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Jun 10

Gradient Similarity Surgery in Multi-Task Deep Learning

The multi-task learning (MTL) paradigm aims to simultaneously learn multiple tasks within a single model capturing higher-level, more general hidden patterns that are shared by the tasks. In deep learning, a significant challenge in the backpropagation training process is the design of advanced optimisers to improve the convergence speed and stability of the gradient descent learning rule. In particular, in multi-task deep learning (MTDL) the multitude of tasks may generate potentially conflicting gradients that would hinder the concurrent convergence of the diverse loss functions. This challenge arises when the gradients of the task objectives have either different magnitudes or opposite directions, causing one or a few to dominate or to interfere with each other, thus degrading the training process. Gradient surgery methods address the problem explicitly dealing with conflicting gradients by adjusting the overall gradient trajectory. This work introduces a novel gradient surgery method, the Similarity-Aware Momentum Gradient Surgery (SAM-GS), which provides an effective and scalable approach based on a gradient magnitude similarity measure to guide the optimisation process. The SAM-GS surgery adopts gradient equalisation and modulation of the first-order momentum. A series of experimental tests have shown the effectiveness of SAM-GS on synthetic problems and MTL benchmarks. Gradient magnitude similarity plays a crucial role in regularising gradient aggregation in MTDL for the optimisation of the learning process.

  • 4 authors
·
Jun 6, 2025

PitVis-2023 Challenge: Workflow Recognition in videos of Endoscopic Pituitary Surgery

The field of computer vision applied to videos of minimally invasive surgery is ever-growing. Workflow recognition pertains to the automated recognition of various aspects of a surgery: including which surgical steps are performed; and which surgical instruments are used. This information can later be used to assist clinicians when learning the surgery; during live surgery; and when writing operation notes. The Pituitary Vision (PitVis) 2023 Challenge tasks the community to step and instrument recognition in videos of endoscopic pituitary surgery. This is a unique task when compared to other minimally invasive surgeries due to the smaller working space, which limits and distorts vision; and higher frequency of instrument and step switching, which requires more precise model predictions. Participants were provided with 25-videos, with results presented at the MICCAI-2023 conference as part of the Endoscopic Vision 2023 Challenge in Vancouver, Canada, on 08-Oct-2023. There were 18-submissions from 9-teams across 6-countries, using a variety of deep learning models. A commonality between the top performing models was incorporating spatio-temporal and multi-task methods, with greater than 50% and 10% macro-F1-score improvement over purely spacial single-task models in step and instrument recognition respectively. The PitVis-2023 Challenge therefore demonstrates state-of-the-art computer vision models in minimally invasive surgery are transferable to a new dataset, with surgery specific techniques used to enhance performance, progressing the field further. Benchmark results are provided in the paper, and the dataset is publicly available at: https://doi.org/10.5522/04/26531686.

  • 32 authors
·
Sep 2, 2024

A Multi-View Pipeline and Benchmark Dataset for 3D Hand Pose Estimation in Surgery

Purpose: Accurate 3D hand pose estimation supports surgical applications such as skill assessment, robot-assisted interventions, and geometry-aware workflow analysis. However, surgical environments pose severe challenges, including intense and localized lighting, frequent occlusions by instruments or staff, and uniform hand appearance due to gloves, combined with a scarcity of annotated datasets for reliable model training. Method: We propose a robust multi-view pipeline for 3D hand pose estimation in surgical contexts that requires no domain-specific fine-tuning and relies solely on off-the-shelf pretrained models. The pipeline integrates reliable person detection, whole-body pose estimation, and state-of-the-art 2D hand keypoint prediction on tracked hand crops, followed by a constrained 3D optimization. In addition, we introduce a novel surgical benchmark dataset comprising over 68,000 frames and 3,000 manually annotated 2D hand poses with triangulated 3D ground truth, recorded in a replica operating room under varying levels of scene complexity. Results: Quantitative experiments demonstrate that our method consistently outperforms baselines, achieving a 31% reduction in 2D mean joint error and a 76% reduction in 3D mean per-joint position error. Conclusion: Our work establishes a strong baseline for 3D hand pose estimation in surgery, providing both a training-free pipeline and a comprehensive annotated dataset to facilitate future research in surgical computer vision.

  • 11 authors
·
Jan 22

Learning Multi-modal Representations by Watching Hundreds of Surgical Video Lectures

Recent advancements in surgical computer vision have been driven by vision-only models, which lack language semantics, relying on manually annotated videos to predict fixed object categories. This limits their generalizability to unseen surgical procedures and tasks. We propose leveraging surgical video lectures from e-learning platforms to provide effective vision and language supervisory signals for multi-modal representation learning, bypassing manual annotations. We address surgery-specific linguistic challenges using multiple automatic speech recognition systems for text transcriptions. We introduce SurgVLP - Surgical Vision Language Pre-training - a novel method for multi-modal representation learning. SurgVLP employs a new contrastive learning objective, aligning video clip embeddings with corresponding multiple text embeddings in a joint latent space. We demonstrate the representational capability of this space through several vision-and-language surgical tasks and vision-only tasks specific to surgery. Unlike current fully supervised approaches, SurgVLP adapts to different surgical procedures and tasks without specific fine-tuning, achieving zero-shot adaptation to tasks such as surgical tool, phase, and triplet recognition without manual annotation. These results highlight the transferability and versatility of the learned multi-modal representations in surgical video analysis. The code is available at https://github.com/CAMMA-public/SurgVLP

