Catheter Tip Tracking

Tendon-driven continuum manipulators are widely used in medical applications, where accurate tip-position estimation is essential for precise navigation and instrument positioning. However, patient anatomy and procedural setup impose task-dependent unknown shaft configurations, while friction, slack, and compliance introduce hysteresis, making tip estimation challenging. This paper presents a motor-history-conditioned gated recurrent unit (GRU) residual estimator for three-dimensional catheter tip estimation without direct shaft-configuration sensing. First, an initial multidirectional sweep strategy is applied to calibrate a geometric catheter model backbone, and encode the motor-angle and drive-torque response into a shaft-configuration context vector. During subsequent motion, the context conditions a GRU that predicts a task-space residual correcting this backbone, relying on motor measurements alone. The context remains fixed for the current shaft configuration, while the recurrent state captures the evolving actuation history. Across four disposable intra-cardiac echocardiography catheters and 16 bent shaft configurations, the method achieves 3.3mm open-loop tip RMSE, a 59% reduction relative to the constant-curvature baseline.

Assessing catheter and tube placement on chest X-rays is safety-critical yet tedious and error-prone. Current deep learning methods either classify placement globally -- losing track of which device is where -- or segment all devices into a single mask, making per-device assessment impossible when catheters overlap. We introduce UCompCXR, a compositional framework that detects local catheter fragments, associates them into device instances via graph-based clustering, fuses per-fragment tip predictions through precision-weighted Gaussian estimation, and classifies placement per device. On the RANZCR CLiP dataset (30,083 images, 5-fold patient-level CV with bootstrap CIs), UCompCXR detects 26% more devices than a strong multi-task baseline sharing the same MobileNetV3 backbone, with 75% fewer false positives and well-calibrated tip uncertainty (95% coverage = 0.948). The aggregate tip error rises -- but only because the model finds devices the baseline misses entirely, especially nasogastric tubes. On matched devices, catastrophic localization failures drop substantially. At 2.27M parameters in a single forward pass, the model is deployable on resource-constrained clinical hardware.

Despite advances in 3D ultrasound, most percutaneous cardiac interventions still rely on 2D visualization, limiting depth perception and spatial understanding. To address this challenge, we developed an Extended Reality (XR)-based platform that enables real-time six-degree-of-freedom (6-DOF) catheter tracking and visualization within a patient-specific 3D heart model. The system combines a custom machine-vision algorithm for 5-DOF catheter tracking with a 3D-printed electromechanical encoder that measures catheter roll, providing complete 6-DOF motion reconstruction. In a proof-of-concept study, 20 novice medical students navigated an intracardiac echocardiography (ICE) catheter to six anatomical targets using either immersive 3D visualization or a conventional 2D cathlab-style view. Participants in the 3D condition completed the task in 54.6 seconds and traveled 1,939 mm on average, compared with 267.5 seconds and 7,854 mm in the 2D condition. Therefore, the XR-based 3D system was more than 5x faster and required ~5x less catheter travel. The 3D mode also improved targeting precision and reduced performance variability. Participants consistently rated immersive visualization higher for accuracy, speed, usability, and clinical value. Kinematic analysis showed smoother depth-axis navigation in 3D, whereas 2D users relied on repeated corrective movements. These findings demonstrate that XR-based visualization can substantially improve procedural training efficiency, precision, and motor control.

Fenestrated/Branched endovascular aneurysm repair (FEVAR/BEVAR) require surgeons to navigate catheters and guidewires into various branches of the abdominal aorta, before deploying stent grafts to alleviate pressure on the aneurysm. Previous clinical studies suggests that surgeons continue to struggle with vessel access using standard commercial instruments, prolonging the procedural time and inducing further complications. In this work, we present two contributions to solving this problem: 1) A bespoke 2-segment steerable catheter, consisting of 4 degrees of freedom to enhance dexterity. 2) An expandable, modular tendon-driven actuation platform that can accommodate for the redundancies introduced in our system. To fabricate the catheter, we capitalized on thermal fiber drawing, a technique that creates high-aspect ratio devices at scale, and processed the catheter with laser micro-machining to soften its tip. We evaluated the system using simulations, where we investigated the catheter's bending stiffness, then its steerability with in-vitro experiments in vascular phantoms. This handheld, robotic steerable catheter system has the potential to shorten the length of future endovascular surgeries, and give clinicians the tools to resolve challenging clinical cases.

