arXiv:2605.16387cs.CVcs.AI2026-05中稿 · MICCAI 2026

提升手术阶段识别的时序稳定性,减少误判传播和瞬时波动影响。

Stabilizing Temporal Inference Dynamics for Online Surgical Phase Recognition

论文配图:Stabilizing Temporal Inference Dynamics for Online Surgical Phase Recognition
图 1 · 摘自论文原文
  • 通过时序误差级联损失稳定特征演化,抑制错误传播。
  • 引入证据门控过渡预测器,仅在证据充分时才切换阶段。
  • 提出时序碎片指数评估不稳定导致的预测分歧,适合临床辅助系统优化。

在线手术阶段识别(SPR)模型虽能达到高帧级准确率,但其预测常缺乏时序稳定性,导致手术流程理解碎片化,降低下游辅助的可靠性。我们发现这种不稳定性并非随机噪声,而是由两个机制导致:早期误分类会污染时序特征状态并向前传播形成误差级联;而阶段转换遵循证据积累动态,多数在线SPR系统却依赖无记忆的帧级决策,对瞬时置信度波动敏感。为此,我们提出统一的训练-推理-评估框架,采用模型无关、即插即用组件实现时序推理动态的显式稳定。训练阶段使用时序误差级联(TEC)损失,通过稳定时序特征演化来抑制错误发生与传播;推理阶段采用证据门控过渡预测器(EGTP),仅当累积证据超过置信阈值时才允许阶段切换;评估阶段引入时序碎片指数(TFI),一种考虑可靠性的度量,量化传统帧级与标记级指标之外的时序不一致。在Cholec80与AutoLaparo数据集上,基于三种代表性主干网络的实验表明,该框架显著提升时序稳定性,减少预测碎片化,同时保持或小幅提升帧级性能。

原文摘要 · Abstract (English)

Online Surgical Phase Recognition (SPR) models can reach high frame-wise accuracy, yet their predictions often lack temporal stability, fragmenting workflow understanding and reducing the reliability of downstream assistance. We show that this instability is not random noise but arises from two mechanisms: early misclassifications corrupt temporal feature states and propagate forward to form error cascades, and phase transitions follow evidence-accumulation dynamics whereas most online SPR systems rely on memoryless frame-wise decisions, making them sensitive to transient confidence fluctuations. We propose a unified Train-Inference-Evaluation framework that explicitly stabilizes temporal inference dynamics using model-agnostic, plug-and-play components. For training, the Temporal Error-Cascade (TEC) loss suppresses error onset and mitigates forward error propagation by stabilizing temporal feature evolution. For inference, the Evidence-Gated Transition Predictor (EGTP) enforces evidence-driven state transitions, allowing phase changes only when accumulated evidence exceeds a confidence boundary. For evaluation, we introduce the Temporal Fragmentation Index (TFI), a reliability-aware metric that quantifies instability-induced temporal disagreement beyond conventional frame-wise and token-based measures. Experiments on Cholec80 and AutoLaparo across three representative backbones show that the proposed framework substantially improves temporal stability and reduces prediction fragmentation, while maintaining or modestly improving frame-wise performance.

手术识别时序稳定医学视觉动态推理

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