Author:

Keywords:

Science & Technology, Technology, Life Sciences & Biomedicine, Engineering, Biomedical, Radiology, Nuclear Medicine & Medical Imaging, Surgery, Engineering, Fetal surgery, Mosaicking, Twin-to-twin transfusion syndrome, Fetoscopy, Deep learning, Self-supervised, ANASTOMOSES, Pregnancy, Female, Humans, Fetofetal Transfusion, Placenta, Laser Therapy, Algorithms, 1103 Clinical Sciences, Nuclear Medicine & Medical Imaging, 3202 Clinical sciences, 4603 Computer vision and multimedia computation

Abstract:

PURPOSE: In twin-to-twin transfusion syndrome (TTTS), abnormal vascular anastomoses in the monochorionic placenta can produce uneven blood flow between the two fetuses. In the current practice, TTTS is treated surgically by closing abnormal anastomoses using laser ablation. This surgery is minimally invasive and relies on fetoscopy. Limited field of view makes anastomosis identification a challenging task for the surgeon. METHODS: To tackle this challenge, we propose a learning-based framework for in vivo fetoscopy frame registration for field-of-view expansion. The novelties of this framework rely on a learning-based keypoint proposal network and an encoding strategy to filter (i) irrelevant keypoints based on fetoscopic semantic image segmentation and (ii) inconsistent homographies. RESULTS: We validate our framework on a dataset of six intraoperative sequences from six TTTS surgeries from six different women against the most recent state-of-the-art algorithm, which relies on the segmentation of placenta vessels. CONCLUSION: The proposed framework achieves higher performance compared to the state of the art, paving the way for robust mosaicking to provide surgeons with context awareness during TTTS surgery.