Using deep learning to identify the recurrent laryngeal nerve during thyroidectomy.

Journal: Scientific reports
Published Date:

Abstract

Surgeons must visually distinguish soft-tissues, such as nerves, from surrounding anatomy to prevent complications and optimize patient outcomes. An accurate nerve segmentation and analysis tool could provide useful insight for surgical decision-making. Here, we present an end-to-end, automatic deep learning computer vision algorithm to segment and measure nerves. Unlike traditional medical imaging, our unconstrained setup with accessible handheld digital cameras, along with the unstructured open surgery scene, makes this task uniquely challenging. We investigate one common procedure, thyroidectomy, during which surgeons must avoid damaging the recurrent laryngeal nerve (RLN), which is responsible for human speech. We evaluate our segmentation algorithm on a diverse dataset across varied and challenging settings of operating room image capture, and show strong segmentation performance in the optimal image capture condition. This work lays the foundation for future research in real-time tissue discrimination and integration of accessible, intelligent tools into open surgery to provide actionable insights.

Authors

  • Julia Gong
    Microsoft Research, Redmond, WA, USA.
  • F Christopher Holsinger
    Department of Otolaryngology-Head and Neck Surgery, Stanford University, Stanford, CA, USA.
  • Julia E Noel
    Division of Head and Neck Surgery, Department of Otolaryngology, Stanford University, Palo Alto, California, USA.
  • Sohei Mitani
    Division of Head and Neck Surgery, Department of Otolaryngology, Stanford University, 875 Blake Wilbur Drive, Stanford, CA, 94305, USA.
  • Jeff Jopling
    Department of Surgery, Stanford University, Stanford, CA, USA.
  • Nikita Bedi
    Division of Head and Neck Surgery, Department of Otolaryngology, Stanford University, 875 Blake Wilbur Drive, Stanford, CA, 94305, USA.
  • Yoon Woo Koh
    Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea.
  • Lisa A Orloff
    Division of Head and Neck Surgery, Department of Otolaryngology, Stanford University, 875 Blake Wilbur Drive, Stanford, CA, 94305, USA.
  • Claudio R Cernea
    Department of Surgery, University of São Paulo Medical School, São Paulo, Brazil.
  • Serena Yeung
    From the Department of Computer Science (S.Y., L.F.-F.), the Center for Biomedical Informatics Research (N.L.D.), the Department of Medicine (A.M.), and the Clinical Excellence Research Center (S.Y., N.L.D., L.F.-F., A.M.), Stanford University, Stanford, CA.