Purpose: Delineating tumor boundaries during breast-conserving surgery is challenging as tumors are often highly mobile, non-palpable, and have irregularly shaped borders. To address these challenges, we introduce a cooperative robotic guidance system that applies haptic feedback for tumor localization. In this pilot study, we aim to assess if and how this system can be successfully integrated into breast cancer care. Methods: A small haptic robot is retrofitted with an electrocautery blade to operate as a cooperatively controlled surgical tool. Ultrasound and electromagnetic navigation are used to identify the tumor boundaries and position. A forbidden region virtual fixture is imposed when the surgical tool collides with the tumor boundary. We conducted a study where users were asked to resect tumors from breast simulants both with and without the haptic guidance. We then assess the results of these simulated resections both qualitatively and quantitatively. Results: Virtual fixture guidance is shown to improve resection margins. On average, users find the task to be less mentally demanding, frustrating, and effort intensive when haptic feedback is available. We also discovered some unanticipated impacts on surgical workflow that will guide design adjustments and training protocol moving forward. Conclusion: Our results suggest that virtual fixtures can help localize tumor boundaries in simulated breast-conserving surgery. Future work will include an extensive user study to further validate these results and fine-tune our guidance system.

Ultrasound imaging of the heart (echocardiography) is widely used to diagnose cardiac diseases. However, obtaining an echocardiogram requires an expert sonographer and a high-quality ultrasound imaging device, which are generally only available in hospitals. Recently, AI-based navigation models and algorithms have been used to aid novice sonographers in acquiring the standardized cardiac views necessary to visualize potential disease pathologies. These navigation systems typically rely on directional guidance to predict the necessary rotation of the ultrasound probe. This paper demonstrates a novel AI navigation system that builds on a decision model for identifying the inferior vena cava (IVC) of the heart. The decision model is trained offline using cardiac ultrasound videos and employs binary classification to determine whether the IVC is present in a given ultrasound video. The underlying model integrates a novel localization algorithm that leverages the learned feature representations to annotate the spatial location of the IVC in real-time. Our model demonstrates strong localization performance on traditional high-quality hospital ultrasound videos, as well as impressive zero-shot performance on lower-quality ultrasound videos from a more affordable Butterfly iQ handheld ultrasound machine. This capability facilitates the expansion of ultrasound diagnostics beyond hospital settings. Currently, the guidance system is undergoing clinical trials and is available on the Butterfly iQ app.

Purpose: We present a virtual model to optimize point of entry (POE) in lung biopsy planning systems. Our model allows to compute the quality of a biopsy sample taken from potential POE, taking into account the margin of error that arises from discrepancies between the orientation in the planning simulation and the actual orientation during the operation. Additionally, the study examines the impact of the characteristics of the lesion. Methods: The quality of the biopsy is given by a heatmap projected onto the skeleton of a patient-specific model of airways. The skeleton provides a 3D representation of airways structure, while the heatmap intensity represents the potential amount of tissue that it could be extracted from each POE. This amount of tissue is determined by the intersection of the lesion with a cone that represents the uncertainty area in the introduction of biopsy instruments. The cone, lesion, and skeleton are modelled as graphical objects that define a 3D scene of the intervention. Results: We have simulated different settings of the intervention scene from a single anatomy extracted from a CT scan and two lesions with regular and irregular shapes. The different scenarios are simulated by systematic rotation of each lesion placed at different distances from airways. Analysis of the heatmaps for the different settings show a strong impact of lesion orientation for irregular shape and the distance for both shapes. Conclusion: The proposed heatmaps help to visually assess the optimal POE and identify whether multiple optimal POEs exist in different zones of the bronchi. They also allow us to model the maximum allowable error in navigation systems and study which variables have the greatest influence on the success of the operation. Additionally, they help determine at what point this influence could potentially jeopardize the operation.

This paper presents the UGSim, a simulator for buoyancy-driven gliders, with a LQR control strategy, and a recursive guidance system. Building on the top of the DAVE and the UUVsim, it is designed to address unique challenges that come from the complex hydrodynamic and hydrostatic impacts on buoyancy-driven gliders, which conventional robotics simulators can't deal with. Since distinguishing features of the class of vehicles, general controllers and guidance systems developed for underwater robotics are infeasible. The simulator is provided to accelerate the development and the evaluation of algorithms that would otherwise require expensive and time-consuming operations at sea. It consists of a basic kinetic module, a LQR control module and a recursive guidance module, which allows the user to concentrate on the single problem rather than the whole robotics system and the software infrastructure. We demonstrate the usage of the simulator through an example, loading the configuration of the buoyancy-driven glider named Petrel-II, presenting its dynamics simulation, performances of the control strategy and the guidance system.

