Ankur Kapoor

Brian Teixeira, Vivek Singh, Birgi Tamersoy et al.

Despite recent developments in CT planning that enabled automation in patient positioning, time-consuming scout scans are still needed to compute dose profile and ensure the patient is properly positioned. In this paper, we present a novel method which eliminates the need for scout scans in CT lung cancer screening by estimating patient scan range, isocenter, and Water Equivalent Diameter (WED) from 3D camera images. We achieve this task by training an implicit generative model on over 60,000 CT scans and introduce a novel approach for updating the prediction using real-time scan data. We demonstrate the effectiveness of our method on a testing set of 110 pairs of depth data and CT scan, resulting in an average error of 5mm in estimating the isocenter, 13mm in determining the scan range, 10mm and 16mm in estimating the AP and lateral WED respectively. The relative WED error of our method is 4%, which is well within the International Electrotechnical Commission (IEC) acceptance criteria of 10%.

Jaeyoung Huh, Paul Klein, Gareth Funka-Lea et al.

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, especially among less experienced operators. To address this challenge, we propose an AIdriven view guidance system that operates in a continuous closed-loop with human-in-the-loop feedback, designed to assist users in navigating ICE imaging without requiring specialized knowledge. Specifically, our method models the relative position and orientation vectors between arbitrary views and clinically defined ICE views in a spatial coordinate system. It guides users on how to manipulate the ICE catheter to transition from the current view to the desired view over time. By operating in a closedloop configuration, the system continuously predicts and updates the necessary catheter manipulations, ensuring seamless integration into existing clinical workflows. The effectiveness of the proposed system is demonstrated through a simulation-based performance evaluation using real clinical data, achieving an 89% success rate with 6,532 test cases. Additionally, a semi-simulation experiment with human-in-the-loop testing validated the feasibility of continuous yet discrete guidance. These results underscore the potential of the proposed method to enhance the accuracy and efficiency of ICE imaging procedures.

Kareem Eissa, Rayal Prasad, Sarith Mohan et al.

Workforce optimization plays a crucial role in efficient organizational operations where decision-making may span several different administrative and time scales. For instance, dispatching personnel to immediate service requests while managing talent acquisition with various expertise sets up a highly dynamic optimization problem. Existing work focuses on specific sub-problems such as resource allocation and facility location, which are solved with heuristics like local-search and, more recently, deep reinforcement learning. However, these may not accurately represent real-world scenarios where such sub-problems are not fully independent. Our aim is to fill this gap by creating a simulator that models a unified workforce optimization problem. Specifically, we designed a modular simulator to support the development of reinforcement learning methods for integrated workforce optimization problems. We focus on three interdependent aspects: personnel dispatch, workforce management, and personnel positioning. The simulator provides configurable parameterizations to help explore dynamic scenarios with varying levels of stochasticity and non-stationarity. To facilitate benchmarking and ablation studies, we also include heuristic and RL baselines for the above mentioned aspects.

Jaeyoung Huh, Ankur Kapoor, Young-Ho Kim

Intra-cardiac Echocardiography (ICE) plays a critical role in Electrophysiology (EP) and Structural Heart Disease (SHD) interventions by providing real-time visualization of intracardiac structures. However, maintaining continuous visibility of the therapy device tip remains a challenge due to frequent adjustments required during manual ICE catheter manipulation. To address this, we propose an AI-driven tracking model that estimates the device tip incident angle and passing point within the ICE imaging plane, ensuring continuous visibility and facilitating robotic ICE catheter control. A key innovation of our approach is the hybrid dataset generation strategy, which combines clinical ICE sequences with synthetic data augmentation to enhance model robustness. We collected ICE images in a water chamber setup, equipping both the ICE catheter and device tip with electromagnetic (EM) sensors to establish precise ground-truth locations. Synthetic sequences were created by overlaying catheter tips onto real ICE images, preserving motion continuity while simulating diverse anatomical scenarios. The final dataset consists of 5,698 ICE-tip image pairs, ensuring comprehensive training coverage. Our model architecture integrates a pretrained ultrasound (US) foundation model, trained on 37.4M echocardiography images, for feature extraction. A transformer-based network processes sequential ICE frames, leveraging historical passing points and incident angles to improve prediction accuracy. Experimental results demonstrate that our method achieves 3.32 degree entry angle error, 12.76 degree rotation angle error. This AI-driven framework lays the foundation for real-time robotic ICE catheter adjustments, minimizing operator workload while ensuring consistent therapy device visibility. Future work will focus on expanding clinical datasets to further enhance model generalization.

Jaeyoung Huh, Ankur Kapoor, Young-Ho Kim

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.

Young-Ho Kim, Jarrod Collins, Zhongyu Li et al.