  • 7 authors
·
Jul 27, 2023

The Price of Freedom: Exploring Expressivity and Runtime Tradeoffs in Equivariant Tensor Products

E(3)-equivariant neural networks have demonstrated success across a wide range of 3D modelling tasks. A fundamental operation in these networks is the tensor product, which interacts two geometric features in an equivariant manner to create new features. Due to the high computational complexity of the tensor product, significant effort has been invested to optimize the runtime of this operation. For example, Luo et al. (2024) recently proposed the Gaunt tensor product (GTP) which promises a significant speedup. In this work, we provide a careful, systematic analysis of a number of tensor product operations. In particular, we emphasize that different tensor products are not performing the same operation. The reported speedups typically come at the cost of expressivity. We introduce measures of expressivity and interactability to characterize these differences. In addition, we realized the original implementation of GTP can be greatly simplified by directly using a spherical grid at no cost in asymptotic runtime. This spherical grid approach is faster on our benchmarks and in actual training of the MACE interatomic potential by 30%. Finally, we provide the first systematic microbenchmarks of the various tensor product operations. We find that the theoretical runtime guarantees can differ wildly from empirical performance, demonstrating the need for careful application-specific benchmarking. Code is available at https://github.com/atomicarchitects/PriceofFreedom.

  • 4 authors
·
Jun 16, 2025

EinHops: Einsum Notation for Expressive Homomorphic Operations on RNS-CKKS Tensors

Fully Homomorphic Encryption (FHE) is an encryption scheme that allows for computation to be performed directly on encrypted data, effectively closing the loop on secure and outsourced computing. Data is encrypted not only during rest and transit, but also during processing. However, FHE provides a limited instruction set: SIMD addition, SIMD multiplication, and cyclic rotation of 1-D vectors. This restriction makes performing multi-dimensional tensor operations challenging. Practitioners must pack these tensors into 1-D vectors and map tensor operations onto this one-dimensional layout rather than their traditional nested structure. And while prior systems have made significant strides in automating this process, they often hide critical packing decisions behind layers of abstraction, making debugging, optimizing, and building on top of these systems difficult. In this work, we approach multi-dimensional tensor operations in FHE through Einstein summation (einsum) notation. Einsum notation explicitly encodes dimensional structure and operations in its syntax, naturally exposing how tensors should be packed and transformed. We decompose einsum expressions into a fixed set of FHE-friendly operations. We implement our design and present EinHops, a minimalist system that factors einsum expressions into a fixed sequence of FHE operations. EinHops enables developers to perform encrypted tensor operations using FHE while maintaining full visibility into the underlying packing strategy. We evaluate EinHops on a range of tensor operations from a simple transpose to complex multi-dimensional contractions. We show that the explicit nature of einsum notation allows us to build an FHE tensor system that is simple, general, and interpretable. We open-source EinHops at the following repository: https://github.com/baahl-nyu/einhops.

  • 3 authors
·
Jul 10, 2025

A mesh-free hybrid Chebyshev-Tucker tensor format with applications to multi-particle modelling

In this paper, we introduce a mesh-free two-level hybrid Tucker tensor format for approximation of multivariate functions, which combines the product Chebyshev interpolation with the ALS-based Tucker decomposition of the tensor of Chebyshev coefficients. It allows to avoid the expenses of the rank-structured approximation of function-related tensors defined on large spacial grids, while benefiting from the Tucker decomposition of the rather small core tensor of Chebyshev coefficients. This leads to nearly optimal Tucker rank parameters which are close to the results for well established Tucker-ALS algorithm applied to the large grid-based tensors. These rank parameters inherited from the Tucker-ALS decomposition of the coefficient tensor can be much less than the polynomial degrees of the initial Chebyshev interpolant via function independent basis set. Furthermore, the tensor product Chebyshev polynomials discretized on a tensor grid leads to a low-rank two-level orthogonal algebraic Tucker tensor that approximates the initial function with controllable accuracy. It is shown that our techniques could be gainfully applied to the long-range part of the electrostatic potential of multi-particle systems approximated in the range-separated tensor format. Error and complexity estimates of the proposed methods are presented. We demonstrate the efficiency of the suggested method numerically on examples of the long-range components of multi-particle interaction potentials generated by 3D Newton kernel for large bio-molecule systems and lattice-type compounds.

