Autonomous navigation for mechanical thrombectomy (MT) remains a critical challenge due to the complexity of vascular anatomy and the need for precise, real-time decision-making. Reinforcement learning (RL)-based approaches have demonstrated potential in automating endovascular navigation, but current methods often struggle with generalization across multiple patient vasculatures and long-horizon tasks. We propose a world model for autonomous endovascular navigation using TD-MPC2, a model-based RL algorithm. We trained a single RL agent across multiple endovascular navigation tasks in ten real patient vasculatures, comparing performance against the state-of-the-art Soft Actor-Critic (SAC) method. Results indicate that TD-MPC2 significantly outperforms SAC in multi-task learning, achieving a 65% mean success rate compared to SAC's 37%, with notable improvements in path ratio. TD-MPC2 exhibited increased procedure times, suggesting a trade-off between success rate and execution speed. These findings highlight the potential of world models for improving autonomous endovascular navigation and lay the foundation for future research in generalizable AI-driven robotic interventions.

Three-dimensional (3D) finite-element simulations of cardiovascular flows provide high-fidelity predictions to support cardiovascular medicine, but their high computational cost limits clinical practicality. Reduced-order models (ROMs) offer computationally efficient alternatives but suffer reduced accuracy, particularly at vessel bifurcations where complex flow physics are inadequately captured by standard Poiseuille flow assumptions. We present an enhanced numerical framework that integrates machine learning-predicted bifurcation coefficients into zero-dimensional (0D) hemodynamic ROMs to improve accuracy while maintaining computational efficiency. We develop a resistor-resistor-inductor (RRI) model that uses neural networks to predict pressure-flow relationships from bifurcation geometry, incorporating linear and quadratic resistances along with inductive effects. The method employs non-dimensionalization to reduce training data requirements and apriori flow split prediction for improved bifurcation characterization. We incorporate the RRI model into a 0D model using an optimization-based solution strategy. We validate the approach in isolated bifurcations and vascular trees, across Reynolds numbers from 0 to 5,500, defining ROM accuracy by comparison to 3D finite element simulation. Results demonstrate substantial accuracy improvements: averaged across all trees and Reynolds numbers, the RRI method reduces inlet pressure errors from 54 mmHg (45%) for standard 0D models to 25 mmHg (17%), while a simplified resistor-inductor (RI) variant achieves 31 mmHg (26%) error. The enhanced 0D models show particular effectiveness at high Reynolds numbers and in extensive vascular networks. This hybrid numerical approach enables accurate, real-time hemodynamic modeling for clinical decision support, uncertainty quantification, and digital twins in cardiovascular biomedical engineering.

Diffusion models demonstrate state-of-the-art performance on image generation, and are gaining traction for sparse medical image reconstruction tasks. However, compared to classical reconstruction algorithms relying on simple analytical priors, diffusion models have the dangerous property of producing realistic looking results \emph{even when incorrect}, particularly with few observations. We investigate the utility of diffusion models as priors for image reconstruction by varying the number of observations and comparing their performance to classical priors (sparse and Tikhonov regularization) using pixel-based, structural, and downstream metrics. We make comparisons on low-dose chest wall computed tomography (CT) for fat mass quantification. First, we find that classical priors are superior to diffusion priors when the number of projections is ``sufficient''. Second, we find that diffusion priors can capture a large amount of detail with very few observations, significantly outperforming classical priors. However, they fall short of capturing all details, even with many observations. Finally, we find that the performance of diffusion priors plateau after extremely few ($\approx$10-15) projections. Ultimately, our work highlights potential issues with diffusion-based sparse reconstruction and underscores the importance of further investigation, particularly in high-stakes clinical settings.

We hereby present a full synthetic model, able to mimic the various constituents of the cerebral vascular tree, including the cerebral arteries, bifurcations and intracranial aneurysms. This model intends to provide a substantial dataset of brain arteries which could be used by a 3D convolutional neural network to efficiently detect Intra-Cranial Aneurysms. The cerebral aneurysms most often occur on a particular structure of the vascular tree named the Circle of Willis. Various studies have been conducted to detect and monitor the aneurysms and those based on Deep Learning achieve the best performance. Specifically, in this work, we propose a full synthetic 3D model able to mimic the brain vasculature as acquired by Magnetic Resonance Angiography, Time Of Flight principle. Among the various MRI modalities, this latter allows for a good rendering of the blood vessels and is non-invasive. Our model has been designed to simultaneously mimic the arteries' geometry, the aneurysm shape, and the background noise. The vascular tree geometry is modeled thanks to an interpolation with 3D Spline functions, and the statistical properties of the background noise is collected from angiography acquisitions and reproduced within the model. In this work, we thoroughly describe the synthetic vasculature model, we build up a neural network designed for aneurysm segmentation and detection, finally, we carry out an in-depth evaluation of the performance gap gained thanks to the synthetic model data augmentation.

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.