Safe steerable catheter control is fundamentally a problem of interaction dynamics: the tip must follow a planned motion, remain compliant against moving tissue, reject friction and hysteresis, and respect a clinically meaningful never-exceed contact-force bound. We formulate catheter--tissue interaction dynamics in the scalar tip-normal coordinate of a single-segment single-tendon catheter. A partial-physics feedforward cancels only the reliable nominal bending dynamics, exposing a configuration-invariant linear interaction-dynamics model whose input gain varies through the scalar catheter inertia. A predictive optimizer then regulates this interaction state subject to hard contact-force, tendon-force, and curvature constraints. An augmented Kalman filter compresses contact, friction, and modeling error into one sensor-free disturbance state, giving nominal offset-free regulation in free space while leaving force safety to the explicit constraint. The unconstrained and disturbance-free limit recovers classical catheter impedance as a special realization of the same interaction dynamics, rather than as the main design object. In a MuJoCo distributed-compliance simulation of an eight-link tendon-driven catheter, disturbance augmentation cuts free-space approach error by 90%, and only the force-constrained predictive interaction-dynamics controller reconciles tracking with the 0.5,N bound: the unconstrained controller drives contact force to 0.60,N against a penetrating target, while the constrained one holds 0.47,N at identical tracking. These results show that offset-free motion regulation and contact-force safety are coupled interaction-dynamics objectives, and that the explicit predictive constraint resolves their tension under stiff tissue contact. The bound also holds under $0.5$,mm, $1.2$,Hz cardiac motion. Hardware validation is future work.

Robot-assisted endovascular intervention can potentially reduce radiation exposure, improve surgeon ergonomics, enable telesurgery, support active assistance and autonomy, and enhance procedural precision. However, existing systems often suffer from limited procedural coverage because constrained patient-side setups, restricted flexibility, and complex instrument exchange hinder clinical workflow integration. This work presents a compact robotic system for endovascular interventions that enables continuous translational and rotational manipulation of standard endovascular instruments. The system consists of two alternating carts with pneumatically actuated membrane grippers integrated into rotating gripper gears. Its top-loading design allows rapid exchange of instruments such as guidewires and catheters without changing the robotic setup. A leader-follower control strategy enables continuous motion despite the finite stroke of each cart. The system was evaluated in motion-tracking experiments with guidewires and catheters and in an in vitro vascular phantom. The motion-tracking experiments showed generally smooth translational and rotational motion profiles. Across all tested guidewire and catheter experiments, the mean relative tracking errors were 3.6% for translational motion and 4.1% for rotational motion. In the vascular phantom, robot-assisted navigation reached the target in most trials, demonstrating the feasibility of the proposed manipulation concept under in vitro conditions. The presented robotic system demonstrates technical feasibility for continuous manipulation of standard endovascular instruments in bench-top and in vitro experiments. The compact top-loading design may ease instrument exchange and clinical workflow integration. Future work will focus on improving gripping performance, actuation speed, force feedback, and evaluation in more clinically realistic settings.

Percutaneous Coronary Intervention (PCI) is a minimally invasive procedure used to restore coronary blood flow obstructed by atherosclerotic plaque. During PCI, repeated injections of iodine-based contrast agents are required to visualize the coronary arteries and guide interventional devices. However, frequent contrast injections increase radiation exposure and the risk of contrast-induced nephropathy, with acute kidney injury reported in up to 30% of patients with renal impairment. Dynamic Coronary Roadmapping (DRM) reduces these risks by overlaying a precomputed angiographic vessel map onto live fluoroscopy and continuously updating it throughout the procedure. Accurate DRM relies on precise cardiac phase matching between angiography and fluoroscopy, together with reliable catheter tip tracking for motion compensation. These tasks remain challenging in ECG-free settings and when only limited manual annotations are available. We present a unified DRM framework that simultaneously performs cardiac phase matching and catheter tip tracking for accurate real-time guidance. Our method employs a large-scale spatio-temporal encoder pretrained on 16 million X-ray frames to learn cardiac motion dynamics. To the best of our knowledge, this is the first application of large-scale spatio-temporal pretraining for motion compensation in DRM. We further introduce auxiliary tasks based on ECG R-peak detection and catheter tip tracking, improving optimization while eliminating the need for extensive catheter mask annotations. Finally, a majority-voting postprocessing strategy aggregates temporal predictions, improving robustness and providing a confidence score that correlates with phase-matching error. Comprehensive evaluation on clinical X-ray datasets demonstrates state-of-the-art performance, achieving low temporal misalignment and robust phase-matching accuracy suitable for real-time DRM.

