AI-assisted report generation offers the opportunity to reduce radiologists' workload stemming from expanded screening guidelines, complex cases and workforce shortages, while maintaining diagnostic accuracy. In addition to describing pathological findings in chest X-ray reports, interpreting lines and tubes (L&T) is demanding and repetitive for radiologists, especially with high patient volumes. We introduce MAIRA-X, a clinically evaluated multimodal AI model for longitudinal chest X-ray (CXR) report generation, that encompasses both clinical findings and L&T reporting. Developed using a large-scale, multi-site, longitudinal dataset of 3.1 million studies (comprising 6 million images from 806k patients) from Mayo Clinic, MAIRA-X was evaluated on three holdout datasets and the public MIMIC-CXR dataset, where it significantly improved AI-generated reports over the state of the art on lexical quality, clinical correctness, and L&T-related elements. A novel L&T-specific metrics framework was developed to assess accuracy in reporting attributes such as type, longitudinal change and placement. A first-of-its-kind retrospective user evaluation study was conducted with nine radiologists of varying experience, who blindly reviewed 600 studies from distinct subjects. The user study found comparable rates of critical errors (3.0% for original vs. 4.6% for AI-generated reports) and a similar rate of acceptable sentences (97.8% for original vs. 97.4% for AI-generated reports), marking a significant improvement over prior user studies with larger gaps and higher error rates. Our results suggest that MAIRA-X can effectively assist radiologists, particularly in high-volume clinical settings.

Atrial fibrillation (AF) increases the risk of thromboembolic events due to impaired function of the left atrial appendage (LAA). Left atrial appendage closure (LAAC) is a minimally invasive intervention designed to reduce stroke risk by sealing the LAA with an expandable occluder device. Current deployment relies on manual catheter control and imaging modalities like fluoroscopy and transesophageal echocardiography, which carry limitations including radiation exposure and limited positioning precision. In this study, we leverage a previously developed force-sensing delivery sheath integrating fiber Bragg gratings (FBGs) at the interface between the catheter and the occluder. Combined with electromagnetic (EM) tracking, this setup enables real-time measurement of interaction forces and catheter tip position during robot-assisted LAAC deployment in an anatomical phantom. We present a novel force-displacement profiling method that characterizes occluder deployment dynamics and identifies key procedural steps without relying on ionizing radiation. The force profiles reveal low-magnitude interaction forces, suggesting minimal mechanical stress on the surrounding anatomy. This approach shows promise in providing clinicians with enhanced intraoperative feedback, improving deployment outcome. Future work will focus on automating deployment steps classification and validating the sensing strategy in dynamic, realistic environments.

Cardiac catheterization remains a cornerstone of minimally invasive interventions, yet it continues to rely heavily on manual operation. Despite advances in robotic platforms, existing systems are predominantly follow-leader in nature, requiring continuous physician input and lacking intelligent autonomy. This dependency contributes to operator fatigue, more radiation exposure, and variability in procedural outcomes. This work moves towards autonomous catheter navigation by introducing DINO-CVA, a multimodal goal-conditioned behavior cloning framework. The proposed model fuses visual observations and joystick kinematics into a joint embedding space, enabling policies that are both vision-aware and kinematic-aware. Actions are predicted autoregressively from expert demonstrations, with goal conditioning guiding navigation toward specified destinations. A robotic experimental setup with a synthetic vascular phantom was designed to collect multimodal datasets and evaluate performance. Results show that DINO-CVA achieves high accuracy in predicting actions, matching the performance of a kinematics-only baseline while additionally grounding predictions in the anatomical environment. These findings establish the feasibility of multimodal, goal-conditioned architectures for catheter navigation, representing an important step toward reducing operator dependency and improving the reliability of catheterbased therapies.

