paper is made publicly available at https://github.com/QiLi111/GPS-Var.

cs.CV↗

arXiv2026

Redefining Instance Matching: A Unified Framework for Part-Aware Matching in Panoptic Segmentation Evaluation

The Panoptic Quality (PQ) metric is the standard for jointly evaluating instance and semantic segmentation. However, its original definition relies on a One-to-One matching between predicted and ground truth segments, which is only straightforward when the IoU threshold exceeds 0.5. Below 0.5, multiple matching strategies emerge in a poorly explored problem space. We systematically elucidate this space by recasting segment matching as a constrained bipartite assignment problem. Independently bounding the prediction- and ground-truth-side degrees yields four matching strategies: One-to-One, Many-to-One, One-to-Many, and Many-to-Many. We show that the first three are well-defined within the PQ framework, while Many-to-Many falls outside it. These strategies become relevant when instances are fragmented, adjacent objects are difficult to delineate, or annotations are noisy. Central to our framework is a vertex-based accounting of TP, FN, and FP, anchored to ground truth and predicted segments rather than to matching edges. We further show that the framework extends naturally to part-aware panoptic segmentation, and we explore part-aware evaluation on biomedical data. Across configurable case studies we report how different combinations of thresholds and matching strategies behave in practice. We release a unified open-source package built on Panoptica. It exposes Voronoi-based region-wise analysis, part-aware evaluation, and Area Under Threshold Curve computations as configurable options.

cs.CV↗

arXiv2026

Intuitive Surgical SurgToolLoc and SurgVU Challenges Results: 2022-2025

Robotic assisted (RA) surgery promises to transform surgical intervention. Intuitive Surgical is committed to fostering these changes and the machine learning models and algorithms that will enable them. With these goals in mind we have invited the surgical data science community to participate in a yearly competition hosted through the Medical Imaging Computing and Computer Assisted Interventions (MICCAI) conference. With varying changes from year to year, we have challenged the community to solve difficult machine learning problems in the context of advanced RA applications. Here we document the results of these challenges, focusing on surgical tool localization (SurgToolLoc) and surgical visual understanding (SurgVU). The publicly released dataset that accompanies these challenges is detailed in a separate paper arXiv:2501.09209 [1].

cs.CV↗

arXiv2026

Towards Real-Time Autonomous Navigation: Transformer-Based Catheter Tip Tracking in Fluoroscopy

Purpose: Mechanical thrombectomy (MT) improves stroke outcomes, but is limited by a lack of local treatment access. Widespread distribution of reinforcement learning (RL)-based robotic systems can be used to alleviate this challenge through autonomous navigation, but current RL methods require live device tip coordinate tracking to function. This paper aims to develop and evaluate a real-time catheter tip tracking pipeline under fluoroscopy, addressing challenges such as low contrast, noise, and device occlusion. Methods: A multi-threaded pipeline was designed, incorporating frame reading, preprocessing, inference, and post-processing. Deep learning segmentation models, including U-Net, U-Net+Transformer, and SegFormer, were trained and benchmarked using two-class and three-class formulations. Post-processing involved two-step component filtering, one-pixel medial skeletonization, and greedy arc-length path following with contour fall-back. Results: On manually-labeled moderate complexity fluoroscopic video data, the two-class SegFormer achieved a mean absolute error of 4.44 mm, outperforming U-Net (4.60 mm), U-Net+Transformer (6.20 mm) and all three-class models (5.19-7.74 mm). On segmentation benchmarks, the system exceeded state-of-the-art CathAction results with improvements of up to +5% in Dice scores for three-segmentation. Conclusion: The results demonstrate that the proposed multi-threaded tracking framework maintains stable performance under challenging imaging conditions, outperforming prior benchmarks, while providing a reliable and efficient foundation for RL-based autonomous MT navigation.

cs.CV↗

arXiv2026

A Position Statement on Endovascular Models and Effectiveness Metrics for Mechanical Thrombectomy Navigation, on behalf of the Stakeholder Taskforce for AI-assisted Robotic Thrombectomy (START)

