CasCVS-Net: A Staged Multi-Task Cascade for Critical View of Safety Assessment

Automated assessment of the Critical View of Safety (CVS) in laparoscopic cholecystectomy requires both recognition of the three CVS criteria and anatomical grounding in small, rare, and often occluded hepatocystic structures. Learning-based methods differ in the anatomical information they use, from image-level classification to detection, segmentation, or graph-based reasoning, yet grounding the safety-critical anatomy remains the main bottleneck. We propose CasCVS-Net, a staged multi-task cascade that jointly performs object detection, semantic segmentation, and CVS assessment, trained on the Endoscapes dataset. The model couples the tasks through predicted anatomy: predicted boxes guide segmentation, and predicted masks provide region-level features for CVS classification, so CVS assessment at inference uses only model predictions rather than ground-truth annotations. To reduce optimisation instability in this coupled setting, training progresses from detection to detection-segmentation and then to the full three-task cascade, followed by task-wise fine-tuning. Evaluation on the public unseen test set shows that CasCVS-Net improves over matched single-task baselines on all three tasks, achieving 32.0 detection mAP, 46.8 semantic mIoU, 15.3 rare-anatomy mIoU, and 67.2 CVS mAP. It outperforms the state-of-the-art LG-CVS and SV2LSTG by 6.3% and 4.5% relative CVS mAP, respectively, corresponding to 4.0 and 2.9 mAP points. These results show that staged task coupling through predicted boxes and masks improves anatomical grounding for CVS assessment, particularly for rare hepatocystic structures.