A novel endoimaging system for endoscopic 3D reconstruction in bladder cancer patients

Abstract

Introduction

The methods employed to document cystoscopic findings in bladder cancer patients lack accuracy and are subject to observer variability. We propose a novel endoimaging system and an online documentation platform to provide post-procedural 3D bladder reconstructions for improved diagnosis, management and follow-up.

Material and methods

The RaVeNNA4pi consortium is comprised of five industrial partners, two university hospitals and two technical institutes. These are grouped into hardware, software and clinical partners according to their professional expertise. The envisaged endoimaging system consists of an innovative cystoscope that generates 3D bladder reconstructions allowing users to remotely access a cloud-based centralized database to visualize individualized 3D bladder models from previous cystoscopies archived in DICOM format.

Results

Preliminary investigations successfully tracked the endoscope's rotational and translational movements. The structure-from-motion pipeline was tested in a bladder phantom and satisfactorily demonstrated 3D reconstructions of the processing sequence. AI-based semantic image segmentation achieved a 0.67 dice-score-coefficient over all classes. An online-platform allows physicians and patients to digitally visualize endoscopic findings by navigating a 3D bladder model.

Conclusions

Our work demonstrates the current developments of a novel endoimaging system equipped with the potential to generate 3D bladder reconstructions from cystoscopy videos and AI-assisted automated detection of bladder tumors.

Keywords:

• Bladder cancer
• cystoscopy
• bladder phantom model
• 3D-reconstruction
• semantic image segmentation
• artificial neural network

Ethical approval

Ethical approval was obtained from the Ethical Committee of the University of Freiburg, Germany.

Declaration of interest

Arkadiusz Miernik: German Federal Ministry of Education and Research, Berlin, DE – research funding, German Association of Urology, Düsseldorf, DE – travel sponsoring, European Association of Urology, Arnhem, NL – travel sponsoring, Walter de Gruyter, Berlin, DE – royalties, RichardWolf GmbH, Knittlingen, DE – speaker, KLS Martin, Tuttlingen, DE – advisor, Avatera medical, Jena, DE – advisor, Lisa laser OHG, DE – proctor, Optimed GmbH, Ettlingen, DE – advisor. The remaining authors have no conflicts of interest to declare.

Author contribution

R.S: Manuscript drafting and data collection; M.N, U.P: 3D reconstruction, data management and analysis; S.H, A.R, A.M, C.G: project development; M.P, P.I: online-platform; A.S, C.M: graphics visualization; F.W, B.G, M.C.K: 3D-printed phantom models; K.K, J.A.F, L.M, J.Y, H.R, M.K, T.S, N.B: Hardware development and Sensor software; S.B: DICOM data archiving.

Additional information

Funding

The project is funded by the German Federal Ministry of Education and Research (BMBF). Project 13GW0203A: ‘Digital platform with 4PI real-time endoimaging for endoscopic 3D reconstruction, visualization and follow-up support in the health care of bladder cancer patients.