Purpose: Intra-Cardiac Echocardiography (ICE) is a powerful imaging modality for guiding cardiac electrophysiology and structural heart interventions. ICE provides real-time observation of anatomy and devices, while enabling direct monitoring of potential complications. In single operator settings, the physician needs to switch back-and-forth between the ICE catheter and therapy device, making continuous ICE support impossible. Two operators setup are therefore sometimes implemented, with the challenge of increase room occupation and cost. Two operator setups are sometimes implemented, but increase procedural costs and room occupation. Methods: ICE catheter robotic control system is developed with automated catheter tip repositioning (i.e. view recovery) method, which can reproduce important views previously navigated to and saved by the user. The performance of the proposed method is demonstrated and evaluated in a combination of heart phantom and animal experiments. Results: Automated ICE view recovery achieved catheter tip position accuracy of 2.09 +/-0.90 mm and catheter image orientation accuracy of 3.93 +/- 2.07 degree in animal studies, and 0.67 +/- 0.79 mm and 0.37 +/- 0.19 degree in heart phantom studies, respectively. Our proposed method is also successfully used during transeptal puncture in animals without complications, showing the possibility for fluoro-less transeptal puncture with ICE catheter robot. Conclusion: Robotic ICE imaging has the potential to provide precise and reproducible anatomical views, which can reduce overall execution time, labor burden of procedures, and x-ray usage for a range of cardiac procedures. Keywords: Automated View Recovery, Path Planning, Intra-cardiac echocardiography (ICE), Catheter, Tendon-driven manipulator, Cardiac Imaging

Young-Ho Kim, Ankur Kapoor, Tommaso Mansi et al.

Position sensitive detectors (PSDs) offer possibility to track single active marker's two (or three) degrees of freedom (DoF) position with a high accuracy, while having a fast response time with high update frequency and low latency, all using a very simple signal processing circuit. However they are not particularly suitable for 6-DoF object pose tracking system due to lack of orientation measurement, limited tracking range, and sensitivity to environmental variation. We propose a novel 6-DoF pose tracking system for a rigid object tracking requiring a single active marker. The proposed system uses a stereo-based PSD pair and multiple Inertial Measurement Units (IMUs). This is done based on a practical approach to identify and control the power of Infrared-Light Emitting Diode (IR-LED) active markers, with an aim to increase the tracking work space and reduce the power consumption. Our proposed tracking system is validated with three different work space sizes and for static and dynamic positional accuracy using robotic arm manipulator with three different dynamic motion patterns. The results show that the static position root-mean-square (RMS) error is 0.6mm. The dynamic position RMS error is 0.7-0.9mm. The orientation RMS error is between 0.04 and 0.9 degree at varied dynamic motion. Overall, our proposed tracking system is capable of tracking a rigid object pose with sub-millimeter accuracy at the mid range of the work space and sub-degree accuracy for all work space under a lab setting.

Dong-Ho Lee, Young-Ho Kim, Jarrod Collins et al.

Tendon-sheath-driven manipulators (TSM) are widely used in minimally invasive surgical systems due to their long, thin shape, flexibility, and compliance making them easily steerable in narrow or tortuous environments. Many commercial TSM-based medical devices have non-linear phenomena resulting from their composition such as backlash hysteresis and dead zone, which lead to a considerable challenge for achieving precise control of the end effector pose. However, many recent works in the literature do not consider the combined effects and compensation of these phenomena, and less focus on practical ways to identify model parameters in realistic conditions. This paper proposes a simplified piecewise linear model to construct both backlash hysteresis and dead zone compensators together. Further, a practical method is introduced to identify model parameters using motor current from a robotic controller for the TSM. Our proposed methods are validated with multiple Intra-cardiac Echocardiography (ICE) catheters, which are typical commercial example of TSM, by periodic and non-periodic motions. Our results show that the errors from backlash hysteresis and dead zone are considerably reduced and therefore the accuracy of robotic control is improved when applying the presented methods.

Young-Ho Kim, Jarrod Collins, Zhongyu Li et al.

Intra-cardiac Echocardiography (ICE) is a powerful imaging modality for guiding electrophysiology and structural heart interventions. ICE provides real-time observation of anatomy, catheters, and emergent complications. However, this increased reliance on intraprocedural imaging creates a high cognitive demand on physicians who can often serve as interventionalist and imager. We present a robotic manipulator for ICE catheters to assist physicians with imaging and serve as a platform for developing processes for procedural automation. Herein, we introduce two application modules towards these goals: (1) a view recovery process that allows physicians to save views during intervention and automatically return with the push of a button and (2) a data-driven approach to compensate kinematic model errors that result from non-linear behaviors in catheter bending, providing more precise control of the catheter tip. View recovery is validated by repeated catheter positioning in cardiac phantom and animal experiments with position- and image-based analysis. We present a simplified calibration approach for error compensation and verify with complex rotation of the catheter in benchtop and phantom experiments under varying realistic curvature conditions. Results support that a robotic manipulator for ICE can provide an efficient and reproducible tool, potentially reducing execution time and promoting greater utilization of ICE imaging.