  • 4 authors
·
Mar 3, 2025

Multi-view Video-Pose Pretraining for Operating Room Surgical Activity Recognition

Understanding the workflow of surgical procedures in complex operating rooms requires a deep understanding of the interactions between clinicians and their environment. Surgical activity recognition (SAR) is a key computer vision task that detects activities or phases from multi-view camera recordings. Existing SAR models often fail to account for fine-grained clinician movements and multi-view knowledge, or they require calibrated multi-view camera setups and advanced point-cloud processing to obtain better results. In this work, we propose a novel calibration-free multi-view multi-modal pretraining framework called Multiview Pretraining for Video-Pose Surgical Activity Recognition PreViPS, which aligns 2D pose and vision embeddings across camera views. Our model follows CLIP-style dual-encoder architecture: one encoder processes visual features, while the other encodes human pose embeddings. To handle the continuous 2D human pose coordinates, we introduce a tokenized discrete representation to convert the continuous 2D pose coordinates into discrete pose embeddings, thereby enabling efficient integration within the dual-encoder framework. To bridge the gap between these two modalities, we propose several pretraining objectives using cross- and in-modality geometric constraints within the embedding space and incorporating masked pose token prediction strategy to enhance representation learning. Extensive experiments and ablation studies demonstrate improvements over the strong baselines, while data-efficiency experiments on two distinct operating room datasets further highlight the effectiveness of our approach. We highlight the benefits of our approach for surgical activity recognition in both multi-view and single-view settings, showcasing its practical applicability in complex surgical environments. Code will be made available at: https://github.com/CAMMA-public/PreViPS.

  • 6 authors
·
Feb 19, 2025

AirLab: Autograd Image Registration Laboratory

Medical image registration is an active research topic and forms a basis for many medical image analysis tasks. Although image registration is a rather general concept specialized methods are usually required to target a specific registration problem. The development and implementation of such methods has been tough so far as the gradient of the objective has to be computed. Also, its evaluation has to be performed preferably on a GPU for larger images and for more complex transformation models and regularization terms. This hinders researchers from rapid prototyping and poses hurdles to reproduce research results. There is a clear need for an environment which hides this complexity to put the modeling and the experimental exploration of registration methods into the foreground. With the "Autograd Image Registration Laboratory" (AIRLab), we introduce an open laboratory for image registration tasks, where the analytic gradients of the objective function are computed automatically and the device where the computations are performed, on a CPU or a GPU, is transparent. It is meant as a laboratory for researchers and developers enabling them to rapidly try out new ideas for registering images and to reproduce registration results which have already been published. AIRLab is implemented in Python using PyTorch as tensor and optimization library and SimpleITK for basic image IO. Therefore, it profits from recent advances made by the machine learning community concerning optimization and deep neural network models. The presented draft of this paper outlines AIRLab with first code snippets and performance analyses. A more exhaustive introduction will follow as a final version soon.

  • 4 authors
·
Mar 1, 2020

Video-based surgical skill assessment using 3D convolutional neural networks

Purpose: A profound education of novice surgeons is crucial to ensure that surgical interventions are effective and safe. One important aspect is the teaching of technical skills for minimally invasive or robot-assisted procedures. This includes the objective and preferably automatic assessment of surgical skill. Recent studies presented good results for automatic, objective skill evaluation by collecting and analyzing motion data such as trajectories of surgical instruments. However, obtaining the motion data generally requires additional equipment for instrument tracking or the availability of a robotic surgery system to capture kinematic data. In contrast, we investigate a method for automatic, objective skill assessment that requires video data only. This has the advantage that video can be collected effortlessly during minimally invasive and robot-assisted training scenarios. Methods: Our method builds on recent advances in deep learning-based video classification. Specifically, we propose to use an inflated 3D ConvNet to classify snippets, i.e., stacks of a few consecutive frames, extracted from surgical video. The network is extended into a Temporal Segment Network during training. Results: We evaluate the method on the publicly available JIGSAWS dataset, which consists of recordings of basic robot-assisted surgery tasks performed on a dry lab bench-top model. Our approach achieves high skill classification accuracies ranging from 95.1% to 100.0%. Conclusions: Our results demonstrate the feasibility of deep learning-based assessment of technical skill from surgical video. Notably, the 3D ConvNet is able to learn meaningful patterns directly from the data, alleviating the need for manual feature engineering. Further evaluation will require more annotated data for training and testing.

  • 4 authors
·
Sep 3, 2019

Influence-guided Data Augmentation for Neural Tensor Completion

How can we predict missing values in multi-dimensional data (or tensors) more accurately? The task of tensor completion is crucial in many applications such as personalized recommendation, image and video restoration, and link prediction in social networks. Many tensor factorization and neural network-based tensor completion algorithms have been developed to predict missing entries in partially observed tensors. However, they can produce inaccurate estimations as real-world tensors are very sparse, and these methods tend to overfit on the small amount of data. Here, we overcome these shortcomings by presenting a data augmentation technique for tensors. In this paper, we propose DAIN, a general data augmentation framework that enhances the prediction accuracy of neural tensor completion methods. Specifically, DAIN first trains a neural model and finds tensor cell importances with influence functions. After that, DAIN aggregates the cell importance to calculate the importance of each entity (i.e., an index of a dimension). Finally, DAIN augments the tensor by weighted sampling of entity importances and a value predictor. Extensive experimental results show that DAIN outperforms all data augmentation baselines in terms of enhancing imputation accuracy of neural tensor completion on four diverse real-world tensors. Ablation studies of DAIN substantiate the effectiveness of each component of DAIN. Furthermore, we show that DAIN scales near linearly to large datasets.