While we are making progress in overcoming infectious diseases and cancer; one of the major medical challenges of the mid-21st century will be the rising prevalence of stroke. Large vessels occlusions are especially debilitating, yet effective treatment (needed within hours to achieve best outcomes) remains limited due to geography. One solution for improving timely access to mechanical thrombectomy in geographically diverse populations is the deployment of robotic surgical systems. Artificial intelligence (AI) assistance may enable the upskilling of operators in this emerging therapeutic delivery approach. Our aim was to establish consensus frameworks for developing and validating AI-assisted robots for thrombectomy. Objectives included standardizing effectiveness metrics and defining reference testbeds across in silico, in vitro, ex vivo, and in vivo environments. To achieve this, we convened experts in neurointervention, robotics, data science, health economics, policy, statistics, and patient advocacy. Consensus was built through an incubator day, a Delphi process, and a final Position Statement. We identified that the four essential testbed environments each had distinct validation roles. Realism requirements vary: simpler testbeds should include realistic vessel anatomy compatible with guidewire and catheter use, while standard testbeds should incorporate deformable vessels. More advanced testbeds should include blood flow, pulsatility, and disease features. There are two macro-classes of effectiveness metrics: one for in silico, in vitro, and ex vivo stages focusing on technical navigation, and another for in vivo stages, focused on clinical outcomes. Patient safety is central to this technology's development. One requisite patient safety task needed now is to correlate in vitro measurements to in vivo complications.

cs.RO↗

arXiv2026

Instance Awareness of Multi-class Semantic Segmentation Loss Functions

Instance-sensitive losses for semantic segmentation such as blob loss and CC loss were designed to address instance imbalance, ensuring small lesions generate the same gradient as large ones, but operate only on single-class segmentation. In multi-class settings, class imbalance poses an additional problem: rare classes with few instances receive a disproportionately small share of the training signal. We show that extending instance-sensitive losses to multi-class segmentation via a one-vs-rest class decomposition repurposes them to also address class imbalance, as uniform averaging over classes ensures each class contributes equally regardless of frequency. We further show that inverse-size weighting, which destabilizes training when applied globally due to weight imbalances across rare and common classes, becomes effective when integrated within the per-component loss, confining the reweighting to each component's spatial context. On the BraTS-METS 2025 dataset (260 test cases), multi-class CC loss improves foreground Dice (0.64 +/- 0.26 vs. 0.59 +/- 0.27 baseline) and rare-class Dice, while maintaining Panoptic Quality at DSC threshold 0.5. Multi-class blob loss achieves the best Panoptic Quality at threshold 0.5 (0.40 +/- 0.24 vs. 0.38 +/- 0.25 baseline) and recognition quality (0.53 +/- 0.29 vs. 0.49 +/- 0.30). Integrating inverse-size weighting within the per-component loss increases rare-class Dice to 0.44 +/- 0.36 at the cost of reduced detection quality.

cs.CV↗

arXiv2026

OOD-SEG: Exploiting out-of-distribution detection techniques for learning image segmentation from sparse multi-class positive-only annotations

Despite significant advancements, segmentation based on deep neural networks in medical and surgical imaging faces several challenges, two of which we aim to address in this work. First, acquiring complete pixel-level segmentation labels for medical images is time-consuming and requires domain expertise. Second, typical segmentation pipelines cannot detect out-of-distribution (OOD) pixels, leaving them prone to spurious outputs during deployment. In this work, we propose a novel segmentation approach which broadly falls within the positive-unlabelled (PU) learning paradigm and exploits tools from OOD detection techniques. Our framework learns only from sparsely annotated pixels from multiple positive-only classes and does not use any annotation for the background class. These multi-class positive annotations naturally fall within the in-distribution (ID) set. Unlabelled pixels may contain positive classes but also negative ones, including what is typically referred to as \emph{background} in standard segmentation formulations. To the best of our knowledge, this work is the first to formulate multi-class segmentation with sparse positive-only annotations as a pixel-wise PU learning problem and to address it using OOD detection techniques. Here, we forgo the need for background annotation and consider these together with any other unseen classes as part of the OOD set. Our framework can integrate, at a pixel-level, any OOD detection approaches designed for classification tasks. To address the lack of existing OOD datasets and established evaluation metric for medical image segmentation, we propose a cross-validation strategy that treats held-out labelled classes as OOD. Extensive experiments on both multi-class hyperspectral and RGB surgical imaging datasets demonstrate the robustness and generalisation capability of our proposed framework.

cs.CV↗

arXiv2026

LEMON: A Large Endoscopic MONocular Dataset and Foundation Model for Perception in Surgical Settings

