@article{EbigboMendelProbstetal., author = {Ebigbo, Alanna and Mendel, Robert and Probst, Andreas and Manzeneder, Johannes and Souza Jr., Luis Antonio de and Papa, Jo{\~a}o Paulo and Palm, Christoph and Messmann, Helmut}, title = {Computer-aided diagnosis using deep learning in the evaluation of early oesophageal adenocarcinoma}, series = {GuT}, volume = {68}, journal = {GuT}, number = {7}, publisher = {British Society of Gastroenterology}, doi = {10.1136/gutjnl-2018-317573}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:898-opus4-68}, pages = {1143 -- 1145}, abstract = {Computer-aided diagnosis using deep learning (CAD-DL) may be an instrument to improve endoscopic assessment of Barrett's oesophagus (BE) and early oesophageal adenocarcinoma (EAC). Based on still images from two databases, the diagnosis of EAC by CAD-DL reached sensitivities/specificities of 97\%/88\% (Augsburg data) and 92\%/100\% (Medical Image Computing and Computer-Assisted Intervention [MICCAI] data) for white light (WL) images and 94\%/80\% for narrow band images (NBI) (Augsburg data), respectively. Tumour margins delineated by experts into images were detected satisfactorily with a Dice coefficient (D) of 0.72. This could be a first step towards CAD-DL for BE assessment. If developed further, it could become a useful adjunctive tool for patient management.}, subject = {Speiser{\"o}hrenkrebs}, language = {en} } @article{WoehlMaierGehmertetal., author = {W{\"o}hl, Rebecca and Maier, Johannes and Gehmert, Sebastian and Palm, Christoph and Riebschl{\"a}ger, Birgit and Nerlich, Michael and Huber, Michaela}, title = {3D Analysis of Osteosyntheses Material using semi-automated CT Segmentation}, series = {BMC Musculoskeletal Disorders}, volume = {19}, journal = {BMC Musculoskeletal Disorders}, publisher = {Springer Nature}, doi = {10.1186/s12891-018-1975-0}, pages = {1 -- 8}, abstract = {Backround Scaphoidectomy and midcarpal fusion can be performed using traditional fixation methods like K-wires, staples, screws or different dorsal (non)locking arthrodesis systems. The aim of this study is to test the Aptus four corner locking plate and to compare the clinical findings to the data revealed by CT scans and semi-automated segmentation. Methods: This is a retrospective review of eleven patients suffering from scapholunate advanced collapse (SLAC) or scaphoid non-union advanced collapse (SNAC) wrist, who received a four corner fusion between August 2011 and July 2014. The clinical evaluation consisted of measuring the range of motion (ROM), strength and pain on a visual analogue scale (VAS). Additionally, the Disabilities of the Arm, Shoulder and Hand (QuickDASH) and the Mayo Wrist Score were assessed. A computerized tomography (CT) of the wrist was obtained six weeks postoperatively. After semi-automated segmentation of the CT scans, the models were post processed and surveyed. Results During the six-month follow-up mean range of motion (ROM) of the operated wrist was 60°, consisting of 30° extension and 30° flexion. While pain levels decreased significantly, 54\% of grip strength and 89\% of pinch strength were preserved compared to the contralateral healthy wrist. Union could be detected in all CT scans of the wrist. While X-ray pictures obtained postoperatively revealed no pathology, two user related technical complications were found through the 3D analysis, which correlated to the clinical outcome. Conclusion Due to semi-automated segmentation and 3D analysis it has been proved that the plate design can keep up to the manufacturers' promises. Over all, this case series confirmed that the plate can compete with the coexisting techniques concerning clinical outcome, union and complication rate.}, subject = {Handchirurgie}, language = {en} } @misc{ScheppachMendelProbstetal., author = {Scheppach, Markus W. and Mendel, Robert and Probst, Andreas and Rauber, David and R{\"u}ckert, Tobias and Meinikheim, Michael and Palm, Christoph and Messmann, Helmut and Ebigbo, Alanna}, title = {Real-time detection and delineation of tissue during third-space endoscopy using artificial intelligence (AI)}, series = {Endoscopy}, volume = {55}, journal = {Endoscopy}, number = {S02}, publisher = {Thieme}, doi = {10.1055/s-0043-1765128}, pages = {S53 -- S54}, abstract = {Aims AI has proven great potential in assisting endoscopists in diagnostics, however its role in therapeutic endoscopy remains unclear. Endoscopic submucosal dissection (ESD) is a technically demanding intervention with a slow learning curve and relevant risks like bleeding and perforation. Therefore, we aimed to develop an algorithm for the real-time detection and delineation of relevant structures during third-space endoscopy. Methods 5470 still images from 59 full length videos (47 ESD, 12 POEM) were annotated. 