Robotic Ultrasound Imaging: State-of-the-Art and Future Perspectives

Ultrasound (US) is one of the most widely used modalities for clinical intervention and diagnosis due to the merits of providing non-invasive, radiation-free, and real-time images. However, free-hand US examinations are highly operator-dependent. Robotic US System (RUSS) aims at overcoming this shortcoming by offering reproducibility, while also aiming at improving dexterity, and intelligent anatomy and disease-aware imaging. In addition to enhancing diagnostic outcomes, RUSS also holds the potential to provide medical interventions for populations suffering from the shortage of experienced sonographers. In this paper, we categorize RUSS as teleoperated or autonomous. Regarding teleoperated RUSS, we summarize their technical developments, and clinical evaluations, respectively. This survey then focuses on the review of recent work on autonomous robotic US imaging. We demonstrate that machine learning and artificial intelligence present the key techniques, which enable intelligent patient and process-specific, motion and deformation-aware robotic image acquisition. We also show that the research on artificial intelligence for autonomous RUSS has directed the research community toward understanding and modeling expert sonographers' semantic reasoning and action. Here, we call this process, the recovery of the "language of sonography". This side result of research on autonomous robotic US acquisitions could be considered as valuable and essential as the progress made in the robotic US examination itself. This article will provide both engineers and clinicians with a comprehensive understanding of RUSS by surveying underlying techniques.

Thoracic Cartilage Ultrasound-CT Registration using Dense Skeleton Graph

Autonomous ultrasound (US) imaging has gained increased interest recently, and it has been seen as a potential solution to overcome the limitations of free-hand US examinations, such as inter-operator variations. However, it is still challenging to accurately map planned paths from a generic atlas to individual patients, particularly for thoracic applications with high acoustic-impedance bone structures under the skin. To address this challenge, a graph-based non-rigid registration is proposed to enable transferring planned paths from the atlas to the current setup by explicitly considering subcutaneous bone surface features instead of the skin surface. To this end, the sternum and cartilage branches are segmented using a template matching to assist coarse alignment of US and CT point clouds. Afterward, a directed graph is generated based on the CT template. Then, the self-organizing map using geographical distance is successively performed twice to extract the optimal graph representations for CT and US point clouds, individually. To evaluate the proposed approach, five cartilage point clouds from distinct patients are employed. The results demonstrate that the proposed graph-based registration can effectively map trajectories from CT to the current setup for displaying US views through limited intercostal space. The non-rigid registration results in terms of Hausdorff distance (Mean$\pm$SD) is 9.48$\pm$0.27 mm and the path transferring error in terms of Euclidean distance is 2.21$\pm$1.11 mm.

Motion Magnification in Robotic Sonography: Enabling Pulsation-Aware Artery Segmentation

Ultrasound (US) imaging is widely used for diagnosing and monitoring arterial diseases, mainly due to the advantages of being non-invasive, radiation-free, and real-time. In order to provide additional information to assist clinicians in diagnosis, the tubular structures are often segmented from US images. To improve the artery segmentation accuracy and stability during scans, this work presents a novel pulsation-assisted segmentation neural network (PAS-NN) by explicitly taking advantage of the cardiac-induced motions. Motion magnification techniques are employed to amplify the subtle motion within the frequency band of interest to extract the pulsation signals from sequential US images. The extracted real-time pulsation information can help to locate the arteries on cross-section US images; therefore, we explicitly integrated the pulsation into the proposed PAS-NN as attention guidance. Notably, a robotic arm is necessary to provide stable movement during US imaging since magnifying the target motions from the US images captured along a scan path is not manually feasible due to the hand tremor. To validate the proposed robotic US system for imaging arteries, experiments are carried out on volunteers' carotid and radial arteries. The results demonstrated that the PAS-NN could achieve comparable results as state-of-the-art on carotid and can effectively improve the segmentation performance for small vessels (radial artery).