  • 4 authors
·
Aug 23, 2021

Text-driven Adaptation of Foundation Models for Few-shot Surgical Workflow Analysis

Purpose: Surgical workflow analysis is crucial for improving surgical efficiency and safety. However, previous studies rely heavily on large-scale annotated datasets, posing challenges in cost, scalability, and reliance on expert annotations. To address this, we propose Surg-FTDA (Few-shot Text-driven Adaptation), designed to handle various surgical workflow analysis tasks with minimal paired image-label data. Methods: Our approach has two key components. First, Few-shot selection-based modality alignment selects a small subset of images and aligns their embeddings with text embeddings from the downstream task, bridging the modality gap. Second, Text-driven adaptation leverages only text data to train a decoder, eliminating the need for paired image-text data. This decoder is then applied to aligned image embeddings, enabling image-related tasks without explicit image-text pairs. Results: We evaluate our approach to generative tasks (image captioning) and discriminative tasks (triplet recognition and phase recognition). Results show that Surg-FTDA outperforms baselines and generalizes well across downstream tasks. Conclusion: We propose a text-driven adaptation approach that mitigates the modality gap and handles multiple downstream tasks in surgical workflow analysis, with minimal reliance on large annotated datasets. The code and dataset will be released in https://github.com/CAMMA-public/Surg-FTDA

  • 5 authors
·
Jan 16, 2025

Spatio-Temporal Representation Decoupling and Enhancement for Federated Instrument Segmentation in Surgical Videos

Surgical instrument segmentation under Federated Learning (FL) is a promising direction, which enables multiple surgical sites to collaboratively train the model without centralizing datasets. However, there exist very limited FL works in surgical data science, and FL methods for other modalities do not consider inherent characteristics in surgical domain: i) different scenarios show diverse anatomical backgrounds while highly similar instrument representation; ii) there exist surgical simulators which promote large-scale synthetic data generation with minimal efforts. In this paper, we propose a novel Personalized FL scheme, Spatio-Temporal Representation Decoupling and Enhancement (FedST), which wisely leverages surgical domain knowledge during both local-site and global-server training to boost segmentation. Concretely, our model embraces a Representation Separation and Cooperation (RSC) mechanism in local-site training, which decouples the query embedding layer to be trained privately, to encode respective backgrounds. Meanwhile, other parameters are optimized globally to capture the consistent representations of instruments, including the temporal layer to capture similar motion patterns. A textual-guided channel selection is further designed to highlight site-specific features, facilitating model adapta tion to each site. Moreover, in global-server training, we propose Synthesis-based Explicit Representation Quantification (SERQ), which defines an explicit representation target based on synthetic data to synchronize the model convergence during fusion for improving model generalization.

  • 6 authors
·
Jun 30, 2025

Rethinking Surgical Instrument Segmentation: A Background Image Can Be All You Need

Data diversity and volume are crucial to the success of training deep learning models, while in the medical imaging field, the difficulty and cost of data collection and annotation are especially huge. Specifically in robotic surgery, data scarcity and imbalance have heavily affected the model accuracy and limited the design and deployment of deep learning-based surgical applications such as surgical instrument segmentation. Considering this, we rethink the surgical instrument segmentation task and propose a one-to-many data generation solution that gets rid of the complicated and expensive process of data collection and annotation from robotic surgery. In our method, we only utilize a single surgical background tissue image and a few open-source instrument images as the seed images and apply multiple augmentations and blending techniques to synthesize amounts of image variations. In addition, we also introduce the chained augmentation mixing during training to further enhance the data diversities. The proposed approach is evaluated on the real datasets of the EndoVis-2018 and EndoVis-2017 surgical scene segmentation. Our empirical analysis suggests that without the high cost of data collection and annotation, we can achieve decent surgical instrument segmentation performance. Moreover, we also observe that our method can deal with novel instrument prediction in the deployment domain. We hope our inspiring results will encourage researchers to emphasize data-centric methods to overcome demanding deep learning limitations besides data shortage, such as class imbalance, domain adaptation, and incremental learning. Our code is available at https://github.com/lofrienger/Single_SurgicalScene_For_Segmentation.

  • 4 authors
·
Jun 23, 2022

RGA-Net: A Vision Enhancement Framework for Robotic Surgical Systems Using Reciprocal Attention Mechanisms

Robotic surgical systems rely heavily on high-quality visual feedback for precise teleoperation; yet, surgical smoke from energy-based devices significantly degrades endoscopic video feeds, compromising the human-robot interface and surgical outcomes. This paper presents RGA-Net (Reciprocal Gating and Attention-fusion Network), a novel deep learning framework specifically designed for smoke removal in robotic surgery workflows. Our approach addresses the unique challenges of surgical smoke-including dense, non-homogeneous distribution and complex light scattering-through a hierarchical encoder-decoder architecture featuring two key innovations: (1) a Dual-Stream Hybrid Attention (DHA) module that combines shifted window attention with frequency-domain processing to capture both local surgical details and global illumination changes, and (2) an Axis-Decomposed Attention (ADA) module that efficiently processes multi-scale features through factorized attention mechanisms. These components are connected via reciprocal cross-gating blocks that enable bidirectional feature modulation between encoder and decoder pathways. Extensive experiments on the DesmokeData and LSD3K surgical datasets demonstrate that RGA-Net achieves superior performance in restoring visual clarity suitable for robotic surgery integration. Our method enhances the surgeon-robot interface by providing consistently clear visualization, laying a technical foundation for alleviating surgeons' cognitive burden, optimizing operation workflows, and reducing iatrogenic injury risks in minimally invasive procedures. These practical benefits could be further validated through future clinical trials involving surgeon usability assessments. The proposed framework represents a significant step toward more reliable and safer robotic surgical systems through computational vision enhancement.