179681 additional unlabeled images were added to the training dataset. Consequently, a DeepLabv3+ neural network architecture was trained with the ECMT semi-supervised algorithm (under review elsewhere). Evaluation of vessel detection was performed on a dataset of 101 standardized video clips from 15 separate third-space endoscopy videos with 200 predefined blood vessels. Results Internal validation yielded an overall mean Dice score of 85\% (68\% for blood vessels, 86\% for submucosal layer, 88\% for muscle layer). On the video test data, the overall vessel detection rate (VDR) was 94\% (96\% for ESD, 74\% for POEM). The median overall vessel detection time (VDT) was 0.32 sec (0.3 sec for ESD, 0.62 sec for POEM). Conclusions Evaluation of the developed algorithm on a video test dataset showed high VDR and quick VDT, especially for ESD. Further research will focus on a possible clinical benefit of the AI application for VDR and VDT during third-space endoscopy.}, subject = {Speiser{\"o}hrenkrankheit}, language = {en} } @inproceedings{FranzKatzkyNeumannetal., author = {Franz, Daniela and Katzky, Uwe and Neumann, Sabine and Perret, Jerome and Hofer, Mathias and Huber, Michaela and Schmitt-R{\"u}th, Stephanie and Haug, Sonja and Weber, Karsten and Prinzen, Martin and Palm, Christoph and Wittenberg, Thomas}, title = {Haptisches Lernen f{\"u}r Cochlea Implantationen}, series = {15. Jahrestagung der Deutschen Gesellschaft f{\"u}r Computer- und Roboterassistierte Chirurgie (CURAC2016), Tagungsband, 2016, Bern, 29.09. - 01.10.}, booktitle = {15. Jahrestagung der Deutschen Gesellschaft f{\"u}r Computer- und Roboterassistierte Chirurgie (CURAC2016), Tagungsband, 2016, Bern, 29.09. - 01.10.}, pages = {21 -- 26}, abstract = {Die Implantation eines Cochlea Implantates ben{\"o}tigt einen chirurgischen Zugang im Felsenbein und durch die Paukenh{\"o}hle des Patienten. Der Chirurg hat eine eingeschr{\"a}nkte Sicht im Operationsgebiet, die weiterhin viele Risikostrukturen enth{\"a}lt. Um eine Cochlea Implantation sicher und fehlerfrei durchzuf{\"u}hren, ist eine umfangreiche theoretische und praktische (teilweise berufsbegleitende) Fortbildung sowie langj{\"a}hrige Erfahrung notwendig. Unter Nutzung von realen klinischen CT/MRT Daten von Innen- und Mittelohr und der interaktiven Segmentierung der darin abgebildeten Strukturen (Nerven, Cochlea, Geh{\"o}rkn{\"o}chelchen,...) wird im HaptiVisT Projekt ein haptisch-visuelles Trainingssystem f{\"u}r die Implantation von Innen- und Mittelohr-Implantaten realisiert, das als sog. „Serious Game" mit immersiver Didaktik gestaltet wird. Die Evaluierung des Demonstrators hinsichtlich Zweckm{\"a}ßigkeit erfolgt prozessbegleitend und ergebnisorientiert, um m{\"o}gliche technische oder didaktische Fehler vor Fertigstellung des Systems aufzudecken. Drei zeitlich versetzte Evaluationen fokussieren dabei chirurgisch-fachliche, didaktische sowie haptisch-ergonomische Akzeptanzkriterien.}, subject = {Cochlea-Implantat}, language = {de} } @inproceedings{SouzaJrHookPapaetal., author = {Souza Jr., Luis Antonio de and Hook, Christian and Papa, Jo{\~a}o Paulo and Palm, Christoph}, title = {Barrett's Esophagus Analysis Using SURF Features}, series = {Bildverarbeitung f{\"u}r die Medizin 2017; Algorithmen - Systeme - Anwendungen. Proceedings des Workshops vom 12. bis 14. M{\"a}rz 2017 in Heidelberg}, booktitle = {Bildverarbeitung f{\"u}r die Medizin 2017; Algorithmen - Systeme - Anwendungen. Proceedings des Workshops vom 12. bis 14. M{\"a}rz 2017 in Heidelberg}, publisher = {Springer}, address = {Berlin}, doi = {10.1007/978-3-662-54345-0_34}, pages = {141 -- 146}, abstract = {The development of adenocarcinoma in Barrett's esophagus is difficult to detect by endoscopic surveillance of patients with signs of dysplasia. Computer assisted diagnosis of endoscopic images (CAD) could therefore be most helpful in the demarcation and classification of neoplastic lesions. In this study we tested the feasibility of a CAD method based on