Magnetic particle imaging (MPI) enables real-time, radiation-free tracking of magnetic nanoparticle-coated instruments, making it highly suitable for interventional procedures. This study proposes a harmonic-aware transformer framework that directly predicts catheter tip positions from raw MPI voltage signals, eliminating the need for image reconstruction and reducing computational latency. The framework incorporates frequency-domain preprocessing to isolate the 2nd to 8th drive-field harmonics, enhancing the signal-to-noise ratio while preserving motion-relevant features. A transformer architecture with six encoder layers and eight attention heads is employed to learn spatio-temporal dependencies across the three receive axes (x, y, z) for accurate three-dimensional position estimation. The model is trained on simulated MPI signals and evaluated on real in vitro datasets under standard, bending, and heartbeat-like motion conditions. The proposed method achieves sub-millimeter localization accuracy, with a minimum L2 error of 0.103 +/- 0.092 mm and mean absolute errors (MAEs) of 0.039 +/- 0.046 mm, 0.054 +/- 0.049 mm, and 0.060 +/- 0.044 mm along the (x, y, z) axes, respectively, for the bending dataset. Across all datasets, the MAE ranges from 0.165 mm to 0.655 mm, demonstrating consistent performance. The optimized inference achieves a latency of 0.55 ms per frame and a throughput of approximately 1800 frames per second, confirming real-time capability. Compared with conventional MPI-guided approaches relying on image reconstruction, the proposed framework provides improved accuracy, reduced latency, and enhanced robustness under complex motion conditions. These results highlight the potential of harmonic-aware transformer models as efficient and scalable solutions for real-time catheter localization in interventional MPI.

Achieving both efficient pushability (propulsion transmission) and proximally concentrated bending for steerability is challenging for magnetically actuated soft catheters: higher axial/bending stiffness improves force transmission but reduces steerability, whereas lower stiffness enables large, proximally concentrated bending yet increases kinking/buckling risk under compressive push loads. To address this trade-off, we propose a stiffness-optimized multi-segment magnetically actuated catheter (SO-MAC) that integrates a decoupled steering-advancement mechanism with a gradient-stiffness architecture. The SO-MAC concentrates bending about a stable proximal pivot during advancement while the distal section passively self-straightens to transmit propulsion, aided by the optimized stiffness distribution and elastic recovery of the spring backbone against friction-induced kinking/buckling. Over $0{-}180^{\circ}$ combined steering and advancement, the pivot remained stable and the distal tip advanced near-straight toward the target direction. A 1.5 mm-diameter SO-MAC achieved up to $180^{\circ}$ steering with a 3 mm bending radius at its 10 mm tip, with an average shape error of $1.39 \pm 0.56$ mm and a steering-pivot error of $0.35 \pm 0.10$ mm. Visual feedback control in a bronchial phantom further confirmed robust navigation through highly curved, bifurcating paths.

Purpose: Mechanical thrombectomy (MT) improves stroke outcomes, but is limited by a lack of local treatment access. Widespread distribution of reinforcement learning (RL)-based robotic systems can be used to alleviate this challenge through autonomous navigation, but current RL methods require live device tip coordinate tracking to function. This paper aims to develop and evaluate a real-time catheter tip tracking pipeline under fluoroscopy, addressing challenges such as low contrast, noise, and device occlusion. Methods: A multi-threaded pipeline was designed, incorporating frame reading, preprocessing, inference, and post-processing. Deep learning segmentation models, including U-Net, U-Net+Transformer, and SegFormer, were trained and benchmarked using two-class and three-class formulations. Post-processing involved two-step component filtering, one-pixel medial skeletonization, and greedy arc-length path following with contour fall-back. Results: On manually-labeled moderate complexity fluoroscopic video data, the two-class SegFormer achieved a mean absolute error of 4.44 mm, outperforming U-Net (4.60 mm), U-Net+Transformer (6.20 mm) and all three-class models (5.19-7.74 mm). On segmentation benchmarks, the system exceeded state-of-the-art CathAction results with improvements of up to +5% in Dice scores for three-segmentation. Conclusion: The results demonstrate that the proposed multi-threaded tracking framework maintains stable performance under challenging imaging conditions, outperforming prior benchmarks, while providing a reliable and efficient foundation for RL-based autonomous MT navigation.

Equipping robotic systems with the capacity to generate $\textit{ex novo}$ hardware during operation extends physical adaptability. Unlike modular systems that rely on discrete component integration pre- or post-deployment, we envision physical adaptation through continuous in-body development via hardware synthesis. Drawing inspiration from circulatory systems that redistribute mass and function in biological organisms, we utilize fluidics to restructure the material interface, a capability currently unmatched in robotics. Here, we realize this proof-of-concept hardware generation through a vascularized robotic composite designed for programmable material synthesis, demonstrated via receptogenesis - the on-demand construction of sensors. By coordinating the fluidic transport of precursors with external localized UV irradiation, we drove an $\textit{in situ}$ photopolymerization that chemically reconstructed the vasculature from the inside out. This reaction converted precursors with photolatent initiator into a solid dispersion of UV-sensitive polypyrrole in PETG, establishing a sensing modality validated by a characteristic decrease in electrical impedance. The newly synthesized sensor closed a local control loop in real time to regulate wing flapping in a moth-inspired robotic demonstrator. Our work is a proof-of-concept materials basis for $\textit{ex novo}$ hardware generation in a vascularized composite - a step towards situated robots adapting to environmental cues.