Data-Centric Learning Framework for Real- Time Detection of Aiming Beam in Fluorescence Lifetime Imaging Guided Surgery.

This study introduces a novel data-centric approach to improve real-time surgical guidance using fiber-based fluorescence lifetime imaging (FLIm). A key aspect of the methodology is the accurate detection of the aiming beam, which is essential for localizing points used to map FLIm measurements onto the tissue region within the surgical field. The primary challenge arises from the complex and variable conditions encountered in the surgical environment, particularly in Transoral Robotic Surgery (TORS). Uneven illumination in the surgical field can cause reflections, reduce contrast, and results in inconsistent color representation, further complicating aiming beam detection. To overcome these challenges, an instance segmentation model was developed using a datacentric training strategy that improves accuracy by minimizing label noise and enhancing detection robustness. The model was evaluated on a dataset comprising 40 in vivo surgical videos, demonstrating a median detection rate of 85%. This performance was maintained when the model was integrated in a clinical system, achieving a similar detection rate of 85% during TORS procedures conducted in patients. The system's computational efficiency, measured at approximately 24 frames per second (FPS), was sufficient for real-time surgical guidance. This study enhances the reliability of FLIm-based aiming beam detection in complex surgical environments, advancing the feasibility of real-time, imageguided interventions for improved surgical precision.