Traditional open-access datasets focusing on surgical procedures are often limited by their small size, typically consisting of fewer than 100 videos and less than 30 hours of footage, which leads to poor model generalization. To address this data limitation, a new dataset called LEMON has been compiled using a novel aggregation pipeline that collects high-resolution videos from online sources. Featuring an extensive collection of over 4K surgical videos totaling 938 hours (85 million frames) of high-quality footage across multiple procedure types, LEMON offers a comprehensive resource surpassing existing alternatives in size and scope, including two novel downstream tasks. To demonstrate the effectiveness of this diverse dataset, we introduce LemonFM, a foundation model pretrained on LEMON using a novel self-supervised augmented knowledge distillation approach. LemonFM consistently outperforms existing surgical foundation models across four downstream tasks and six datasets, achieving significant gains in surgical phase recognition (+9.5pp, +9.4pp, and +8.4pp in Jaccard on AutoLaparo, M2CAI16, and Cholec80), surgical action recognition (+4.4pp in mAP on CholecT50), surgical tool presence detection (+5.3pp and +10.2pp in mAP on Cholec80 and GraSP), and surgical semantic segmentation (+10.3pp in mDice on CholecSeg8k). LEMON and LemonFM will serve as foundational resources for the research community and industry, accelerating progress in developing autonomous robotic surgery systems and ultimately contributing to safer and more accessible surgical care worldwide. Dataset, code, and models are publicly available at https://github.com/visurg-ai/LEMON.

cs.CV↗

arXiv2026

Average Calibration Losses for Reliable Uncertainty in Medical Image Segmentation

Deep neural networks for medical image segmentation are often overconfident, compromising both reliability and clinical utility. In this work, we propose differentiable formulations of marginal L1 Average Calibration Error (mL1-ACE) as an auxiliary loss that can be computed on a per-image basis. We compare both hard- and soft-binning approaches to directly improve pixel-wise calibration. Our experiments on four datasets (ACDC, AMOS, KiTS, BraTS) demonstrate that incorporating mL1-ACE significantly reduces calibration errors, particularly Average Calibration Error (ACE) and Maximum Calibration Error (MCE), while largely maintaining high Dice Similarity Coefficients (DSCs). We find that the soft-binned variant yields the greatest improvements in calibration over the DSC plus cross-entropy loss baseline but often compromises segmentation performance, with hard-binned mL1-ACE maintaining segmentation performance, albeit with weaker calibration improvement. To gain further insight into calibration performance and its variability across an imaging dataset, we introduce dataset reliability histograms, an aggregation of per-image reliability diagrams. The resulting analysis highlights improved alignment between predicted confidences and true accuracies. Overall, our approach provides practitioners with explicit control over the calibration-accuracy trade-off, enabling more reliable integration of deep learning methods into clinical workflows. We share our code here: https://github.com/cai4cai/Average-Calibration-Losses

cs.CV↗

arXiv2026

ROBUST-MIPS: A Combined Skeletal Pose and Instance Segmentation Dataset for Laparoscopic Surgical Instruments

Localisation of surgical tools constitutes a foundational building block for computer-assisted interventional technologies. Works in this field typically focus on training deep learning models to perform segmentation tasks. Performance of learning-based approaches is limited by the availability of diverse annotated data. We argue that skeletal pose annotations are a more efficient annotation approach for surgical tools, striking a balance between richness of semantic information and ease of annotation, thus allowing for accelerated growth of available annotated data. To encourage adoption of this annotation style, we present, ROBUST-MIPS, a combined tool pose and tool instance segmentation dataset derived from the existing ROBUST-MIS dataset. Our enriched dataset facilitates the joint study of these two annotation styles and allow head-to-head comparison on various downstream tasks. To demonstrate the adequacy of pose annotations for surgical tool localisation, we set up a simple benchmark using popular pose estimation methods and observe high-quality results. To ease adoption, together with the dataset, we release our benchmark models and custom tool pose annotation software.

cs.CV↗

arXiv2026

Learning From a Steady Hand: A Weakly Supervised Agent for Robot Assistance under Microscopy

This paper rethinks steady-hand robotic manipulation by using a weakly supervised framework that fuses calibration-aware perception with admittance control. Unlike conventional automation that relies on labor-intensive 2D labeling, our framework leverages reusable warm-up trajectories to extract implicit spatial information, thereby achieving calibration-aware, depth-resolved perception without the need for external fiducials or manual depth annotation. By explicitly characterizing residuals from observation and calibration models, the system establishes a task-space error budget from recorded warm-ups. The uncertainty budget yields a lateral closed-loop accuracy of approx. 49 micrometers at 95% confidence (worst-case testing subset) and a depth accuracy of <= 291 micrometers at 95% confidence bound during large in-plane moves. In a within-subject user study (N=8), the learned agent reduces overall NASA-TLX workload by 77.1% relative to the simple steady-hand assistance baseline. These results demonstrate that the weakly supervised agent improves the reliability of microscope-guided biomedical micromanipulation without introducing complex setup requirements, offering a practical framework for microscope-guided intervention.