CommonScenes: Generating Commonsense 3D Indoor Scenes with Scene Graphs

Controllable scene synthesis aims to create interactive environments for various industrial use cases. Scene graphs provide a highly suitable interface to facilitate these applications by abstracting the scene context in a compact manner. Existing methods, reliant on retrieval from extensive databases or pre-trained shape embeddings, often overlook scene-object and object-object relationships, leading to inconsistent results due to their limited generation capacity. To address this issue, we present CommonScenes, a fully generative model that converts scene graphs into corresponding controllable 3D scenes, which are semantically realistic and conform to commonsense. Our pipeline consists of two branches, one predicting the overall scene layout via a variational auto-encoder and the other generating compatible shapes via latent diffusion, capturing global scene-object and local inter-object relationships while preserving shape diversity. The generated scenes can be manipulated by editing the input scene graph and sampling the noise in the diffusion model. Due to lacking a scene graph dataset offering high-quality object-level meshes with relations, we also construct SG-FRONT, enriching the off-the-shelf indoor dataset 3D-FRONT with additional scene graph labels. Extensive experiments are conducted on SG-FRONT where CommonScenes shows clear advantages over other methods regarding generation consistency, quality, and diversity. Codes and the dataset will be released upon acceptance.

AutoPaint: A Self-Inpainting Method for Unsupervised Anomaly Detection

Robust and accurate detection and segmentation of heterogenous tumors appearing in different anatomical organs with supervised methods require large-scale labeled datasets covering all possible types of diseases. Due to the unavailability of such rich datasets and the high cost of annotations, unsupervised anomaly detection (UAD) methods have been developed aiming to detect the pathologies as deviation from the normality by utilizing the unlabeled healthy image data. However, developed UAD models are often trained with an incomplete distribution of healthy anatomies and have difficulties in preserving anatomical constraints. This work intends to, first, propose a robust inpainting model to learn the details of healthy anatomies and reconstruct high-resolution images by preserving anatomical constraints. Second, we propose an autoinpainting pipeline to automatically detect tumors, replace their appearance with the learned healthy anatomies, and based on that segment the tumoral volumes in a purely unsupervised fashion. Three imaging datasets, including PET, CT, and PET-CT scans of lung tumors and head and neck tumors, are studied as benchmarks for evaluation. Experimental results demonstrate the significant superiority of the proposed method over a wide range of state-of-the-art UAD methods. Moreover, the unsupervised method we propose produces comparable results to a robust supervised segmentation method when applied to multimodal images.

Self-Supervised Learning for Physiologically-Based Pharmacokinetic Modeling in Dynamic PET

Dynamic positron emission tomography imaging (dPET) provides temporally resolved images of a tracer enabling a quantitative measure of physiological processes. Voxel-wise physiologically-based pharmacokinetic (PBPK) modeling of the time activity curves (TAC) can provide relevant diagnostic information for clinical workflow. Conventional fitting strategies for TACs are slow and ignore the spatial relation between neighboring voxels. We train a spatio-temporal UNet to estimate the kinetic parameters given TAC from F-18-fluorodeoxyglucose (FDG) dPET. This work introduces a self-supervised loss formulation to enforce the similarity between the measured TAC and those generated with the learned kinetic parameters. Our method provides quantitatively comparable results at organ-level to the significantly slower conventional approaches, while generating pixel-wise parametric images which are consistent with expected physiology. To the best of our knowledge, this is the first self-supervised network that allows voxel-wise computation of kinetic parameters consistent with a non-linear kinetic model. The code will become publicly available upon acceptance.

