Deep-learning-based object detection of pelvic autonomic nerves during total mesorectal excision

Figure 1 Flowchart of the study design. PAN: Pelvic autonomic nerves; YOLO: You Only Look Once; DL: Deep learning.

Figure 2 Visualization of object detection results by the deep learning model. A-E: First row: Manual annotation boxes with confidence > 90%; F-J: Second row: Corresponding prediction boxes by the deep learning model. IMP: Inferior mesenteric plexus; SHP: Superior hypogastric plexus; HN: Hypogastric nerves; PN: Pelvic nerve; NVB: Neurovascular bundle.

Figure 3 Intraoperative marking of pelvic autonomic nerves branches labeled by the deep learning model and pathological examination results. A: Hypogastric nerves (HN) predicted image and colorectal branch of HN; B: Superior hypogastric plexus (SHP) predicted image and colorectal branch of SHP; C: Nerve tissue is visible on pathological examination (S100 staining) (indicated by black arrow). IMP: Inferior mesenteric plexus; SHP: Superior hypogastric plexus; HN: Hypogastric nerves.

Figure 4 Characteristics of false-positive and false-negative recognition by the deep learning model. A-E: False-positive analysis: Cord-like fibrous tissue (A); Vascular-related structures (B); Fat-related structures (C); Peritoneal incision and mesenteric tissue (D); Surgery-related artifacts (E); F-J: False-negative analysis: Deep embedding in tissue (F); Insufficient exposure (G); Fat adhesion (H); Accompanying blood vessels (I); Bleeding (J). HN: Hypogastric nerves; PN: Pelvic nerve; IMP: Inferior mesenteric plexus; NVB: Neurovascular bundle.