Yuan Bi

Dianye Huang, Yuan Bi, Nassir Navab et al.

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).

Feng Li, Yuan Bi, Tianyu Song et al.

Purpose: Spinal instability is a widespread condition that causes pain, fatigue, and restricted mobility, profoundly affecting patients' quality of life. In clinical practice, the gold standard for diagnosis is dynamic X-ray imaging. However, X-ray provides only 2D motion information, while 3D modalities such as computed tomography (CT) or cone beam computed tomography (CBCT) cannot efficiently capture motion. Therefore, there is a need for a system capable of visualizing real-time 3D spinal motion while minimizing radiation exposure. Methods: We propose ultrasound as an auxiliary modality for 3D spine visualization. Due to acoustic limitations, ultrasound captures only the superficial spinal surface. Therefore, the partially compounded ultrasound volume is registered to preoperative 3D imaging. In this study, CBCT provides the neutral spine configuration, while robotic ultrasound acquisition is performed at maximal spinal bending. A kinematic model is applied to the CBCT-derived spine model for coarse registration, followed by ICP for fine registration, with kinematic parameters optimized based on the registration results. Real-time ultrasound motion tracking is then used to estimate continuous 3D spinal motion by interpolating between the neutral and maximally bent states. Results: The pipeline was evaluated on a bendable 3D-printed lumbar spine phantom. The registration error was $1.941 \pm 0.199$ mm and the interpolated spinal motion error was $2.01 \pm 0.309$ mm (median). Conclusion: The proposed robotic ultrasound framework enables radiation-reduced, real-time 3D visualization of spinal motion, offering a promising 3D alternative to conventional dynamic X-ray imaging for assessing spinal instability.

Yuan Bi, Cheng Qian, Zhicheng Zhang et al.

Ultrasound (US) has been widely used in daily clinical practice for screening internal organs and guiding interventions. However, due to the acoustic shadow cast by the subcutaneous rib cage, the US examination for thoracic application is still challenging. To fully cover and reconstruct the region of interest in US for diagnosis, an intercostal scanning path is necessary. To tackle this challenge, we present a reinforcement learning (RL) approach for planning scanning paths between ribs to monitor changes in lesions on internal organs, such as the liver and heart, which are covered by rib cages. Structured anatomical information of the human skeleton is crucial for planning these intercostal paths. To obtain such anatomical insight, an RL agent is trained in a virtual environment constructed using computational tomography (CT) templates with randomly initialized tumors of various shapes and locations. In addition, task-specific state representation and reward functions are introduced to ensure the convergence of the training process while minimizing the effects of acoustic attenuation and shadows during scanning. To validate the effectiveness of the proposed approach, experiments have been carried out on unseen CTs with randomly defined single or multiple scanning targets. The results demonstrate the efficiency of the proposed RL framework in planning non-shadowed US scanning trajectories in areas with limited acoustic access.

Yue Zhou, Yuan Bi, Wenjuan Tong et al.

Precise anomaly detection in medical images is critical for clinical decision-making. While recent unsupervised or semi-supervised anomaly detection methods trained on large-scale normal data show promising results, they lack fine-grained differentiation, such as benign vs. malignant tumors. Additionally, ultrasound (US) imaging is highly sensitive to devices and acquisition parameter variations, creating significant domain gaps in the resulting US images. To address these challenges, we propose UltraAD, a vision-language model (VLM)-based approach that leverages few-shot US examples for generalized anomaly localization and fine-grained classification. To enhance localization performance, the image-level token of query visual prototypes is first fused with learnable text embeddings. This image-informed prompt feature is then further integrated with patch-level tokens, refining local representations for improved accuracy. For fine-grained classification, a memory bank is constructed from few-shot image samples and corresponding text descriptions that capture anatomical and abnormality-specific features. During training, the stored text embeddings remain frozen, while image features are adapted to better align with medical data. UltraAD has been extensively evaluated on three breast US datasets, outperforming state-of-the-art methods in both lesion localization and fine-grained medical classification. The code will be released upon acceptance.