cs.RO↗

arXiv2026

Quantification of dual-state 5-ALA-induced PpIX fluorescence: Methodology and validation in tissue-mimicking phantoms

Quantification of protoporphyrin IX (PpIX) fluorescence in human brain tumours has the potential to significantly improve patient outcomes in neuro-oncology, but represents a formidable imaging challenge. Protoporphyrin is a biological molecule which interacts with the tissue micro-environment to form two photochemical states in glioma. Each exhibits markedly different quantum efficiencies, with distinct but overlapping emission spectra that also overlap with tissue autofluorescence. Fluorescence emission is known to be distorted by the intrinsic optical properties of tissue, coupled with marked intra-tumoural heterogeneity as a hallmark of glioma tumours. Existing quantitative fluorescence systems are developed and validated using simplified phantoms that do not simultaneously mimic the complex interactions between fluorophores and tissue optical properties or micro-environment. Consequently, existing systems risk introducing systematic errors into PpIX quantification when used in tissue. In this work, we introduce a novel pipeline for quantification of PpIX in glioma, which robustly differentiates both emission states from background autofluorescence without reliance on a priori spectral information, and accounts for variations in their quantum efficiency. Unmixed PpIX emission forms are then corrected for wavelength-dependent optical distortions and weighted for accurate quantification. Significantly, this pipeline is developed and validated using novel tissue-mimicking phantoms replicating the optical properties of glioma tissues and photochemical variability of PpIX fluorescence in glioma. Our workflow achieves strong correlation with ground-truth PpIX concentrations (R2 = 0.918+-0.002), demonstrating its potential for robust, quantitative PpIX fluorescence imaging in clinical settings.

physics.med-ph↗

arXiv2026

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↗

arXiv2026

Comparative validation of surgical phase recognition, instrument keypoint estimation, and instrument instance segmentation in endoscopy: Results of the PhaKIR 2024 challenge

Reliable recognition and localization of surgical instruments in endoscopic video recordings are foundational for a wide range of applications in computer- and robot-assisted minimally invasive surgery (RAMIS), including surgical training, skill assessment, and autonomous assistance. However, robust performance under real-world conditions remains a significant challenge. Incorporating surgical context - such as the current procedural phase - has emerged as a promising strategy to improve robustness and interpretability. To address these challenges, we organized the Surgical Procedure Phase, Keypoint, and Instrument Recognition (PhaKIR) sub-challenge as part of the Endoscopic Vision (EndoVis) challenge at MICCAI 2024. We introduced a novel, multi-center dataset comprising thirteen full-length laparoscopic cholecystectomy videos collected from three distinct medical institutions, with unified annotations for three interrelated tasks: surgical phase recognition, instrument keypoint estimation, and instrument instance segmentation. Unlike existing datasets, ours enables joint investigation of instrument localization and procedural context within the same data while supporting the integration of temporal information across entire procedures. We report results and findings in accordance with the BIAS guidelines for biomedical image analysis challenges. The PhaKIR sub-challenge advances the field by providing a unique benchmark for developing temporally aware, context-driven methods in RAMIS and offers a high-quality resource to support future research in surgical scene understanding.

cs.CV↗

arXiv2026

Where It Moves, It Matters: Referring Surgical Instrument Segmentation via Motion

Enabling intuitive, language-driven interaction with surgical scenes is a critical step toward intelligent operating rooms and autonomous surgical robotic assistance. However, the task of referring segmentation, localizing surgical instruments based on natural language descriptions, remains underexplored in surgical videos, with existing approaches struggling to generalize due to reliance on static visual cues and predefined instrument names. In this work, we introduce SurgRef, a novel motion-guided framework that grounds free-form language expressions in instrument motion, capturing how tools move and interact across time, rather than what they look like. This allows models to understand and segment instruments even under occlusion, ambiguity, or unfamiliar terminology. To train and evaluate SurgRef, we present Ref-IMotion, a diverse, multi-institutional video dataset with dense spatiotemporal masks and rich motion-centric expressions. SurgRef achieves state-of-the-art accuracy and generalization across surgical procedures, setting a new benchmark for robust, language-driven surgical video segmentation.

cs.CV↗