# Real-time landmark detection for precise endoscopic submucosal dissection via shape-aware relation network

arXiv: https://arxiv.org/abs/2111.04733 · HTML: https://mlsanity.com/paper/2111.04733/

## Key facts

- Cited by 3 papers in the map (data through 14 Oct 2026).
- Builds on 27 of its 58 references that are in the map.
- First posted on arXiv 8 Nov 2021.

## Builds on (most cited first, 27 of 27)

- [Deep Residual Learning for Image Recognition](https://mlsanity.com/paper/1512.03385/) (2015)
- [Microsoft COCO: Common Objects in Context](https://mlsanity.com/paper/1405.0312/) (2014)
- [Very Deep Convolutional Networks for Large-Scale Image Recognition](https://mlsanity.com/paper/1409.1556/) (2014)
- [Faster R-CNN: Towards Real-Time Object Detection with Region Proposal Networks](https://mlsanity.com/paper/1506.01497/) (2015)
- [Mask R-CNN](https://mlsanity.com/paper/1703.06870/) (2017)
- [YOLOv3: An Incremental Improvement](https://mlsanity.com/paper/1804.02767/) (2018)
- [YOLO9000: Better, Faster, Stronger](https://mlsanity.com/paper/1612.08242/) (2016)
- [Objects as Points](https://mlsanity.com/paper/1904.07850/) (2019)
- [EfficientDet: Scalable and Efficient Object Detection](https://mlsanity.com/paper/1911.09070/) (2019)
- [CornerNet: Detecting Objects as Paired Keypoints](https://mlsanity.com/paper/1808.01244/) (2018)
- [Tracking Objects as Points](https://mlsanity.com/paper/2004.01177/) (2020)
- [Deep Layer Aggregation](https://mlsanity.com/paper/1707.06484/) (2017)
- [Relation Networks for Object Detection](https://mlsanity.com/paper/1711.11575/) (2017)
- [Bottom-up Object Detection by Grouping Extreme and Center Points](https://mlsanity.com/paper/1901.08043/) (2019)
- [TeCNO: Surgical Phase Recognition with Multi-Stage Temporal Convolutional Networks](https://mlsanity.com/paper/2003.10751/) (2020)
- [Learning Human-Object Interaction Detection using Interaction Points](https://mlsanity.com/paper/2003.14023/) (2020)
- [Sequence Level Semantics Aggregation for Video Object Detection](https://mlsanity.com/paper/1907.06390/) (2019)
- [Relation Distillation Networks for Video Object Detection](https://mlsanity.com/paper/1908.09511/) (2019)
- [Multi-Task Recurrent Convolutional Network with Correlation Loss for Surgical Video Analysis](https://mlsanity.com/paper/1907.06099/) (2019)
- [Temporal Memory Relation Network for Workflow Recognition from Surgical Video](https://mlsanity.com/paper/2103.16327/) (2021)
- [Actions as Moving Points](https://mlsanity.com/paper/2001.04608/) (2020)
- [Deep Distance Transform for Tubular Structure Segmentation in CT Scans](https://mlsanity.com/paper/1912.03383/) (2019)
- [Concurrent Segmentation and Localization for Tracking of Surgical Instruments](https://mlsanity.com/paper/1703.10701/) (2017)
- [Spatial Aggregation of Holistically-Nested Convolutional Neural Networks for Automated Pancreas Localization and Segmentation](https://mlsanity.com/paper/1702.00045/) (2017)
- [AP-MTL: Attention Pruned Multi-task Learning Model for Real-time Instrument Detection and Segmentation in Robot-assisted Surgery](https://mlsanity.com/paper/2003.04769/) (2020)
- [One to Many: Adaptive Instrument Segmentation via Meta Learning and Dynamic Online Adaptation in Robotic Surgical Video](https://mlsanity.com/paper/2103.12988/) (2021)
- [Dual Semantic Fusion Network for Video Object Detection](https://mlsanity.com/paper/2009.07498/) (2020)

## Built on by (most cited first, 3 of 3)

- [CoPESD: A Multi-Level Surgical Motion Dataset for Training Large Vision-Language Models to Co-Pilot Endoscopic Submucosal Dissection](https://mlsanity.com/paper/2410.07540/) (2024)
- [Multitask Learning in Minimally Invasive Surgical Vision: A Review](https://mlsanity.com/paper/2401.08256/) (2024)
- [Learning dissection trajectories from expert surgical videos via imitation learning with equivariant diffusion](https://mlsanity.com/paper/2506.04716/) (2025)

## Abstract (arXiv)

We propose a novel shape-aware relation network for accurate and real-time landmark detection in endoscopic submucosal dissection (ESD) surgery. This task is of great clinical significance but extremely challenging due to bleeding, lighting reflection, and motion blur in the complicated surgical environment. Compared with existing solutions, which either neglect geometric relationships among targeting objects or capture the relationships by using complicated aggregation schemes, the proposed network is capable of achieving satisfactory accuracy while maintaining real-time performance by taking full advantage of the spatial relations among landmarks. We first devise an algorithm to automatically generate relation keypoint heatmaps, which are able to intuitively represent the prior knowledge of spatial relations among landmarks without using any extra manual annotation efforts. We then develop two complementary regularization schemes to progressively incorporate the prior knowledge into the training process. While one scheme introduces pixel-level regularization by multi-task learning, the other integrates global-level regularization by harnessing a newly designed grouped consistency evaluator, which adds relation constraints to the proposed network in an adversarial manner. Both schemes are beneficial to the model in training, and can be readily unloaded in inference to achieve real-time detection. We establish a large in-house dataset of ESD surgery for esophageal cancer to validate the effectiveness of our proposed method. Extensive experimental results demonstrate that our approach outperforms state-of-the-art methods in terms of accuracy and efficiency, achieving better detection results faster. Promising results on two downstream applications further corroborate the great potential of our method in ESD clinical practice.