Walid Bekhtaoui, Ruhan Sa, Brian Teixeira et al.

Point cloud based methods have produced promising results in areas such as 3D object detection in autonomous driving. However, most of the recent point cloud work focuses on single depth sensor data, whereas less work has been done on indoor monitoring applications, such as operation room monitoring in hospitals or indoor surveillance. In these scenarios multiple cameras are often used to tackle occlusion problems. We propose an end-to-end multi-person 3D pose estimation network, Point R-CNN, using multiple point cloud sources. We conduct extensive experiments to simulate challenging real world cases, such as individual camera failures, various target appearances, and complex cluttered scenes with the CMU panoptic dataset and the MVOR operation room dataset. Unlike most of the previous methods that attempt to use multiple sensor information by building complex fusion models, which often lead to poor generalization, we take advantage of the efficiency of concatenating point clouds to fuse the information at the input level. In the meantime, we show our end-to-end network greatly outperforms cascaded state-of-the-art models.

Brian Teixeira, Birgi Tamersoy, Vivek Singh et al.

Landmark localization is a challenging problem in computer vision with a multitude of applications. Recent deep learning based methods have shown improved results by regressing likelihood maps instead of regressing the coordinates directly. However, setting the precision of these regression targets during the training is a cumbersome process since it creates a trade-off between trainability vs localization accuracy. Using precise targets introduces a significant sampling bias and hence makes the training more difficult, whereas using imprecise targets results in inaccurate landmark detectors. In this paper, we introduce "Adaloss", an objective function that adapts itself during the training by updating the target precision based on the training statistics. This approach does not require setting problem-specific parameters and shows improved stability in training and better localization accuracy during inference. We demonstrate the effectiveness of our proposed method in three different applications of landmark localization: 1) the challenging task of precisely detecting catheter tips in medical X-ray images, 2) localizing surgical instruments in endoscopic images, and 3) localizing facial features on in-the-wild images where we show state-of-the-art results on the 300-W benchmark dataset.

Elena Balashova, Jiangping Wang, Vivek Singh et al.

Automatic delineation and measurement of main organs such as liver is one of the critical steps for assessment of hepatic diseases, planning and postoperative or treatment follow-up. However, addressing this problem typically requires performing computed tomography (CT) scanning and complicated postprocessing of the resulting scans using slice-by-slice techniques. In this paper, we show that 3D organ shape can be automatically predicted directly from topogram images, which are easier to acquire and have limited exposure to radiation during acquisition, compared to CT scans. We evaluate our approach on the challenging task of predicting liver shape using a generative model. We also demonstrate that our method can be combined with user annotations, such as a 2D mask, for improved prediction accuracy. We show compelling results on 3D liver shape reconstruction and volume estimation on 2129 CT scans.

Xiaoxiao Li, Vivek Singh, Yifan Wu et al.

Tracking organ motion is important in image-guided interventions, but motion annotations are not always easily available. Thus, we propose Repetitive Motion Estimation Network (RMEN) to recover cardiac and respiratory signals. It learns the spatio-temporal repetition patterns, embedding high dimensional motion manifolds to 1D vectors with partial motion phase boundary annotations. Compared with the best alternative models, our proposed RMEN significantly decreased the QRS peaks detection offsets by 59.3%. Results showed that RMEN could handle the irregular cardiac and respiratory motion cases. Repetitive motion patterns learned by RMEN were visualized and indicated in the feature maps.

Yuehaw Khoo, Ankur Kapoor

We describe a convex programming framework for pose estimation in 2D/3D point-set registration with unknown point correspondences. We give two mixed-integer nonlinear program (MINP) formulations of the 2D/3D registration problem when there are multiple 2D images, and propose convex relaxations for both of the MINPs to semidefinite programs (SDP) that can be solved efficiently by interior point methods. Our approach to the 2D/3D registration problem is non-iterative in nature as we jointly solve for pose and correspondence. Furthermore, these convex programs can readily incorporate feature descriptors of points to enhance registration results. We prove that the convex programs exactly recover the solution to the original nonconvex 2D/3D registration problem under noiseless condition. We apply these formulations to the registration of 3D models of coronary vessels to their 2D projections obtained from multiple intra-operative fluoroscopic images. For this application, we experimentally corroborate the exact recovery property in the absence of noise and further demonstrate robustness of the convex programs in the presence of noise.