Human guidance in reinforcement learning (RL) is often impractical for large-scale applications due to high costs and time constraints. Large Language Models (LLMs) offer a promising alternative to mitigate RL sample inefficiency and potentially replace human trainers. However, applying LLMs as RL trainers is challenging due to their overconfidence and less reliable solutions in sequential tasks. We address this limitation by introducing a calibrated guidance system that uses Monte Carlo Dropout to enhance LLM advice reliability by assessing prediction variances from multiple forward passes. Additionally, we develop a novel RL policy shaping method based on dynamic model average entropy to adjust the LLM's influence on RL policies according to guidance uncertainty. This approach ensures robust RL training by relying on reliable LLM guidance. To validate our contributions, we conduct extensive experiments in a Minigrid environment with three goals in varying environment sizes. The results showcase superior model performance compared to uncalibrated LLMs, unguided RL, and calibrated LLMs with different shaping policies. Moreover, we analyze various uncertainty estimation methods, demonstrating the effectiveness of average entropy in reflecting higher uncertainty in incorrect guidance. These findings highlight the persistent overconfidence in fine-tuned LLMs and underscore the importance of effective calibration in sequential decision-making problems.

Abstract-- Intra-cardiac Echocardiography (ICE) is a crucial imaging modality used in electrophysiology (EP) and structural heart disease (SHD) interventions, providing realtime, high-resolution views from within the heart. Despite its advantages, effective manipulation of the ICE catheter requires significant expertise, which can lead to inconsistent outcomes, particularly among less experienced operators. To address this challenge, we propose an AIdriven closed-loop view guidance system with human-inthe-loop feedback, designed to assist users in navigating ICE imaging without requiring specialized knowledge. Our method models the relative position and orientation vectors between arbitrary views and clinically defined ICE views in a spatial coordinate system, guiding users on how to manipulate the ICE catheter to transition from the current view to the desired view over time. Overview of the proposed view guidance system. The primary use cases of the ICE imaging involve visualizing target anatomy, detecting and tracking therapeutic devices, and validating treatments in real-time. HE Intra-cardiac Echocardiography (ICE) is a sophisticated imaging modality that offers real-time, highresolution have significant expertise in interpreting anatomical views views from within the heart, making it an invaluable via ICE images and skillfully maneuvering the ICE catheter tool in both electrophysiology (EP) and structural heart disease using two knobs (anterior-posterior, right-left) and the rotating/translating (SHD) interventions.

Overtaking on two-lane roads is a great challenge for autonomous vehicles, as oncoming traffic appearing on the opposite lane may require the vehicle to change its decision and abort the overtaking. Deep reinforcement learning (DRL) has shown promise for difficult decision problems such as this, but it requires massive number of data, especially if the action space is continuous. This paper proposes to incorporate guidance from an expert system into DRL to increase its sample efficiency in the autonomous overtaking setting. The guidance system developed in this study is composed of constrained iterative LQR and PID controllers. The novelty lies in the incorporation of a fading guidance function, which gradually decreases the effect of the expert system, allowing the agent to initially learn an appropriate action swiftly and then improve beyond the performance of the expert system. This approach thus combines the strengths of traditional control engineering with the flexibility of learning systems, expanding the capabilities of the autonomous system. The proposed methodology for autonomous vehicle overtaking does not depend on a particular DRL algorithm and three state-of-the-art algorithms are used as baselines for evaluation. Simulation results show that incorporating expert system guidance improves state-of-the-art DRL algorithms greatly in both sample efficiency and driving safety.

Were you unable to attend Transform 2022? Check out all of the summit sessions in our on-demand library now! Machine learning (ML) might be considered the core subset of artificial intelligence (AI), and reinforcement learning may be the quintessential subset of ML that people imagine when they think of AI. Reinforcement learning is the process by which a machine learning algorithm, robot, etc. can be programmed to respond to complex, real-time and real-world environments to optimally reach a desired target or outcome. Think of the challenge posed by self-driving cars.

Next time you pass a farm where a modern tractor is cruising around a field, take a closer look. While there is a farmer sitting in the cab, the vehicle might be driving itself. That tractor is often operating on auto pilot using semi-autonomous, self-driving technology. While the tractor plows along thanks to features like autosteer and computer-assisted technologies for applying fertilizers or pesticides, the farmer can send work texts or emails, pay bills or even flip through Instagram stories or TikTok videos. For farmers, this kind of efficiency is not a luxury.

We use Reinforcement Meta Learning to optimize an adaptive guidance system suitable for the approach phase of a gliding hypersonic vehicle. Adaptability is achieved by optimizing over a range of off-nominal flight conditions including perturbation of aerodynamic coefficient parameters, actuator failure scenarios, and sensor noise. The system maps observations directly to commanded bank angle and angle of attack rates. These observations include a velocity field tracking error formulated using parallel navigation, but adapted to work over long trajectories where the Earth's curvature must be taken into account. Minimizing the tracking error keeps the curved space line of sight to the target location aligned with the vehicle's velocity vector. The optimized guidance system will then induce trajectories that bring the vehicle to the target location with a high degree of accuracy at the designated terminal speed, while satisfying heating rate, load, and dynamic pressure constraints. We demonstrate the adaptability of the guidance system by testing over flight conditions that were not experienced during optimization. The guidance system's performance is then compared to that of a linear quadratic regulator tracking an optimal trajectory.