Intra-cardiac Echocardiography (ICE) plays a critical role in Electrophysiology (EP) and Structural Heart Disease (SHD) interventions by providing real-time visualization of intracardiac structures. However, maintaining continuous visibility of the therapy device tip remains a challenge due to frequent adjustments required during manual ICE catheter manipulation. To address this, we propose an AI-driven tracking model that estimates the device tip incident angle and passing point within the ICE imaging plane, ensuring continuous visibility and facilitating robotic ICE catheter control. A key innovation of our approach is the hybrid dataset generation strategy, which combines clinical ICE sequences with synthetic data augmentation to enhance model robustness. We collected ICE images in a water chamber setup, equipping both the ICE catheter and device tip with electromagnetic (EM) sensors to establish precise ground-truth locations. Synthetic sequences were created by overlaying catheter tips onto real ICE images, preserving motion continuity while simulating diverse anatomical scenarios. The final dataset consists of 5,698 ICE-tip image pairs, ensuring comprehensive training coverage. Our model architecture integrates a pretrained ultrasound (US) foundation model, trained on 37.4M echocardiography images, for feature extraction. A transformer-based network processes sequential ICE frames, leveraging historical passing points and incident angles to improve prediction accuracy. Experimental results demonstrate that our method achieves 3.32 degree entry angle error, 12.76 degree rotation angle error. This AI-driven framework lays the foundation for real-time robotic ICE catheter adjustments, minimizing operator workload while ensuring consistent therapy device visibility. Future work will focus on expanding clinical datasets to further enhance model generalization.

To restore proper blood flow in blocked coronary arteries via angioplasty procedure, accurate placement of devices such as catheters, balloons, and stents under live fluoroscopy or diagnostic angiography is crucial. Identified balloon markers help in enhancing stent visibility in X-ray sequences, while the catheter tip aids in precise navigation and co-registering vessel structures, reducing the need for contrast in angiography. However, accurate detection of these devices in interventional X-ray sequences faces significant challenges, particularly due to occlusions from contrasted vessels and other devices and distractions from surrounding, resulting in the failure to track such small objects. While most tracking methods rely on spatial correlation of past and current appearance, they often lack strong motion comprehension essential for navigating through these challenging conditions, and fail to effectively detect multiple instances in the scene. To overcome these limitations, we propose a self-supervised learning approach that enhances its spatio-temporal understanding by incorporating supplementary cues and learning across multiple representation spaces on a large dataset. Followed by that, we introduce a generic real-time tracking framework that effectively leverages the pretrained spatio-temporal network and also takes the historical appearance and trajectory data into account. This results in enhanced localization of multiple instances of device landmarks. Our method outperforms state-of-the-art methods in interventional X-ray device tracking, especially stability and robustness, achieving an 87% reduction in max error for balloon marker detection and a 61% reduction in max error for catheter tip detection.

Minimally invasive robotic surgery has gained significant attention over the past two decades. Telerobotic systems, combined with robot-mediated minimally invasive techniques, have enabled surgeons and clinicians to mitigate radiation exposure for medical staff and extend medical services to remote and hard-to-reach areas. To enhance these services, teleoperated robotic surgery systems incorporating master and follower devices should offer transparency, enabling surgeons and clinicians to remotely experience a force interaction similar to the one the follower device experiences with patients' bodies. This paper presents the design and development of a three-degree-of-freedom master-follower teleoperated system for robotic catheterization. To resemble manual intervention by clinicians, the follower device features a grip-insert-release mechanism to eliminate catheter buckling and torsion during operation. The bidirectionally navigable ablation catheter is statically characterized for force-interactive medical interventions. The system's performance is evaluated through approaching and open-loop path tracking over typical circular, infinity-like, and spiral paths. Path tracking errors are presented as mean Euclidean error (MEE) and mean absolute error (MAE). The MEE ranges from 0.64 cm (infinity-like path) to 1.53 cm (spiral path). The MAE also ranges from 0.81 cm (infinity-like path) to 1.92 cm (spiral path). The results indicate that while the system's precision and accuracy with an open-loop controller meet the design targets, closed-loop controllers are necessary to address the catheter's hysteresis and dead zone, and system nonlinearities.

