CT-Enabled Patient-Specific Simulation and Contact-Aware Robotic Planning for Cochlear Implantation

Objective: Cochlear implants (CIs) are bionic prostheses that restores hearing via electrical stimulation of the auditory nerve. Hybrid CIs, which use electroacoustic stimulation (EAS), combine residual low-frequency acoustic hearing with CI electrical stimulation. Intracochlear fibrosis, which forms in response to the presence of the implant, may impede residual hearing function and gradually reduce the efficacy of EAS. It is therefore a translational objective to study the formation of cochlear fibrosis in rodents, with the goal of reducing fibrotic burden and improving outcomes for CI patients. Methods: We generate and annotate a novel dataset of optical coherence tomography (OCT) images from chronically implanted guinea pigs as part of an ongoing study focused on implant induced fibrosis. Objectively assessing fibrotic burden in this model, with high resolution and repeatability, presents an obvious use case for computer vision methods. Results: We present the results of several state-of-the-art semantic segmentation models and compare their efficacy for identifying cochlear fibrosis and other relevant annotations, using a new library of manually segmented OCT images. Conclusions: We find that the best performance is achieved by using a modified version of the well-known UNET architecture (which we term 2D-OCT-UNET) that operates on the upscaled OCT input resolution. Significance: For the first time, we have successfully applied computer vision techniques to an OCT dataset of implanted cochleae with fibrosis. Using this deep learning model, the cochlear fibrotic burden calculation can be reliably carried out as we verify in our experimental section. The dataset and the project code are available at: https://github.com/juliadietlmeier/CF-OCT-segmentation

Contact-rich precision insertion is a key manipulation skill in robotic assembly. Tight clearances make insertion more sensitive to alignment errors and prone to collisions and jamming, while variations in geometry and clearance across parts further complicate policy reuse. We present a reinforcement learning framework that trains insertion policies entirely in simulation for direct deployment without real-world demonstrations or policy fine-tuning. By combining target poses with compact three-dimensional fingertip force feedback, the policy learns to search for alignment and correct its motion despite errors in the estimated hole position. A decoupled gated reward coordinates alignment and insertion. Force-signal smoothing and state-independent standard deviations stabilize the learning process. The resulting policies perform real-world insertion across multiple hole geometries with a minimum nominal clearance of 0.02 mm and improve success while reducing peak contact forces under hole-position errors. Cross-clearance and cross-geometry evaluations further confirm policy generalization. The system achieved the first perfect score of 20/20 on ManipulationNet's peg-in-hole benchmark under its Human-in-the-Loop protocol, with fully autonomous insertion motions. A single policy trained only on a simulated hexagonal insertion task achieved an overall success rate of 95.0% across eight unseen real-world insertion tasks. These results show that learning entirely in simulation can yield precision insertion skills that can be deployed directly and reused across real-world tasks. The project website (https://mzhsoul.github.io/InsertAnything/) provides open-source simulation and real-robot experiment scripts, assets, and trained checkpoints.

Slice-to-volume registration between ultrasound (US) and preoperative computed tomography (CT) imaging would enhance many minimally invasive interventions, for example by locating soft tissue structures intra-operatively that are discernible in CT. While optical tracking enables initial rigid registration, contact from the probe induces soft tissue deformations that inhibit accurate alignment. In this work, we introduce a deformable CT-ultrasound registration framework that incorporates anatomical priors derived from CT to improve registration under deformation. Rigid registration is first established using a robot-assisted optical tracking system, after which a deformable transformation is estimated using a sinusoidal implicit neural representation (SIREN) optimized per frame. Tissue stiffness is approximated from CT-based HU values and used as spatially varying regularization, suppressing deformation in rigid structures such as bone while allowing more flexibility in soft tissue. Two additional constraints capture the physics of probe contact: a contact-zone displacement prior that drives the displacement field to compress tissue below the probe face, and a fan-geometry regularization term based on beam direction and convex transducer field of view. Model parameters are optimized with a normalized gradient field (NGF). The proposed approach improves alignment over rigid initialisation by 17% and outperforms classical deformable baselines while maintaining near-zero topological folding.