用自监督方法从术前CT预测鼓室成形术切口形状,提升人工耳蜗手术规划精度。
From Preoperative CT to Postmastoidectomy Mesh Construction: Mastoidectomy Shape Prediction for Cochlear Implant Surgery
- 结合自监督与弱监督学习,无需人工标注即可预测鼓室成形术切除区域
- 平均Dice分数达0.72,优于现有方法,能精准捕捉复杂边界形态
- 适合耳科手术规划、医学影像智能分析领域的研究者与临床医生
人工耳蜗(CI)手术通过将电极阵列植入耳蜗以刺激听觉神经,治疗重度听力损失。其中鼓室成形术是关键步骤,需切除颞骨部分乳突组织以获得手术通路。基于术前影像准确预测鼓室成形术切除形状,可优化术前规划、降低风险并改善手术效果。然而,由于难以获取真实标签,深度学习研究仍有限。本文提出一种混合自监督与弱监督学习框架,直接从完整乳突的术前CT扫描中预测鼓室成形术切除区域。该方法在复杂且无明确边界的切除形状预测上达到0.72的平均Dice分数,超越当前最优方法。同时,首次将3D T分布损失引入弱监督医学影像学习,为从术前CT直接构建术后三维表面提供基础。本工作为人工耳蜗手术规划提供了高效稳健的解决方案。
原文摘要 · Abstract (English)
Cochlear Implant (CI) surgery treats severe hearing loss by inserting an electrode array into the cochlea to stimulate the auditory nerve. An important step in this procedure is mastoidectomy, which removes part of the mastoid region of the temporal bone to provide surgical access. Accurate mastoidectomy shape prediction from preoperative imaging improves pre-surgical planning, reduces risks, and enhances surgical outcomes. Despite its importance, there are limited deep-learning-based studies regarding this topic due to the challenges of acquiring ground-truth labels. We address this gap by investigating self-supervised and weakly-supervised learning models to predict the mastoidectomy region without human annotations. We propose a hybrid self-supervised and weakly-supervised learning framework to predict the mastoidectomy region directly from preoperative CT scans, where the mastoid remains intact. Our hybrid method achieves a mean Dice score of 0.72 when predicting the complex and boundary-less mastoidectomy shape, surpassing state-of-the-art approaches and demonstrating strong performance. The method provides groundwork for constructing 3D postmastoidectomy surfaces directly from the corresponding preoperative CT scans. To our knowledge, this is the first work that integrating self-supervised and weakly-supervised learning for mastoidectomy shape prediction, offering a robust and efficient solution for CI surgical planning while leveraging 3D T-distribution loss in weakly-supervised medical imaging.
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