Computer Vision Enabled Segmentation of Kidney Stones During Ureteroscopy and Laser Lithotripsy.

Objective: To evaluate the performance of computer vision models for automated kidney stone segmentation during flexible ureteroscopy and laser lithotripsy. Materials and Methods: We collected 20 ureteroscopy videos of intrarenal kidney stone treatment and extracted frames (N = 578) from these videos. We manually annotated kidney stones on each frame. Eighty percent of the data were used to train three standard computer vision models (U-Net, U-Net++, and DenseNet) for automatic stone segmentation during flexible ureteroscopy. The remaining data (20%) were used to compare performance of the three models after optimization through Dice coefficients and binary cross entropy. We identified the highest performing model and evaluated automatic segmentation performance during ureteroscopy for both stone localization and treatment using a separate set of endoscopic videos. We evaluated performance of the pixel-based analysis using area under the receiver operating characteristic curve (AUC-ROC), accuracy, sensitivity, and positive predictive value both in previously recorded videos and in real time. Results: A computer vision model (U-Net++) was evaluated, trained, and optimized for kidney stone segmentation during ureteroscopy using 20 surgical videos (mean video duration of 22 seconds, standard deviation ±13 seconds). The model showed good performance for stone localization with both digital ureteroscopes (AUC-ROC: 0.98) and fiberoptic ureteroscopes (AUC-ROC: 0.93). Furthermore, the model was able to accurately segment stones and stone fragments <270 µm in diameter during laser fragmentation (AUC-ROC: 0.87) and dusting (AUC-ROC: 0.77). The model automatically annotated videos intraoperatively in three cases and could do so in real time at 30 frames per second (FPS). Conclusion: Computer vision models demonstrate strong performance for automatic stone segmentation during ureteroscopy. Automatically annotating new videos at 30 FPS demonstrate the feasibility of real-time application during surgery, which could facilitate tracking tools for stone treatment.

Comprehensive shape analysis of the cortex in Huntington's disease.

The striatum has traditionally been the focus of Huntington's disease research due to the primary insult to this region and its central role in motor symptoms. Beyond the striatum, evidence of cortical alterations caused by Huntington's disease has surfaced. However, findings are not coherent between studies which have used cortical thickness for Huntington's disease since it is the well-established cortical metric of interest in other diseases. In this study, we propose a more comprehensive approach to cortical morphology in Huntington's disease using cortical thickness, sulcal depth, and local gyrification index. Our results show consistency with prior findings in cortical thickness, including its limitations. Our comparison between cortical thickness and local gyrification index underscores the complementary nature of these two measures-cortical thickness detects changes in the sensorimotor and posterior areas while local gyrification index identifies insular differences. Since local gyrification index and cortical thickness measures detect changes in different regions, the two used in tandem could provide a clinically relevant measure of disease progression. Our findings suggest that differences in insular regions may correspond to earlier neurodegeneration and may provide a complementary cortical measure for detection of subtle early cortical changes due to Huntington's disease.