Sequence-aware Pre-training for Echocardiography Probe Guidance

Cardiac ultrasound probe guidance aims to help novices adjust the 6-DOF probe pose to obtain high-quality sectional images. Cardiac ultrasound faces two major challenges: (1) the inherently complex structure of the heart, and (2) significant individual variations. Previous works have only learned the population-averaged 2D and 3D structures of the heart rather than personalized cardiac structural features, leading to a performance bottleneck. Clinically, we observed that sonographers adjust their understanding of a patient's cardiac structure based on prior scanning sequences, thereby modifying their scanning strategies. Inspired by this, we propose a sequence-aware self-supervised pre-training method. Specifically, our approach learns personalized 2D and 3D cardiac structural features by predicting the masked-out images and actions in a scanning sequence. We hypothesize that if the model can predict the missing content it has acquired a good understanding of the personalized cardiac structure. In the downstream probe guidance task, we also introduced a sequence modeling approach that models individual cardiac structural information based on the images and actions from historical scan data, enabling more accurate navigation decisions. Experiments on a large-scale dataset with 1.36 million samples demonstrated that our proposed sequence-aware paradigm can significantly reduce navigation errors, with translation errors decreasing by 15.90% to 36.87% and rotation errors decreasing by 11.13% to 20.77%, compared to state-of-the-art methods.

Structure-aware World Model for Probe Guidance via Large-scale Self-supervised Pre-train

The complex structure of the heart leads to significant challenges in echocardiography, especially in acquisition cardiac ultrasound images. Successful echocardiography requires a thorough understanding of the structures on the two-dimensional plane and the spatial relationships between planes in three-dimensional space. In this paper, we innovatively propose a large-scale self-supervised pre-training method to acquire a cardiac structure-aware world model. The core innovation lies in constructing a self-supervised task that requires structural inference by predicting masked structures on a 2D plane and imagining another plane based on pose transformation in 3D space. To support large-scale pre-training, we collected over 1.36 million echocardiograms from ten standard views, along with their 3D spatial poses. In the downstream probe guidance task, we demonstrate that our pre-trained model consistently reduces guidance errors across the ten most common standard views on the test set with 0.29 million samples from 74 routine clinical scans, indicating that structure-aware pre-training benefits the scanning.

Cardiac Copilot: Automatic Probe Guidance for Echocardiography with World Model

Echocardiography is the only technique capable of real-time imaging of the heart and is vital for diagnosing the majority of cardiac diseases. However, there is a severe shortage of experienced cardiac sonographers, due to the heart's complex structure and significant operational challenges. To mitigate this situation, we present a Cardiac Copilot system capable of providing real-time probe movement guidance to assist less experienced sonographers in conducting freehand echocardiography. This system can enable non-experts, especially in primary departments and medically underserved areas, to perform cardiac ultrasound examinations, potentially improving global healthcare delivery. The core innovation lies in proposing a data-driven world model, named Cardiac Dreamer, for representing cardiac spatial structures. This world model can provide structure features of any cardiac planes around the current probe position in the latent space, serving as an precise navigation map for autonomous plane localization. We train our model with real-world ultrasound data and corresponding probe motion from 110 routine clinical scans with 151K sample pairs by three certified sonographers. Evaluations on three standard planes with 37K sample pairs demonstrate that the world model can reduce navigation errors by up to 33\% and exhibit more stable performance.