Metric Surface Reconstruction of Neurosurgical Scenes from Monocular Operating Microscope Images and Microscope Pose

Objective: We evaluated whether metric 3D geometry of neurosurgical operative exposure can be recovered from standard monocular operating-microscope images combined with microscope pose data. Methods: In a phantom-based laboratory study, two aneurysm training phantoms were imaged with a ZEISS Pentero 800 microscope integrated with Brainlab Cranial Navigation. Microscope images from the standard composite video output were stored with synchronous microscope poses. After intrinsic and extrinsic calibration, depth was estimated with the pretrained Depth Anything 3 model without task-specific fine-tuning. Fused point clouds were converted to meshes using Poisson surface reconstruction. Reconstructions were compared with reference surfaces from structured-light scanning and fine-slice CT. Results: For phantom A, representing a deeper surgical corridor, reconstruction accuracy ranged from 1.95 $\pm$ 1.70 mm to 2.33 $\pm$ 2.15 mm. For phantom B, representing a directly exposed surface, accuracy ranged from 1.02 $\pm$ 0.93 mm to 1.52 $\pm$ 1.21 mm. Larger image sets mainly improved completeness, while accuracy remained within a narrower range. Corridor analysis showed preservation of overall geometry with local deviations in incompletely reconstructed regions. Conclusions: Standard monocular microscope images combined with navigation-derived pose data can reconstruct millimeter-range 3D surfaces using a foundation-model-based pipeline. These results show technical feasibility in a controlled phantom setting and support further development toward objective quantification of operative exposure, image fusion, and characterization of working spaces for future surgical instrumentation.

A Lightweight Fiducial-Based Pipeline for 3D Hyperspectral Mapping of ex-vivo Lumpectomy Specimens

Hyperspectral Imaging (HSI) is a promising modality for intraoperative assessment of resection margins in Breast-Conserving Surgery (BCS), but its clinical translation requires aligning the inherently 2D spectral information onto the 3D shape of the excised tissue so that suspicious regions can be precisely localized for targeted follow-up. We present a fully automated, calibration-free pipeline that produces a 3D hyperspectral point cloud of an ex-vivo lumpectomy specimen from a set of consumer-camera RGB images and a single top-down HSI acquisition. The 3D geometry is reconstructed with a deep-learning Structure-from-Motion backbone, stabilized in a metric reference frame by a custom bundle adjustment that enforces consistency on the corners of four ArUco markers placed around the specimen. The HSI cube is then registered to the reconstruction without recovering the HSI camera pose: the markers, visible in both modalities, define 16 corner correspondences that drive a planar homography, and 3D coordinates are recovered by lookup on an orthographically rendered depth map. Evaluated on two ex-vivo lumpectomy specimens, the pipeline achieves a median 3D registration error below 1~mm and a 2D reprojection error below 0.02 mm, with a total per-specimen processing time under 4 minutes on accelerated hardware. These results support the feasibility of integrating HSI-guided spatial localization into intraoperative margin assessment workflows for breast-conserving surgery.