Anatomical Prior-Driven Framework for Autonomous Robotic Cardiac Ultrasound Standard View Acquisition

Robotic ultrasound has advanced local image-driven control, contact regulation, and view optimization, yet current systems lack the anatomical understanding needed to determine what to scan, where to begin, and how to adapt to individual patient anatomy. These gaps make systems still reliant on expert intervention to initiate scanning. Here we present SAMe, a semantic anatomy mapping engine that provides robotic ultrasound with an explicit anatomical prior layer. SAMe addresses scan initiation as a target-to-anatomy-to-action process: it grounds under-specified clinical complaints into structured target organs, instantiates a patient-specific anatomical representation for the grounded targets from a single external body image, and translates this representation into control-facing 6-DoF probe initialization states without any additional registration using preoperative CT or MRI. The anatomical representation maintained by SAMe is explicit, lightweight (single-organ inference in 0.08s), and compatible with downstream control by design. Across semantic grounding, anatomical instantiation, and real-robot evaluation, SAMe shows strong performance across the full initialization pipeline. In real-robot experiments, centroid-based SAMe initialization outperformed the body-keypoint-based heuristic baseline under a budget-matched single-target setting for both liver (86.7% versus 46.7%) and kidney (80.0% versus 73.3%) initialization. Furthermore, The trial-level organ-hit rate reached 97.3% for liver and 83.3% for kidney when multiple candidate targets were available. These results establish an explicit anatomical prior layer that addresses scan initialization and is designed to support broader downstream autonomous scanning pipelines, providing the anatomical foundation for complaint-driven, anatomically informed robotic ultrasonography.

Artificial intelligence-assisted ultrasound scanning enhances diagnostic reliability and efficiency by providing real-time guidance for standardized image acquisition and reducing operator dependence. However, existing reinforcement learning and learning-assisted ultrasound scanning methods typically rely on carefully designed reward functions or extensive interaction data, which limits their generalization ability and stability across different devices, patient populations, and complex clinical scenarios. To address these challenges, we propose an ultrasound vision-language-action model (US-VLA) for automated ultrasound scanning that explicitly encodes clinical semantic goals and generates sequential probe manipulation actions under real-time ultrasound feedback. In particular, we first design an ultrasound-aware expert fusion module to jointly integrate ultrasound observations with auxiliary contextual information, enabling semantic ultrasound feedback to effectively guide the scanning process. Then, we construct US-VLA-Data, a real-world dataset covering liver and kidney examinations, which includes five clinically defined standard planes and comprises 320 expert scanning trajectories with approximately 80,000 synchronized timesteps. Extensive experiments demonstrate that US-VLA achieves competitive performance in ultrasound probe manipulation tasks, indicating its effectiveness and promising generalization within the evaluated abdominal ultrasound setting. The source code is available at https://github.com/VMVLab/US-VLA.

Self-supervised pre-training paradigm has gained increasing prominence for learning transferable representations in medical imaging, yet existing methods for ultrasound (US) images operate at the image or frame level, overlooking the anatomical context for clinical-aligned representation learning. In this work, we propose an anatomy-anchored ultrasound self-supervision framework ANAUS that shifts representation learning from generic visual regions to clinically meaningful anatomical structures. Utilizing a learnable latent prompt engine alongside a one-time domain adaptation on existing public image-mask pairs, we empower the LP-SAM module to achieve annotation-free anatomy delineation at scale. Building upon this anatomical grounding, we propose a dual-policy self-supervised learning paradigm consisting of inter-view semantics-aware anatomy-separating alignment and contextual core-region prediction to enhance representation learning. Specifically, the former enforces feature invariance within identical anatomical regions while promoting discriminability across distinct structures; the latter compels the model to reconstruct corrupted regions, thereby capturing fine-grained structural details. Extensive evaluations on six public datasets demonstrate that ANAUS consistently outstrips current state-of-the-art methods while maintaining the computational efficiency essential for clinical deployment. Code is available at https://github.com/zhcz328/ANAUS.