Young-Ho Kim

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.

Abdoul Aziz Amadou, Laura Peralta, Paul Dryburgh et al.

Ultrasound is well-established as an imaging modality for diagnostic and interventional purposes. However, the image quality varies with operator skills as acquiring and interpreting ultrasound images requires extensive training due to the imaging artefacts, the range of acquisition parameters and the variability of patient anatomies. Automating the image acquisition task could improve acquisition reproducibility and quality but training such an algorithm requires large amounts of navigation data, not saved in routine examinations. Thus, we propose a method to generate large amounts of ultrasound images from other modalities and from arbitrary positions, such that this pipeline can later be used by learning algorithms for navigation. We present a novel simulation pipeline which uses segmentations from other modalities, an optimized volumetric data representation and GPU-accelerated Monte Carlo path tracing to generate view-dependent and patient-specific ultrasound images. We extensively validate the correctness of our pipeline with a phantom experiment, where structures' sizes, contrast and speckle noise properties are assessed. Furthermore, we demonstrate its usability to train neural networks for navigation in an echocardiography view classification experiment by generating synthetic images from more than 1000 patients. Networks pre-trained with our simulations achieve significantly superior performance in settings where large real datasets are not available, especially for under-represented classes. The proposed approach allows for fast and accurate patient-specific ultrasound image generation, and its usability for training networks for navigation-related tasks is demonstrated.

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.