--Recently, the emergence of multitask deep learning models has enhanced catheterization procedures by providing tactile and visual perception data through an end-to-end architecture. This information is derived from a segmentation and force estimation head, which localizes the catheter in X-ray images and estimates the applied pressure based on its deflection within the image. These stereo vision architectures incorporate a CNN-based encoder-decoder that captures the dependencies between X-ray images from two viewpoints, enabling simultaneous 3D force estimation and stereo segmentation of the catheter . With these tasks in mind, this work approaches the problem from a new perspective. We propose a novel encoder-decoder Vision Transformer model that processes two input X-ray images as separate sequences. Given sequences of X-ray patches from two perspectives, the transformer captures long-range dependencies without the need to gradually expand the receptive field for either image. The embeddings generated by both the encoder and decoder are fed into two shared segmentation heads, while a regression head employs the fused information from the decoder for 3D force estimation. The proposed model is a stereo Vision Transformer capable of simultaneously segmenting the catheter from two angles while estimating the generated forces at its tip in 3D. This model has undergone extensive experiments on synthetic X-ray images with various noise levels and has been compared against state-of-the-art pure segmentation models, vision-based catheter force estimation methods, and a multitask catheter segmentation and force estimation approach. It outperforms existing models, setting a new state-of-the-art in both catheter segmentation and force estimation. A catheter is a flexible, intravascular tube used in cardiac catheterization to access and navigate the cardiovascular system with precision.

--Safe navigation of steerable and robotic catheters in the cerebral vasculature requires awareness of the catheter's shape and pose. Currently, a significant perception burden is placed on interventionalists to mentally reconstruct and predict catheter motions from biplane fluoroscopy images. Efforts to track these catheters are limited to planar segmentation or bulky sensing instrumentation, which are incompatible with microcatheters used in neurointervention. In this work, a catheter is equipped with custom radiopaque markers arranged to enable simultaneous shape and pose estimation under biplane fluoroscopy. A design measure is proposed to guide the arrangement of these markers to minimize sensitivity to marker tracking uncertainty. Endovascular neurosurgery is a rapidly growing domain which enables treatment of cerebrovascular disease with minimally-invasive approaches. Among the most common endovascular neurointerventions include aneurysm coiling and mechanical thrombectomy (MT), which has become the gold standard for treating strokes caused by large vessel occlusions (L VOs).

In this paper, we propose a model-based contact-aware motion planner for autonomous navigation of neuroendovascular tools in acute ischemic stroke. The planner is designed to find the optimal control strategy for telescopic pre-bent catheterization tools such as guidewire and catheters, currently used for neuroendovascular procedures. A kinematic model for the telescoping tools and their interaction with the surrounding anatomy is derived to predict tools steering. By leveraging geometrical knowledge of the anatomy, obtained from pre-operative segmented 3D images, and the mechanics of the telescoping tools, the planner finds paths to the target enabled by interacting with the surroundings. We propose an actuation platform for insertion and rotation of the telescopic tools and present experimental results for the navigation from the base of the descending aorta to the LCCA. We demonstrate that, by leveraging the pre-operative plan, we can consistently navigate the LCCA with 100% success of over 50 independent trials. We also study the robustness of the planner towards motion of the aorta and errors in the initial positioning of the robotic tools. The proposed plan can successfully reach the LCCA for rotations of the aorta of up to 10{\deg}, and displacement of up to 10mm, on the coronal plane.

The success rate of catheterization procedures is closely linked to the sensory data provided to the surgeon. Vision-based deep learning models can deliver both tactile and visual information in a sensor-free manner, while also being cost-effective to produce. Given the complexity of these models for devices with limited computational resources, research has focused on force estimation and catheter segmentation separately. However, there is a lack of a comprehensive architecture capable of simultaneously segmenting the catheter from two different angles and estimating the applied forces in 3D. To bridge this gap, this work proposes a novel, lightweight, multi-input, multi-output encoder-decoder-based architecture. It is designed to segment the catheter from two points of view and concurrently measure the applied forces in the x, y, and z directions. This network processes two simultaneous X-Ray images, intended to be fed by a biplane fluoroscopy system, showing a catheter's deflection from different angles. It uses two parallel sub-networks with shared parameters to output two segmentation maps corresponding to the inputs. Additionally, it leverages stereo vision to estimate the applied forces at the catheter's tip in 3D. The architecture features two input channels, two classification heads for segmentation, and a regression head for force estimation through a single end-to-end architecture. The output of all heads was assessed and compared with the literature, demonstrating state-of-the-art performance in both segmentation and force estimation. To the best of the authors' knowledge, this is the first time such a model has been proposed