Speeded up Robust Feature Detection (SURF). A given database containing 100 images from 39 patients served as benchmark for feature based classification models. Half of the images had previously been diagnosed by five clinical experts as being "cancerous", the other half as "non-cancerous". Cancerous image regions had been visibly delineated (masked) by the clinicians. SURF features acquired from full images as well as from masked areas were utilized for the supervised training and testing of an SVM classifier. The predictive accuracy of the developed CAD system is illustrated by sensitivity and specificity values. The results based on full image matching where 0.78 (sensitivity) and 0.82 (specificity) were achieved, while the masked region approach generated results of 0.90 and 0.95, respectively.}, subject = {Speiser{\"o}hrenkrankheit}, language = {en} } @inproceedings{MendelEbigboProbstetal., author = {Mendel, Robert and Ebigbo, Alanna and Probst, Andreas and Messmann, Helmut and Palm, Christoph}, title = {Barrett's Esophagus Analysis Using Convolutional Neural Networks}, series = {Bildverarbeitung f{\"u}r die Medizin 2017; Algorithmen - Systeme - Anwendungen. Proceedings des Workshops vom 12. bis 14. M{\"a}rz 2017 in Heidelberg}, booktitle = {Bildverarbeitung f{\"u}r die Medizin 2017; Algorithmen - Systeme - Anwendungen. Proceedings des Workshops vom 12. bis 14. M{\"a}rz 2017 in Heidelberg}, publisher = {Springer}, address = {Berlin}, doi = {10.1007/978-3-662-54345-0_23}, pages = {80 -- 85}, abstract = {We propose an automatic approach for early detection of adenocarcinoma in the esophagus. High-definition endoscopic images (50 cancer, 50 Barrett) are partitioned into a dataset containing approximately equal amounts of patches showing cancerous and non-cancerous regions. A deep convolutional neural network is adapted to the data using a transfer learning approach. The final classification of an image is determined by at least one patch, for which the probability being a cancer patch exceeds a given threshold. The model was evaluated with leave one patient out cross-validation. With sensitivity and specificity of 0.94 and 0.88, respectively, our findings improve recently published results on the same image data base considerably. Furthermore, the visualization of the class probabilities of each individual patch indicates, that our approach might be extensible to the segmentation domain.}, subject = {Speiser{\"o}hrenkrebs}, language = {en} } @inproceedings{MaierHaugHuberetal., author = {Maier, Johannes and Haug, Sonja and Huber, Michaela and Katzky, Uwe and Neumann, Sabine and Perret, J{\´e}r{\^o}me and Prinzen, Martin and Weber, Karsten and Wittenberg, Thomas and W{\"o}hl, Rebecca and Scorna, Ulrike and Palm, Christoph}, title = {Development of a haptic and visual assisted training simulation concept for complex bone drilling in minimally invasive hand surgery}, series = {CARS Conference, 5.10.-7.10.2017}, booktitle = {CARS Conference, 5.10.-7.10.2017}, language = {en} } @article{SouzaJrPassosSantanaetal., author = {Souza Jr., Luis Antonio de and Passos, Leandro A. and Santana, Marcos Cleison S. and Mendel, Robert and Rauber, David and Ebigbo, Alanna and Probst, Andreas and Messmann, Helmut and Papa, Jo{\~a}o Paulo and Palm, Christoph}, title = {Layer-selective deep representation to improve esophageal cancer classification}, series = {Medical \& Biological Engineering \& Computing}, volume = {62}, journal = {Medical \& Biological Engineering \& Computing}, publisher = {Springer Nature}, address = {Heidelberg}, doi = {10.1007/s11517-024-03142-8}, pages = {3355 -- 3372}, abstract = {Even though artificial intelligence and machine learning have demonstrated remarkable performances in medical image computing, their accountability and transparency level must be improved to transfer this success into clinical practice. The reliability of machine learning decisions must be explained and interpreted, especially for supporting the medical diagnosis.For this task, the deep learning techniques' black-box nature must somehow be lightened up to clarify its promising results. Hence, we aim to investigate the impact of the ResNet-50 deep convolutional design for Barrett's esophagus and adenocarcinoma classification. For such a task, and aiming at proposing a two-step learning technique, the output of each convolutional layer that composes the ResNet-50 architecture was trained and classified for further definition of layers that would provide more impact in the architecture. We showed that local information and high-dimensional features are essential to improve the classification for our task. Besides, we observed a significant improvement when the most discriminative layers expressed more impact in the training and classification of ResNet-50 for Barrett's esophagus and adenocarcinoma classification, demonstrating that both human knowledge and computational processing may influence the correct learning of such a problem.