Yuan Bi, Lucie Huang, Ricarda Clarenbach et al.

Anomaly detection in medical imaging plays a crucial role in identifying pathological regions across various imaging modalities, such as brain MRI, liver CT, and carotid ultrasound (US). However, training fully supervised segmentation models is often hindered by the scarcity of expert annotations and the complexity of diverse anatomical structures. To address these issues, we propose a novel unsupervised anomaly detection framework based on a diffusion model that incorporates a synthetic anomaly (Synomaly) noise function and a multi-stage diffusion process. Synomaly noise introduces synthetic anomalies into healthy images during training, allowing the model to effectively learn anomaly removal. The multi-stage diffusion process is introduced to progressively denoise images, preserving fine details while improving the quality of anomaly-free reconstructions. The generated high-fidelity counterfactual healthy images can further enhance the interpretability of the segmentation models, as well as provide a reliable baseline for evaluating the extent of anomalies and supporting clinical decision-making. Notably, the unsupervised anomaly detection model is trained purely on healthy images, eliminating the need for anomalous training samples and pixel-level annotations. We validate the proposed approach on brain MRI, liver CT datasets, and carotid US. The experimental results demonstrate that the proposed framework outperforms existing state-of-the-art unsupervised anomaly detection methods, achieving performance comparable to fully supervised segmentation models in the US dataset. Ablation studies further highlight the contributions of Synomaly noise and the multi-stage diffusion process in improving anomaly segmentation. These findings underscore the potential of our approach as a robust and annotation-efficient alternative for medical anomaly detection.

Zhongliang Jiang, Yunfeng Kang, Yuan Bi et al.

Ultrasound imaging has been widely used in clinical examinations owing to the advantages of being portable, real-time, and radiation-free. Considering the potential of extensive deployment of autonomous examination systems in hospitals, robotic US imaging has attracted increased attention. However, due to the inter-patient variations, it is still challenging to have an optimal path for each patient, particularly for thoracic applications with limited acoustic windows, e.g., intercostal liver imaging. To address this problem, a class-aware cartilage bone segmentation network with geometry-constraint post-processing is presented to capture patient-specific rib skeletons. Then, a dense skeleton graph-based non-rigid registration is presented to map the intercostal scanning path from a generic template to individual patients. By explicitly considering the high-acoustic impedance bone structures, the transferred scanning path can be precisely located in the intercostal space, enhancing the visibility of internal organs by reducing the acoustic shadow. To evaluate the proposed approach, the final path mapping performance is validated on five distinct CTs and two volunteer US data, resulting in ten pairs of CT-US combinations. Results demonstrate that the proposed graph-based registration method can robustly and precisely map the path from CT template to individual patients (Euclidean error: $2.21\pm1.11~mm$).

Zhongliang Jiang, Xuesong Li, Chenyu Zhang et al.

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).

Zhongliang Jiang, Yue Zhou, Yuan Bi et al.

Tissue deformation in ultrasound (US) imaging leads to geometrical errors when measuring tissues due to the pressure exerted by probes. Such deformation has an even larger effect on 3D US volumes as the correct compounding is limited by the inconsistent location and geometry. This work proposes a patient-specified stiffness-based method to correct the tissue deformations in robotic 3D US acquisitions. To obtain the patient-specified model, robotic palpation is performed at sampling positions on the tissue. The contact force, US images and the probe poses of the palpation procedure are recorded. The contact force and the probe poses are used to estimate the nonlinear tissue stiffness. The images are fed to an optical flow algorithm to compute the pixel displacement. Then the pixel-wise tissue deformation under different forces is characterized by a coupled quadratic regression. To correct the deformation at unseen positions on the trajectory for building 3D volumes, an interpolation is performed based on the stiffness values computed at the sampling positions. With the stiffness and recorded force, the tissue displacement could be corrected. The method was validated on two blood vessel phantoms with different stiffness. The results demonstrate that the method can effectively correct the force-induced deformation and finally generate 3D tissue geometries