Pose Estimation for Intra-cardiac Echocardiography Catheter via AI-Based Anatomical Understanding

Intra-cardiac Echocardiography (ICE) plays a crucial role in Electrophysiology (EP) and Structural Heart Disease (SHD) interventions by providing high-resolution, real-time imaging of cardiac structures. However, existing navigation methods rely on electromagnetic (EM) tracking, which is susceptible to interference and position drift, or require manual adjustments based on operator expertise. To overcome these limitations, we propose a novel anatomy-aware pose estimation system that determines the ICE catheter position and orientation solely from ICE images, eliminating the need for external tracking sensors. Our approach leverages a Vision Transformer (ViT)-based deep learning model, which captures spatial relationships between ICE images and anatomical structures. The model is trained on a clinically acquired dataset of 851 subjects, including ICE images paired with position and orientation labels normalized to the left atrium (LA) mesh. ICE images are patchified into 16x16 embeddings and processed through a transformer network, where a [CLS] token independently predicts position and orientation via separate linear layers. The model is optimized using a Mean Squared Error (MSE) loss function, balancing positional and orientational accuracy. Experimental results demonstrate an average positional error of 9.48 mm and orientation errors of (16.13 deg, 8.98 deg, 10.47 deg) across x, y, and z axes, confirming the model accuracy. Qualitative assessments further validate alignment between predicted and target views within 3D cardiac meshes. This AI-driven system enhances procedural efficiency, reduces operator workload, and enables real-time ICE catheter localization for tracking-free procedures. The proposed method can function independently or complement existing mapping systems like CARTO, offering a transformative approach to ICE-guided interventions.