DopUS-Net: Quality-Aware Robotic Ultrasound Imaging based on Doppler Signal

Medical ultrasound (US) is widely used to evaluate and stage vascular diseases, in particular for the preliminary screening program, due to the advantage of being radiation-free. However, automatic segmentation of small tubular structures (e.g., the ulnar artery) from cross-sectional US images is still challenging. To address this challenge, this paper proposes the DopUS-Net and a vessel re-identification module that leverage the Doppler effect to enhance the final segmentation result. Firstly, the DopUS-Net combines the Doppler images with B-mode images to increase the segmentation accuracy and robustness of small blood vessels. It incorporates two encoders to exploit the maximum potential of the Doppler signal and recurrent neural network modules to preserve sequential information. Input to the first encoder is a two-channel duplex image representing the combination of the grey-scale Doppler and B-mode images to ensure anatomical spatial correctness. The second encoder operates on the pure Doppler images to provide a region proposal. Secondly, benefiting from the Doppler signal, this work first introduces an online artery re-identification module to qualitatively evaluate the real-time segmentation results and automatically optimize the probe pose for enhanced Doppler images. This quality-aware module enables the closed-loop control of robotic screening to further improve the confidence and robustness of image segmentation. The experimental results demonstrate that the proposed approach with the re-identification process can significantly improve the accuracy and robustness of the segmentation results (dice score: from 0:54 to 0:86; intersection over union: from 0:47 to 0:78).

Skeleton Graph-based Ultrasound-CT Non-rigid Registration

Autonomous ultrasound (US) scanning has attracted increased attention, and it has been seen as a potential solution to overcome the limitations of conventional US examinations, such as inter-operator variations. However, it is still challenging to autonomously and accurately transfer a planned scan trajectory on a generic atlas to the current setup for different patients, particularly for thorax applications with limited acoustic windows. To address this challenge, we proposed a skeleton graph-based non-rigid registration to adapt patient-specific properties using subcutaneous bone surface features rather than the skin surface. To this end, the self-organization mapping is successively used twice to unify the input point cloud and extract the key points, respectively. Afterward, the minimal spanning tree is employed to generate a tree graph to connect all extracted key points. To appropriately characterize the rib cartilage outline to match the source and target point cloud, the path extracted from the tree graph is optimized by maximally maintaining continuity throughout each rib. To validate the proposed approach, we manually extract the US cartilage point cloud from one volunteer and seven CT cartilage point clouds from different patients. The results demonstrate that the proposed graph-based registration is more effective and robust in adapting to the inter-patient variations than the ICP (distance error mean/SD: 5.0/1.9 mm vs 8.6/6.7 mm on seven CTs).

Incremental 3D Semantic Scene Graph Prediction from RGB Sequences

3D semantic scene graphs are a powerful holistic representation as they describe the individual objects and depict the relation between them. They are compact high-level graphs that enable many tasks requiring scene reasoning. In real-world settings, existing 3D estimation methods produce robust predictions that mostly rely on dense inputs. In this work, we propose a real-time framework that incrementally builds a consistent 3D semantic scene graph of a scene given an RGB image sequence. Our method consists of a novel incremental entity estimation pipeline and a scene graph prediction network. The proposed pipeline simultaneously reconstructs a sparse point map and fuses entity estimation from the input images. The proposed network estimates 3D semantic scene graphs with iterative message passing using multi-view and geometric features extracted from the scene entities. Extensive experiments on the 3RScan dataset show the effectiveness of the proposed method in this challenging task, outperforming state-of-the-art approaches.

Next-generation Surgical Navigation: Multi-view Marker-less 6DoF Pose Estimation of Surgical Instruments

State-of-the-art research of traditional computer vision is increasingly leveraged in the surgical domain. A particular focus in computer-assisted surgery is to replace marker-based tracking systems for instrument localization with pure image-based 6DoF pose estimation. However, the state of the art has not yet met the accuracy required for surgical navigation. In this context, we propose a high-fidelity marker-less optical tracking system for surgical instrument localization. We developed a multi-view camera setup consisting of static and mobile cameras and collected a large-scale RGB-D video dataset with dedicated synchronization and data fusions methods. Different state-of-the-art pose estimation methods were integrated into a deep learning pipeline and evaluated on multiple camera configurations. Furthermore, the performance impacts of different input modalities and camera positions, as well as training on purely synthetic data, were compared. The best model achieved an average position and orientation error of 1.3 mm and 1.0{\deg} for a surgical drill as well as 3.8 mm and 5.2{\deg} for a screwdriver. These results significantly outperform related methods in the literature and are close to clinical-grade accuracy, demonstrating that marker-less tracking of surgical instruments is becoming a feasible alternative to existing marker-based systems.