  • 6 authors
·
Feb 14

Challenges in Multi-centric Generalization: Phase and Step Recognition in Roux-en-Y Gastric Bypass Surgery

Most studies on surgical activity recognition utilizing Artificial intelligence (AI) have focused mainly on recognizing one type of activity from small and mono-centric surgical video datasets. It remains speculative whether those models would generalize to other centers. In this work, we introduce a large multi-centric multi-activity dataset consisting of 140 videos (MultiBypass140) of laparoscopic Roux-en-Y gastric bypass (LRYGB) surgeries performed at two medical centers: the University Hospital of Strasbourg (StrasBypass70) and Inselspital, Bern University Hospital (BernBypass70). The dataset has been fully annotated with phases and steps. Furthermore, we assess the generalizability and benchmark different deep learning models in 7 experimental studies: 1) Training and evaluation on BernBypass70; 2) Training and evaluation on StrasBypass70; 3) Training and evaluation on the MultiBypass140; 4) Training on BernBypass70, evaluation on StrasBypass70; 5) Training on StrasBypass70, evaluation on BernBypass70; Training on MultiBypass140, evaluation 6) on BernBypass70 and 7) on StrasBypass70. The model's performance is markedly influenced by the training data. The worst results were obtained in experiments 4) and 5) confirming the limited generalization capabilities of models trained on mono-centric data. The use of multi-centric training data, experiments 6) and 7), improves the generalization capabilities of the models, bringing them beyond the level of independent mono-centric training and validation (experiments 1) and 2)). MultiBypass140 shows considerable variation in surgical technique and workflow of LRYGB procedures between centers. Therefore, generalization experiments demonstrate a remarkable difference in model performance. These results highlight the importance of multi-centric datasets for AI model generalization to account for variance in surgical technique and workflows.

  • 10 authors
·
Dec 18, 2023

Enabling Efficient Equivariant Operations in the Fourier Basis via Gaunt Tensor Products

Developing equivariant neural networks for the E(3) group plays an important role in modeling 3D data across real-world applications. Enforcing this equivariance primarily involves the tensor products of irreducible representations (irreps). However, the computational complexity of such operations increases significantly as higher-order tensors are used. In this work, we propose a systematic approach to substantially accelerate the computation of the tensor products of irreps. We mathematically connect the commonly used Clebsch-Gordan coefficients to the Gaunt coefficients, which are integrals of products of three spherical harmonics. Through Gaunt coefficients, the tensor product of irreps becomes equivalent to the multiplication between spherical functions represented by spherical harmonics. This perspective further allows us to change the basis for the equivariant operations from spherical harmonics to a 2D Fourier basis. Consequently, the multiplication between spherical functions represented by a 2D Fourier basis can be efficiently computed via the convolution theorem and Fast Fourier Transforms. This transformation reduces the complexity of full tensor products of irreps from O(L^6) to O(L^3), where L is the max degree of irreps. Leveraging this approach, we introduce the Gaunt Tensor Product, which serves as a new method to construct efficient equivariant operations across different model architectures. Our experiments on the Open Catalyst Project and 3BPA datasets demonstrate both the increased efficiency and improved performance of our approach.

  • 3 authors
·
Jan 18, 2024

Catheter Detection and Segmentation in X-ray Images via Multi-task Learning

Automated detection and segmentation of surgical devices, such as catheters or wires, in X-ray fluoroscopic images have the potential to enhance image guidance in minimally invasive heart surgeries. In this paper, we present a convolutional neural network model that integrates a resnet architecture with multiple prediction heads to achieve real-time, accurate localization of electrodes on catheters and catheter segmentation in an end-to-end deep learning framework. We also propose a multi-task learning strategy in which our model is trained to perform both accurate electrode detection and catheter segmentation simultaneously. A key challenge with this approach is achieving optimal performance for both tasks. To address this, we introduce a novel multi-level dynamic resource prioritization method. This method dynamically adjusts sample and task weights during training to effectively prioritize more challenging tasks, where task difficulty is inversely proportional to performance and evolves throughout the training process. Experiments on both public and private datasets have demonstrated that the accuracy of our method surpasses the existing state-of-the-art methods in both single segmentation task and in the detection and segmentation multi-task. Our approach achieves a good trade-off between accuracy and efficiency, making it well-suited for real-time surgical guidance applications.