Abstract: Extended Reality (XR) technologies are gaining traction as effective tools for medical training and procedural guidance, particularly in complex cardiac interventions. This paper presents a novel system for real-time 3D tracking and visualization of intracardiac echocardiography (ICE) catheters, with precise measurement of the roll angle. The system's data is integrated into an interactive Unity-based environment, rendered through the Meta Quest 3 XR headset, combining a dynamically tracked catheter with a patient-specific 3D heart model. This immersive environment allows the testing of the importance of 3D depth perception, in comparison to 2D projections, as a form of visualization in XR. Our experimental study, conducted using the ICE catheter with six participants, suggests that 3D visualization is not necessarily beneficial over 2D views offered by the XR system; although all cardiologists saw its utility for pre-operative training, planning, and intra-operative guidance. The proposed system qualitatively shows great promise in transforming catheter-based interventions, particularly ICE procedures, by improving visualization, interactivity, and skill development. Keywords: Percutaneous Cardiac Intervention, Extended Reality, Computer Vision, 3D visualization, ICE catheter, Roll Angle 1. INTRODUCTION Minimally invasive interventions (MII) have revolutionized the field of cardiac care, offering patients reduced recovery times, lower risks of complications, and shorter hospital stays compared to traditional open-heart surgeries. These procedures, such as percutaneous cardiac interventions, rely on the precise navigation of catheters through complex vascular structures and heart chambers[1-6].

Vascular diseases such as thrombosis, atherosclerosis, and aneurysm, which can lead to blockage of blood flow or blood vessel rupture, are common and life-threatening. Conventional minimally invasive treatments utilize catheters, or long tubes, to guide small devices or therapeutic agents to targeted regions for intervention. Unfortunately, catheters suffer from difficult and unreliable navigation in narrow, winding vessels such as those found in the brain. Magnetically actuated untethered robots, which have been extensively explored as an alternative, are promising for navigation in complex vasculatures and vascular disease treatments. Most current robots, however, cannot swim against high flows or are inadequate in treating certain conditions. Here, we introduce a multifunctional and magnetically actuated milli-spinner robot for rapid navigation and performance of various treatments in complicated vasculatures. The milli-spinner, with a unique hollow structure including helical fins and slits for propulsion, generates a distinct flow field upon spinning. The milli-spinner is the fastest-ever untethered magnetic robot for movement in tubular environments, easily achieving speeds of 23 cm/s, demonstrating promise as an untethered medical device for effective navigation in blood vessels and robotic treatment of numerous vascular diseases.

This paper introduces a novel magnetic navigation system for cardiac ablation. The system is formed from two key elements: a magnetic ablation catheter consisting of a chain of spherical permanent magnets; and an actuation system comprised of two cart-mounted permanent magnets undergoing pure rotation. The catheter design enables a large magnetic content with the goal of minimizing the footprint of the actuation system for easier integration with the clinical workflow. We present a quasi-static model of the catheter, the design of the actuation units, and their control modalities. Experimental validation shows that we can use small rotating magnets (119mm diameter) to reach cardiac ablation targets while generating clinically-relevant forces. Catheter control using a joystick is compared with manual catheter control. blue While total task completion time is similar, smoother navigation is observed using the proposed robotic system. We also demonstrate that the ball chain can ablate heart tissue and generate lesions comparable to the current clinical ablation catheters.