4.5 Article

Multispectral Imaging for Automated Tissue Identification of Normal Human Surgical Specimens

Journal

OTOLARYNGOLOGY-HEAD AND NECK SURGERY
Volume 164, Issue 2, Pages 328-335

Publisher

SAGE PUBLICATIONS INC
DOI: 10.1177/0194599820941013

Keywords

surgical technology; tissue classification; multispectral imaging; machine learning

Funding

  1. AAOHNSF Resident Research award
  2. Kaufer Family Fund

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This study demonstrates the feasibility of using multispectral imaging and deep learning to enhance surgical vision for automated identification of normal human head and neck tissues. By developing and testing a novel multispectral imaging system and utilizing convolutional neural network machine learning models, the accuracy of tissue classification was significantly improved, outperforming traditional white-light imaging and surgical residents in tissue identification.
Objective Safe surgery requires the accurate discrimination of tissue intraoperatively. We assess the feasibility of using multispectral imaging and deep learning to enhance surgical vision by automated identification of normal human head and neck tissues. Study Design Construction and feasibility testing of novel multispectral imaging system for surgery. Setting Academic university hospital. Subjects and Methods Multispectral images of fresh-preserved human cadaveric tissues were captured with our adapted digital operating microscope. Eleven tissue types were sampled, each sequentially exposed to 6 lighting conditions. Two convolutional neural network machine learning models were developed to classify tissues based on multispectral and white-light color images (ARRInet-M and ARRInet-W, respectively). Blinded otolaryngology residents were asked to identify tissue specimens from white-light color images, and their performance was compared with that of the ARRInet models. Results A novel multispectral imaging system was developed with minimal adaptation to an existing digital operating microscope. With 81.8% accuracy in tissue identification of full-size images, the multispectral ARRInet-M classifier outperformed the white-light-only ARRInet-W model (45.5%) and surgical residents (69.7%). Challenges with discrimination occurred with parotid vs fat and blood vessels vs nerve. Conclusions A deep learning model using multispectral imaging outperformed a similar model and surgical residents using traditional white-light imaging at the task of classifying normal human head and neck tissue ex vivo. These results suggest that multispectral imaging can enhance surgical vision and augment surgeons' ability to identify tissues during a procedure.

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