  • 6 authors
·
Mar 4, 2025

TeRA: Vector-based Random Tensor Network for High-Rank Adaptation of Large Language Models

Parameter-Efficient Fine-Tuning (PEFT) methods, such as Low-Rank Adaptation (LoRA), have significantly reduced the number of trainable parameters needed in fine-tuning large language models (LLMs). Subsequent developments of LoRA-style adapters have diverged into two main directions: (1) enhancing model expressivity with high-rank adapters, and (2) pushing for further parameter reduction, as exemplified by vector-based methods. However, these approaches present a trade-off, as achieving the expressivity of high-rank weight updates typically comes at the cost of sacrificing the extreme parameter efficiency offered by vector-based techniques. To address this issue, we propose a vector-based random \textbf{Te}nsor network for high-\textbf{R}ank \textbf{A}daptation (TeRA), a novel PEFT method that achieves high-rank weight updates while retaining the parameter efficiency of vector-based PEFT adapters. This is achieved by parameterizing the tensorized weight update matrix as a Tucker-like tensor network (TN), in which large randomly initialized factors are frozen and shared across layers, while only small layer-specific scaling vectors, formed by entries in diagonal factor matrices, are trained. This design effectively decouples the rank of the weight update matrix from the number of trainable parameters. Comprehensive experiments demonstrate that TeRA matches or even outperforms high-rank adapters, while requiring a trainable parameter count similar to vector-based methods. Theoretical analysis and ablation studies further validate the effectiveness of our approach.

  • 4 authors
·
Sep 3, 2025

Leveraging Generic Foundation Models for Multimodal Surgical Data Analysis

We investigate how both the adaptation of a generic foundation model via transfer learning and the integration of complementary modalities from the operating room (OR) can support surgical data science. To this end, we use V-JEPA as the single-modality foundation of a multimodal model for minimally invasive surgery support. We analyze how the model's downstream performance can benefit (a) from finetuning on unlabeled surgical video data and (b) from providing additional time-resolved data streams from the OR in a multimodal setup. In an in-house dataset of liver surgery videos, we analyze the tasks of predicting hospital length of stay and postoperative complications. In videos of the public HeiCo dataset, we analyze the task of surgical phase recognition. As a baseline, we apply pretrained V-JEPA to all tasks. We then finetune it on unlabeled, held-out videos to investigate its change in performance after domain adaptation. Following the idea of modular decision support networks, we integrate additional data streams from the OR by training a separate encoder to form a shared representation space with V-JEPA's embeddings. Our experiments show that finetuning on domain-specific data increases model performance. On the in-house data, integrating additional time-resolved data likewise benefits the model. On the HeiCo data, accuracy of the pretrained video-only, single-modality baseline setup is on par with the top-performing submissions of the EndoVis2017 challenge, while finetuning on domain-specific data increases accuracy further. Our results thus demonstrate how surgical data science can leverage public, generic foundation models. Likewise, they indicate the potential of domain adaptation and of integrating suitable complementary data streams from the OR. To support further research, we release our code and model weights at https://github.com/DigitalSurgeryLab-Basel/ML-CDS-2025.

  • 5 authors
·
Sep 8, 2025

Rapid patient-specific neural networks for intraoperative X-ray to volume registration

The integration of artificial intelligence in image-guided interventions holds transformative potential, promising to extract 3D geometric and quantitative information from conventional 2D imaging modalities during complex procedures. Achieving this requires the rapid and precise alignment of 2D intraoperative images (e.g., X-ray) with 3D preoperative volumes (e.g., CT, MRI). However, current 2D/3D registration methods fail across the broad spectrum of procedures dependent on X-ray guidance: traditional optimization techniques require custom parameter tuning for each subject, whereas neural networks trained on small datasets do not generalize to new patients or require labor-intensive manual annotations, increasing clinical burden and precluding application to new anatomical targets. To address these challenges, we present xvr, a fully automated framework for training patient-specific neural networks for 2D/3D registration. xvr uses physics-based simulation to generate abundant high-quality training data from a patient's own preoperative volumetric imaging, thereby overcoming the inherently limited ability of supervised models to generalize to new patients and procedures. Furthermore, xvr requires only 5 minutes of training per patient, making it suitable for emergency interventions as well as planned procedures. We perform the largest evaluation of a 2D/3D registration algorithm on real X-ray data to date and find that xvr robustly generalizes across a diverse dataset comprising multiple anatomical structures, imaging modalities, and hospitals. Across surgical tasks, xvr achieves submillimeter-accurate registration at intraoperative speeds, improving upon existing methods by an order of magnitude. xvr is released as open-source software freely available at https://github.com/eigenvivek/xvr.

  • 8 authors
·
Mar 20, 2025

A Comparative Study in Surgical AI: Datasets, Foundation Models, and Barriers to Med-AGI

Recent Artificial Intelligence (AI) models have matched or exceeded human experts in several benchmarks of biomedical task performance, but have lagged behind on surgical image-analysis benchmarks. Since surgery requires integrating disparate tasks -- including multimodal data integration, human interaction, and physical effects -- generally-capable AI models could be particularly attractive as a collaborative tool if performance could be improved. On the one hand, the canonical approach of scaling architecture size and training data is attractive, especially since there are millions of hours of surgical video data generated per year. On the other hand, preparing surgical data for AI training requires significantly higher levels of professional expertise, and training on that data requires expensive computational resources. These trade-offs paint an uncertain picture of whether and to-what-extent modern AI could aid surgical practice. In this paper, we explore this question through a case study of surgical tool detection using state-of-the-art AI methods available in 2026. We demonstrate that even with multi-billion parameter models and extensive training, current Vision Language Models fall short in the seemingly simple task of tool detection in neurosurgery. Additionally, we show scaling experiments indicating that increasing model size and training time only leads to diminishing improvements in relevant performance metrics. Thus, our experiments suggest that current models could still face significant obstacles in surgical use cases. Moreover, some obstacles cannot be simply ``scaled away'' with additional compute and persist across diverse model architectures, raising the question of whether data and label availability are the only limiting factors. We discuss the main contributors to these constraints and advance potential solutions.

