Francisco Caetano, Tim J. M. Jaspers, Haiko Middeljans +7cs.CV cs.AI
Developing foundation generative models for endoscopy is limited by the gap between natural and clinical images and the computational cost of training large Diffusion Transformers. Although representation alignment has improved efficiency in general computer vision, its role within the highly specialized endoscopic image space remains unclear. We introduce REVEAL (Representation-driven Endoscopic Visual Embedding Alignment), the largest generative foundation model for endoscopy to date, trained on GastroNet-5M (GN-5M), a multicenter dataset of 5 million endoscopic frames. Instead of depending on out-of-domain priors, REVEAL employs encoders pretrained directly on the endoscopic distribution to align diffusion latents with domain-specific visual features, preserving fine textures and intricate anatomical structures. Beyond image generation, REVEAL also serves as a powerful feature extractor; in multiple benchmarks, it delivers performance that is competitive with, and in several cases exceeds, endoscopic foundation models such as EndoViT and Endo-FM, specifically tuned for classification tasks, while demonstrating strong representation robustness under realistic imaging corruptions. REVEAL produces high-fidelity images and maintains robust structural coherence in latent-space edits such as inpainting and outpainting. This high-capacity backbone lowers the computational threshold for building specialized clinical tools, offering an open, versatile foundation for conditional synthesis, segmentation, and out-of-distribution detection in future intelligent gastroenterology systems.
Robot-assisted minimally invasive surgery (MIS) critically depends on reliable endoscopic perception for navigation and safety. However, conventional endoscopes provide only a limited field of view, leaving large portions of surrounding anatomy unobserved. Recent neural rendering approaches, such as Neural Radiance Fields and 3D Gaussian Splatting, enable novel view synthesis from endoscopic videos, but their reliance on sparse observations often leads to severe artifacts when extrapolating beyond the training trajectory.In this work, we propose ExtraGS, a framework for enhancing endoscopic view extrapolation via diffusion-guided 3D Gaussian Splatting. Starting from an initial reconstruction, we introduce an uncertainty-guided virtual camera sampling strategy to actively explore blind spots and maximize information gain. The rendered views from these sampled locations are refined using a diffusion model to recover plausible anatomical structures, producing pseudo observations that guide further optimization. To prevent the generated content from degrading reliable regions, we adopt a confidence-weighted fine-tuning strategy when incorporating these pseudo observations.Extensive experiments on multiple public endoscopic datasets demonstrate that ExtraGS significantly reduces extrapolation artifacts and achieves state-of-the-art performance in endoscopic novel view synthesis.
Novel view synthesis (NVS) is an active research topic in computer vision, owing to the success of neural radiance field (NeRF) and 3D Gaussian splatting (3DGS) methods. While NVS opens the door to potential applications in gastroendoscopy, such as extending the field of view of endoscopic images and enabling digital twins for 3D archiving and endoscopist manipulation training, the dataset is insufficient to evaluate NVS for gastroendoscopy. In this paper, we present the first real gastroscopy dataset for NVS, namely the GastroNVS dataset, which contains a set of gastroscopic images, camera poses, and a point cloud for real gastroendoscopy inspection. To assess the suitability of the GastroNVS dataset, we evaluate several 3DGS methods and discuss the challenges for future development. The dataset is available on request from our project page.