}, language = {en} } @article{EbigboMendelProbstetal., author = {Ebigbo, Alanna and Mendel, Robert and Probst, Andreas and Meinikheim, Michael and Byrne, Michael F. and Messmann, Helmut and Palm, Christoph}, title = {Multimodal imaging for detection and segmentation of Barrett's esophagus-related neoplasia using artificial intelligence}, series = {Endoscopy}, volume = {54}, journal = {Endoscopy}, number = {10}, edition = {E-Video}, publisher = {Georg Thieme Verlag}, address = {Stuttgart}, doi = {10.1055/a-1704-7885}, pages = {1}, abstract = {The early diagnosis of cancer in Barrett's esophagus is crucial for improving the prognosis. However, identifying Barrett's esophagus-related neoplasia (BERN) is challenging, even for experts [1]. Four-quadrant biopsies may improve the detection of neoplasia, but they can be associated with sampling errors. The application of artificial intelligence (AI) to the assessment of Barrett's esophagus could improve the diagnosis of BERN, and this has been demonstrated in both preclinical and clinical studies [2] [3]. In this video demonstration, we show the accurate detection and delineation of BERN in two patients ([Video 1]). In part 1, the AI system detects a mucosal cancer about 20 mm in size and accurately delineates the lesion in both white-light and narrow-band imaging. In part 2, a small island of BERN with high-grade dysplasia is detected and delineated in white-light, narrow-band, and texture and color enhancement imaging. The video shows the results using a transparent overlay of the mucosal cancer in real time as well as a full segmentation preview. Additionally, the optical flow allows for the assessment of endoscope movement, something which is inversely related to the reliability of the AI prediction. We demonstrate that multimodal imaging can be applied to the AI-assisted detection and segmentation of even small focal lesions in real time.}, language = {en} } @article{KolevKirchgessnerHoubenetal., author = {Kolev, Kalin and Kirchgeßner, Norbert and Houben, Sebastian and Csisz{\´a}r, Agnes and Rubner, Wolfgang and Palm, Christoph and Eiben, Bj{\"o}rn and Merkel, Rudolf and Cremers, Daniel}, title = {A variational approach to vesicle membrane reconstruction from fluorescence imaging}, series = {Pattern Recognition}, volume = {44}, journal = {Pattern Recognition}, number = {12}, publisher = {Elsevier}, doi = {10.1016/j.patcog.2011.04.019}, pages = {2944 -- 2958}, abstract = {Biological applications like vesicle membrane analysis involve the precise segmentation of 3D structures in noisy volumetric data, obtained by techniques like magnetic resonance imaging (MRI) or laser scanning microscopy (LSM). Dealing with such data is a challenging task and requires robust and accurate segmentation methods. In this article, we propose a novel energy model for 3D segmentation fusing various cues like regional intensity subdivision, edge alignment and orientation information. The uniqueness of the approach consists in the definition of a new anisotropic regularizer, which accounts for the unbalanced slicing of the measured volume data, and the generalization of an efficient numerical scheme for solving the arising minimization problem, based on linearization and fixed-point iteration. We show how the proposed energy model can be optimized globally by making use of recent continuous convex relaxation techniques. The accuracy and robustness of the presented approach are demonstrated by evaluating it on multiple real data sets and comparing it to alternative segmentation methods based on level sets. Although the proposed model is designed with focus on the particular application at hand, it is general enough to be applied to a variety of different segmentation tasks.}, subject = {Dreidimensionale Bildverarbeitung}, language = {en} }