EndoPBR: Material and Lighting Estimation for Photorealistic Surgical Simulations via Physically-based Rendering

The lack of labeled datasets in 3D vision for surgical scenes inhibits the development of robust 3D reconstruction algorithms in the medical domain. Despite the popularity of Neural Radiance Fields and 3D Gaussian Splatting in the general computer vision community, these systems have yet to find consistent success in surgical scenes due to challenges such as non-stationary lighting and non-Lambertian surfaces. As a result, the need for labeled surgical datasets continues to grow. In this work, we introduce a differentiable rendering framework for material and lighting estimation from endoscopic images and known geometry. Compared to previous approaches that model lighting and material jointly as radiance, we explicitly disentangle these scene properties for robust and photorealistic novel view synthesis. To disambiguate the training process, we formulate domain-specific properties inherent in surgical scenes. Specifically, we model the scene lighting as a simple spotlight and material properties as a bidirectional reflectance distribution function, parameterized by a neural network. By grounding color predictions in the rendering equation, we can generate photorealistic images at arbitrary camera poses. We evaluate our method with various sequences from the Colonoscopy 3D Video Dataset and show that our method produces competitive novel view synthesis results compared with other approaches. Furthermore, we demonstrate that synthetic data can be used to develop 3D vision algorithms by finetuning a depth estimation model with our rendered outputs. Overall, we see that the depth estimation performance is on par with fine-tuning with the original real images.

  • 2 authors
·
Feb 27, 2025

Exploring the Effect of Dataset Diversity in Self-Supervised Learning for Surgical Computer Vision

Over the past decade, computer vision applications in minimally invasive surgery have rapidly increased. Despite this growth, the impact of surgical computer vision remains limited compared to other medical fields like pathology and radiology, primarily due to the scarcity of representative annotated data. Whereas transfer learning from large annotated datasets such as ImageNet has been conventionally the norm to achieve high-performing models, recent advancements in self-supervised learning (SSL) have demonstrated superior performance. In medical image analysis, in-domain SSL pretraining has already been shown to outperform ImageNet-based initialization. Although unlabeled data in the field of surgical computer vision is abundant, the diversity within this data is limited. This study investigates the role of dataset diversity in SSL for surgical computer vision, comparing procedure-specific datasets against a more heterogeneous general surgical dataset across three different downstream surgical applications. The obtained results show that using solely procedure-specific data can lead to substantial improvements of 13.8%, 9.5%, and 36.8% compared to ImageNet pretraining. However, extending this data with more heterogeneous surgical data further increases performance by an additional 5.0%, 5.2%, and 2.5%, suggesting that increasing diversity within SSL data is beneficial for model performance. The code and pretrained model weights are made publicly available at https://github.com/TimJaspers0801/SurgeNet.

  • 12 authors
·
Jul 25, 2024

Jumpstarting Surgical Computer Vision

Purpose: General consensus amongst researchers and industry points to a lack of large, representative annotated datasets as the biggest obstacle to progress in the field of surgical data science. Self-supervised learning represents a solution to part of this problem, removing the reliance on annotations. However, the robustness of current self-supervised learning methods to domain shifts remains unclear, limiting our understanding of its utility for leveraging diverse sources of surgical data. Methods: In this work, we employ self-supervised learning to flexibly leverage diverse surgical datasets, thereby learning taskagnostic representations that can be used for various surgical downstream tasks. Based on this approach, to elucidate the impact of pre-training on downstream task performance, we explore 22 different pre-training dataset combinations by modulating three variables: source hospital, type of surgical procedure, and pre-training scale (number of videos). We then finetune the resulting model initializations on three diverse downstream tasks: namely, phase recognition and critical view of safety in laparoscopic cholecystectomy and phase recognition in laparoscopic hysterectomy. Results: Controlled experimentation highlights sizable boosts in performance across various tasks, datasets, and labeling budgets. However, this performance is intricately linked to the composition of the pre-training dataset, robustly proven through several study stages. Conclusion: The composition of pre-training datasets can severely affect the effectiveness of SSL methods for various downstream tasks and should critically inform future data collection efforts to scale the application of SSL methodologies. Keywords: Self-Supervised Learning, Transfer Learning, Surgical Computer Vision, Endoscopic Videos, Critical View of Safety, Phase Recognition

  • 6 authors
·
Dec 10, 2023

SCOPE-MRI: Bankart Lesion Detection as a Case Study in Data Curation and Deep Learning for Challenging Diagnoses

Deep learning has shown strong performance in musculoskeletal imaging, but prior work has largely targeted conditions where diagnosis is relatively straightforward. More challenging problems remain underexplored, such as detecting Bankart lesions (anterior-inferior glenoid labral tears) on standard MRIs. These lesions are difficult to diagnose due to subtle imaging features, often necessitating invasive MRI arthrograms (MRAs). We introduce ScopeMRI, the first publicly available, expert-annotated dataset for shoulder pathologies, and present a deep learning framework for Bankart lesion detection on both standard MRIs and MRAs. ScopeMRI contains shoulder MRIs from patients who underwent arthroscopy, providing ground-truth labels from intraoperative findings, the diagnostic gold standard. Separate models were trained for MRIs and MRAs using CNN- and transformer-based architectures, with predictions ensembled across multiple imaging planes. Our models achieved radiologist-level performance, with accuracy on standard MRIs surpassing radiologists interpreting MRAs. External validation on independent hospital data demonstrated initial generalizability across imaging protocols. By releasing ScopeMRI and a modular codebase for training and evaluation, we aim to accelerate research in musculoskeletal imaging and foster development of datasets and models that address clinically challenging diagnostic tasks.