Identification of vessel structures of different sizes in biomedical images is crucial in the diagnosis of many neurodegenerative diseases. However, the sparsity of good-quality annotations of such images makes the task of vessel segmentation challenging. Deep learning offers an efficient way to segment vessels of different sizes by learning their high-level feature representations and the spatial continuity of such features across dimensions. Semi-supervised patch-based approaches have been effective in identifying small vessels of one to two voxels in diameter. This study focuses on improving the segmentation quality by considering the spatial correlation of the features using the Maximum Intensity Projection~(MIP) as an additional loss criterion. Two methods are proposed with the incorporation of MIPs of label segmentation on the single~(z-axis) and multiple perceivable axes of the 3D volume. The proposed MIP-based methods produce segmentations with improved vessel continuity, which is evident in visual examinations of ROIs. Patch-based training is improved by introducing an additional loss term, MIP loss, to penalise the predicted discontinuity of vessels. A training set of 14 volumes is selected from the StudyForrest dataset comprising of 18 7-Tesla 3D Time-of-Flight~(ToF) Magnetic Resonance Angiography (MRA) images. The generalisation performance of the method is evaluated using the other unseen volumes in the dataset. It is observed that the proposed method with multi-axes MIP loss produces better quality segmentations with a median Dice of $80.245 \pm 0.129$. Also, the method with single-axis MIP loss produces segmentations with a median Dice of $79.749 \pm 0.109$. Furthermore, a visual comparison of the ROIs in the predicted segmentation reveals a significant improvement in the continuity of the vessels when MIP loss is incorporated into training.

Microvascular anatomy is known to be involved in various neurological disorders. However, understanding these disorders is hindered by the lack of imaging modalities capable of capturing the comprehensive three-dimensional vascular network structure at microscopic resolution. With a lateral resolution of $<=$20 {\textmu}m and ability to reconstruct large tissue blocks up to tens of cubic centimeters, serial-section optical coherence tomography (sOCT) is well suited for this task. This method uses intrinsic optical properties to visualize the vessels and therefore does not possess a specific contrast, which complicates the extraction of accurate vascular models. The performance of traditional vessel segmentation methods is heavily degraded in the presence of substantial noise and imaging artifacts and is sensitive to domain shifts, while convolutional neural networks (CNNs) require extensive labeled data and are also sensitive the precise intensity characteristics of the data that they are trained on. Building on the emerging field of synthesis-based training, this study demonstrates a synthesis engine for neurovascular segmentation in sOCT images. Characterized by minimal priors and high variance sampling, our highly generalizable method tested on five distinct sOCT acquisitions eliminates the need for manual annotations while attaining human-level precision. Our approach comprises two phases: label synthesis and label-to-image transformation. We demonstrate the efficacy of the former by comparing it to several more realistic sets of training labels, and the latter by an ablation study of synthetic noise and artifact models.

Accurate analysis and modeling of renal functions require a precise segmentation of the renal blood vessels. Micro-CT scans provide image data at higher resolutions, making more small vessels near the renal cortex visible. Although deep-learning-based methods have shown state-of-the-art performance in automatic blood vessel segmentations, they require a large amount of labeled training data. However, voxel-wise labeling in micro-CT scans is extremely time-consuming given the huge volume sizes. To mitigate the problem, we simulate synthetic renal vascular trees physiologically while generating corresponding scans of the simulated trees by training a generative model on unlabeled scans. This enables the generative model to learn the mapping implicitly without the need for explicit functions to emulate the image acquisition process. We further propose an additional segmentation branch over the generative model trained on the generated scans. We demonstrate that the model can directly segment blood vessels on real scans and validate our method on both 3D micro-CT scans of rat kidneys and a proof-of-concept experiment on 2D retinal images. Code and 3D results are available at https://github.com/miccai2023anony/RenalVesselSeg

Emerging technologies like hypersonic aircraft, space exploration vehicles, and batteries avail fluid circulation in embedded microvasculatures for efficient thermal regulation. Modeling is vital during these engineered systems' design and operational phases. However, many challenges exist in developing a modeling framework. What is lacking is an accurate framework that (i) captures sharp jumps in the thermal flux across complex vasculature layouts, (ii) deals with oblique derivatives (involving tangential and normal components), (iii) handles nonlinearity because of radiative heat transfer, (iv) provides a high-speed forecast for real-time monitoring, and (v) facilitates robust inverse modeling. This paper addresses these challenges by availing the power of physics-informed neural networks (PINNs). We develop a fast, reliable, and accurate Scientific Machine Learning (SciML) framework for vascular-based thermal regulation -- called CoolPINNs: a PINNs-based modeling framework for active cooling. The proposed mesh-less framework elegantly overcomes all the mentioned challenges. The significance of the reported research is multi-fold. First, the framework is valuable for real-time monitoring of thermal regulatory systems because of rapid forecasting. Second, researchers can address complex thermoregulation designs inasmuch as the approach is mesh-less. Finally, the framework facilitates systematic parameter identification and inverse modeling studies, perhaps the current framework's most significant utility.

Segmentation of brain arterio-venous malformations (bAVMs) in 3D rotational angiographies (3DRA) is still an open problem in the literature, with high relevance for clinical practice. While deep learning models have been applied for segmenting the brain vasculature in these images, they have never been used in cases with bAVMs. This is likely caused by the difficulty to obtain sufficiently annotated data to train these approaches. In this paper we introduce a first deep learning model for blood vessel segmentation in 3DRA images of patients with bAVMs. To this end, we densely annotated 5 3DRA volumes of bAVM cases and used these to train two alternative 3DUNet-based architectures with different segmentation objectives. Our results show that the networks reach a comprehensive coverage of relevant structures for bAVM analysis, much better than what is obtained using standard methods. This is promising for achieving a better topological and morphological characterisation of the bAVM structures of interest. Furthermore, the models have the ability to segment venous structures even when missing in the ground truth labelling, which is relevant for planning interventional treatments. Ultimately, these results could be used as more reliable first initial guesses, alleviating the cumbersome task of creating manual labels.