Objective: The objective of this work is to introduce and demonstrate the effectiveness of a novel sensing modality for contact detection between an off-the-shelf aspiration catheter and a thrombus. Methods: A custom robotic actuator with a pressure sensor was used to generate an oscillatory vacuum excitation and sense the pressure inside the extracorporeal portion of the catheter. Vacuum pressure profiles and robotic motion data were used to train a support vector machine (SVM) classification model to detect contact between the aspiration catheter tip and a mock thrombus. Validation consisted of benchtop accuracy verification, as well as user study comparison to the current standard of angiographic presentation. Results: Benchtop accuracy of the sensing modality was shown to be 99.67%. The user study demonstrated statistically significant improvement in identifying catheter-thrombus contact compared to the current standard. The odds ratio of successful detection of clot contact was 2.86 (p=0.03) when using the proposed sensory method compared to without it. Conclusion: The results of this work indicate that the proposed sensing modality can offer intraoperative feedback to interventionalists that can improve their ability to detect contact between the distal tip of a catheter and a thrombus. Significance: By offering a relatively low-cost technology that affords off-the-shelf aspiration catheters as clot-detecting sensors, interventionalists can improve the first-pass effect of the mechanical thrombectomy procedure while reducing procedural times and mental burden.

Source: OpenAI's DALL·E 2 with prompt "a hyperrealistic picture of a robot reading the news on a laptop at a coffee shop" Welcome to the third edition of Robo-Insight, a biweekly robotics news update! In this post, we are excited to share a range of new advancements in the field and highlight progress in areas like motion, unfamiliar navigation, dynamic control, digging, agriculture, surgery, and food sorting. In a world of constant motion, a newly developed robot named M4 (Multi-Modal Mobility Morphobot) has demonstrated the ability to switch between eight different modes of motion, including rolling, flying, and walking. Designed by researchers from Caltech's Center for Autonomous Systems and Technologies (CAST) and Northeastern University, the robot can autonomously adapt its movement strategy based on its environment. Created by engineers Mory Gharib and Alireza Ramezani, the M4 project aims to enhance robot locomotion by utilizing a combination of adaptable components and artificial intelligence. Speaking of movement, researchers from the Hamburg University of Applied Sciences have presented an innovative navigation algorithm for a mobile robot assistance system based on OpenStreetMap data.

Small catheters undergo significant torsional deflections during endovascular interventions. A key challenge in enabling robot control of these catheters is the estimation of their bending planes. This paper considers approaches for estimating these bending planes based on bi-plane image feedback. The proposed approaches attempt to minimize error between either the direct (position-based) or instantaneous (velocity-based) kinematics with the reconstructed kinematics from bi-plane image feedback. A comparison between these methods is carried out on a setup using two cameras in lieu of a bi-plane fluoroscopy setup. The results show that the position-based approach is less susceptible to segmentation noise and works best when the segment is in a non-straight configuration. These results suggest that estimation of the bending planes can be accompanied with errors under 30 degrees. Considering that the torsional buildup of these catheters can be more than 180 degrees, we believe that this method can be used for catheter control with improved safety due to the reduction of this uncertainty.

Intra-cardiac Echocardiography (ICE) has been evolving as a real-time imaging modality of choice for guiding electrophiosology and structural heart interventions. ICE provides real-time imaging of anatomy, catheters, and complications such as pericardial effusion or thrombus formation. However, there now exists a high cognitive demand on physicians with the increased reliance on intraprocedural imaging. In response, we present a robotic manipulator for AcuNav ICE catheters to alleviate the physician's burden and support applied methods for more automated. Herein, we introduce two methods towards these goals: (1) a data-driven method to compensate kinematic model errors due to non-linear elasticity in catheter bending, providing more precise robotic control and (2) an automated image recovery process that allows physicians to bookmark images during intervention and automatically return with the push of a button. To validate our error compensation method, we demonstrate a complex rotation of the ultrasound imaging plane evaluated on benchtop. Automated view recovery is validated by repeated imaging of landmarks on benchtop and in vivo experiments with position- and image-based analysis. Results support that a robotic-assist system for more autonomous ICE can provide a safe and efficient tool, potentially reducing the execution time and allowing more complex procedures to become common place.