  • 7 authors
·
Apr 29, 2025

Next-ViT: Next Generation Vision Transformer for Efficient Deployment in Realistic Industrial Scenarios

Due to the complex attention mechanisms and model design, most existing vision Transformers (ViTs) can not perform as efficiently as convolutional neural networks (CNNs) in realistic industrial deployment scenarios, e.g. TensorRT and CoreML. This poses a distinct challenge: Can a visual neural network be designed to infer as fast as CNNs and perform as powerful as ViTs? Recent works have tried to design CNN-Transformer hybrid architectures to address this issue, yet the overall performance of these works is far away from satisfactory. To end these, we propose a next generation vision Transformer for efficient deployment in realistic industrial scenarios, namely Next-ViT, which dominates both CNNs and ViTs from the perspective of latency/accuracy trade-off. In this work, the Next Convolution Block (NCB) and Next Transformer Block (NTB) are respectively developed to capture local and global information with deployment-friendly mechanisms. Then, Next Hybrid Strategy (NHS) is designed to stack NCB and NTB in an efficient hybrid paradigm, which boosts performance in various downstream tasks. Extensive experiments show that Next-ViT significantly outperforms existing CNNs, ViTs and CNN-Transformer hybrid architectures with respect to the latency/accuracy trade-off across various vision tasks. On TensorRT, Next-ViT surpasses ResNet by 5.5 mAP (from 40.4 to 45.9) on COCO detection and 7.7% mIoU (from 38.8% to 46.5%) on ADE20K segmentation under similar latency. Meanwhile, it achieves comparable performance with CSWin, while the inference speed is accelerated by 3.6x. On CoreML, Next-ViT surpasses EfficientFormer by 4.6 mAP (from 42.6 to 47.2) on COCO detection and 3.5% mIoU (from 45.1% to 48.6%) on ADE20K segmentation under similar latency. Our code and models are made public at: https://github.com/bytedance/Next-ViT

  • 9 authors
·
Jul 12, 2022

Cataract-LMM Large-Scale Multi-Source Multi-Task Benchmark for Deep Learning in Surgical Video Analysis

The development of computer-assisted surgery systems relies on large-scale, annotated datasets. Existing cataract surgery resources lack the diversity and annotation depth required to train generalizable deep-learning models. To address this gap, we present a dataset of 3,000 phacoemulsification cataract surgery videos acquired at two surgical centers from surgeons with varying expertise. The dataset provides four annotation layers: temporal surgical phases, instance segmentation of instruments and anatomical structures, instrument-tissue interaction tracking, and quantitative skill scores based on competency rubrics adapted from ICO-OSCAR and GRASIS. We demonstrate the technical utility of the dataset through benchmarking deep learning models across four tasks: workflow recognition, scene segmentation, instrument-tissue interaction tracking, and automated skill assessment. Furthermore, we establish a domain-adaptation baseline for phase recognition and instance segmentation by training on one surgical center and evaluating on a held-out center. Ultimately, these multi-source acquisitions, multi-layer annotations, and paired skill-kinematic labels facilitate the development of generalizable multi-task models for surgical workflow analysis, scene understanding, and competency-based training research. The dataset and annotations are available in Google Form (https://docs.google.com/forms/d/e/1FAIpQLSfmyMAPSTGrIy2sTnz0-TMw08ZagTimRulbAQcWdaPwDy187A/viewform?usp=dialog).

  • 9 authors
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Apr 24

Evolving Normalization-Activation Layers

Normalization layers and activation functions are fundamental components in deep networks and typically co-locate with each other. Here we propose to design them using an automated approach. Instead of designing them separately, we unify them into a single tensor-to-tensor computation graph, and evolve its structure starting from basic mathematical functions. Examples of such mathematical functions are addition, multiplication and statistical moments. The use of low-level mathematical functions, in contrast to the use of high-level modules in mainstream NAS, leads to a highly sparse and large search space which can be challenging for search methods. To address the challenge, we develop efficient rejection protocols to quickly filter out candidate layers that do not work well. We also use multi-objective evolution to optimize each layer's performance across many architectures to prevent overfitting. Our method leads to the discovery of EvoNorms, a set of new normalization-activation layers with novel, and sometimes surprising structures that go beyond existing design patterns. For example, some EvoNorms do not assume that normalization and activation functions must be applied sequentially, nor need to center the feature maps, nor require explicit activation functions. Our experiments show that EvoNorms work well on image classification models including ResNets, MobileNets and EfficientNets but also transfer well to Mask R-CNN with FPN/SpineNet for instance segmentation and to BigGAN for image synthesis, outperforming BatchNorm and GroupNorm based layers in many cases.

  • 4 authors
·
Apr 6, 2020