STUNet-Fusion: Spatiotemporal Needle-Tip Localization in Ultrasound Video via Multi-Channel Motion Fusion

Purpose: Ultrasound-guided needle interventions are widely used in clinical practice, but their success critically depends on accurate needle placement, which is frequently hindered by the poor and intermittent visibility of needles in ultrasound images. Existing approaches remain limited by artifacts, occlusions, and low contrast, and often fail to support real-time continuous insertion. To overcome these challenges, this study introduces a robust real-time framework for continuous needle detection. Methods: We present ConVibNet, an extension of VibNet for detecting needles with significantly reduced visibility, addressing real-time, continuous needle tracking during insertion. ConVibNet leverages temporal dependencies across successive ultrasound frames to enable continuous estimation of both needle tip position and shaft angle in dynamic scenarios. To strengthen temporal awareness of needle-tip motion, we introduce a novel intersection-and-difference loss that explicitly leverages motion correlations across consecutive frames. In addition, we curated a dedicated dataset for model development and evaluation. Results: The performance of the proposed ConVibNet model was evaluated on our dataset, demonstrating superior accuracy compared to the baseline VibNet and UNet-LSTM models. Specifically, ConVibNet achieved a tip error of 2.80+-2.42 mm and an angle error of 1.69+-2.00 deg. These results represent a 0.75 mm improvement in tip localization accuracy over the best-performing baseline, while preserving real-time inference capability. Conclusion: ConVibNet advances real-time needle detection in ultrasound-guided interventions by integrating temporal correlation modeling with a novel intersection-and-difference loss, thereby improving accuracy and robustness and demonstrating high potential for integration into autonomous insertion systems.

Freehand 3-D ultrasound (US) imaging has attracted increasing attention owing to its intuitive volumetric visualization, ease of use, and low cost. However, accurate 3-D reconstruction critically depends on stable probe pose estimation, yet existing trackerless methods remain susceptible to accumulated pose errors, particularly over long scanning trajectories. To address this limitation, we propose a global-to-local pose estimation framework that exploits external camera observations for globally stable localization and B-mode US images for anatomy-aware local refinement. Specifically, the framework comprises a dual-camera branch that performs contextual feature aggregation across camera views and temporal observations to estimate a globally consistent probe trajectory, and a B-mode branch that performs anatomical feature aggregation from sequential US images to capture tissue-dependent local motion cues. A cross-modal fusion module subsequently integrates the contextual camera features and anatomical US features to predict pose residuals and refine the camera-derived estimates in the transformation space. Furthermore, a multi-scale pose loss constrains relative motion over multiple temporal horizons to suppress accumulated drift during extended scans. The proposed framework is validated on phantom and in vivo datasets. On two in-house datasets (FUSION-J and FUSION-L) collected using different machines, the proposed US + Dual-Cam model reduces average trajectory drift to 1.67 mm and 1.29 mm, representing improvement of 16.50% and 27.12%, respectively, over a strong dual-camera baseline, while substantially outperforming US-only pose estimation (>13 mm drift). In in vivo forearm arteries reconstruction, it achieves Hausdorff distances of 1.58 mm, demonstrating the effectiveness of the proposed method on real clinical scenarios.

Ultrasound (US)-guided needle insertion is a critical yet challenging procedure due to dynamic imaging conditions and difficulties in needle visualization. Many methods have been proposed for automated needle insertion, but they often rely on hand-crafted pipelines with modular controllers, whose performance degrades in challenging cases. In this paper, a Vision-Language-Action (VLA) model is proposed for adaptive and automated US-guided needle insertion and tracking on a robotic ultrasound (RUS) system. This framework provides a unified approach to needle tracking and needle insertion control, enabling real-time, dynamically adaptive adjustment of insertion based on the obtained needle position and environment awareness. To achieve real-time and end-to-end tracking, a Cross-Depth Fusion (CDF) tracking head is proposed, integrating shallow positional and deep semantic features from the large-scale vision backbone. To adapt the pretrained vision backbone for tracking tasks, a Tracking-Conditioning (TraCon) register is introduced for parameter-efficient feature conditioning. After needle tracking, an uncertainty-aware control policy and an asynchronous VLA pipeline are presented for adaptive needle insertion control, ensuring timely decision-making for improved safety and outcomes. Extensive experiments on both needle tracking and insertion show that our method consistently outperforms state-of-the-art trackers and manual operation, achieving higher tracking accuracy, improved insertion success rates, and reduced procedure time, highlighting promising directions for RUS-based intelligent intervention.