arXiv subjects

Yuan Bi

Publications and source records attributed to Yuan Bi.

At least 19 recordsLinked to original sources

arXiv2026

SurgOnAir: Hierarchy-Aware Real-Time Surgical Video Commentary

Understanding surgical workflow in real time is fundamental for intelligent surgical embodiment, where AI systems continuously perceive and respond as surgery proceeds. In the operating room, critical decisions depend on subtle, moment-to-moment changes, such as fine instrument movements and evolving tissue states, where even slight perceptual delays can limit assistance or compromise safety. Yet existing methods remain offline or operate at coarse temporal scales, generating descriptions only after processing clips, preventing immediate reaction. We address this by proposing SurgOnAir, a streaming vision-language model that processes frames sequentially without future access and progressively generates narration tokens as visual input arrives. SurgOnAir achieves fine-grained frame-to-token generation, enabling instant responsiveness to evolving surgical dynamics. Built upon our curated hierarchical dataset SurgOnAir-11k spanning action-, step-, and phase-level supervision, the model is trained to produce multi-level textual responses that reflect the inherent hierarchy of surgical procedures. Furthermore, special transition tokens are generated to explicitly mark state changes, allowing SurgOnAir to capture and signal key workflow transitions as they occur. Experiments show that SurgOnAir enables real-time understanding through a single vision-language model that unifies streaming across multiple hierarchies of the surgical workflow, generating superior and hierarchy-aware narrations. Code and dataset will be public.

cs.CV↗

arXiv2026

Look-Closer-Then-Diagnose: Confidence-Aware Ultrasound VQA via Active Zooming

Vision-Language Models (VLMs) have significantly advanced medical visual question answering, yet their performance in ultrasound remains suboptimal. In clinical practice, sonographers explicitly focus on lesion regions to formulate reports, though diagnostic interpretations sometimes vary due to inherent subjectivity. However, existing VLMs are not explicitly structured to interactively zoom into lesions prior to diagnosis; moreover, they typically treat annotations as unbiased ground truths, failing to account for their inherent subjectivity and ambiguity. In this paper, we propose a framework specifically designed to consider the sonographer's cognitive workflow. We first introduce a structured Zoom-then-Diagnose paradigm, which replicates the interactive search process to enable lesion-focused reasoning. Furthermore, within the Group Relative Policy Optimization (GRPO) framework, we introduce an uncertainty-aware reward derived from stochastic group-wise rollouts to estimate prediction consistency as a proxy for model confidence. Together, these two components encourage the model to reinforce accurate predictions on clear cases while remaining cautious under ambiguity. Experiments across liver, breast, and thyroid datasets show that our framework improves lesion localization by 39.3\%, demonstrating that our model has learned the ability to actively look closer and diagnose.

cs.CV↗

arXiv2026

Feasibility of Augmented Reality-Guided Robotic Ultrasound with Cone-Beam CT Integration for Spine Procedures

Accurate needle placement in spine interventions is critical for effective pain management, yet it depends on reliable identification of anatomical landmarks and careful trajectory planning. Conventional imaging guidance often relies both on CT and X-ray fluoroscopy, exposing patients and staff to high dose of radiation while providing limited real-time 3D feedback. We present an optical see-through augmented reality (OST-AR)-guided robotic system for spine procedures that provides in situ visualization of spinal structures to support needle trajectory planning. We integrate a cone-beam CT (CBCT)-derived 3D spine model which is co-registered with live ultrasound, enabling users to combine global anatomical context with local, real-time imaging. We evaluated the system in a phantom user study involving two representative spine procedures: facet joint injection and lumbar puncture. Sixteen participants performed insertions under two visualization conditions: conventional screen vs. AR. Results show that AR significantly reduces execution time and across-task placement error, while also improving usability, trust, and spatial understanding and lowering cognitive workload. These findings demonstrate the feasibility of AR-guided robotic ultrasound for spine interventions, highlighting its potential to enhance accuracy, efficiency, and user experience in image-guided procedures.

cs.HC↗

arXiv2026

From Scanning Guidelines to Action: A Robotic Ultrasound Agent with LLM-Based Reasoning

Robotic ultrasound offers advantages over free-hand scanning, including improved reproducibility and reduced operator dependency. In clinical practice, US acquisition relies heavily on the sonographer's experience and situational judgment. When transferring this process to robotic systems, such expertise is often encoded explicitly through fixed procedures and task-specific models, yielding pipelines that can be difficult to adapt to new scanning tasks. In this work, we propose a unified framework for autonomous robotic US scanning that leverages a LLM-based agent to interpret US scanning guidelines and execute scans by dynamically invoking a set of provided software tools. Instead of encoding fixed scanning procedures, the LLM agent retrieves and reasons over guideline steps from scanning handbooks and adapts its planning decisions based on observations and the current scanning state. This enables the system to handle variable and decision-dependent workflows, such as adjusting scanning strategies, repeating steps, or selecting the appropriate next tool call in response to image quality or anatomical findings. Because the reasoning underlying tool selection is also critical for transparent and trustworthy planning, we further fine tune the LLM agent using a RL based strategy to improve both its reasoning quality and the correctness of tool selection and parameterization, while maintaining robust generalization to unseen guidelines and related tasks. We first validate the approach via verbal execution on 10 US scanning guidelines, assessing reasoning as well as tool selection and parameterization, and showing the benefit of RL fine tuning. We then demonstrate real world feasibility on robotic scanning of the gallbladder, spine, and kidney. Overall, the framework follows diverse guidelines and enables reliable autonomous scanning across multiple anatomical targets within a unified system.

cs.RO↗

arXiv2026

Robotic Ultrasound Makes CBCT Alive

Intraoperative Cone Beam Computed Tomography (CBCT) provides a reliable 3D anatomical context essential for interventional planning. However, its static nature fails to provide continuous monitoring of soft-tissue deformations induced by respiration, probe pressure, and surgical manipulation, leading to navigation discrepancies. We propose a deformation-aware CBCT updating framework that leverages robotic ultrasound as a dynamic proxy to infer tissue motion and update static CBCT slices in real time. Starting from calibration-initialized alignment with linear correlation of linear combination (LC2)-based rigid refinement, our method establishes accurate multimodal correspondence. To capture intraoperative dynamics, we introduce the ultrasound correlation UNet (USCorUNet), a lightweight network trained with optical flow-guided supervision to learn deformation-aware correlation representations, enabling accurate, real-time dense deformation field estimation from ultrasound streams. The inferred deformation is spatially regularized and transferred to the CBCT reference to produce deformation-consistent visualizations without repeated radiation exposure. We validate the proposed approach through deformation estimation and ultrasound-guided CBCT updating experiments. Results demonstrate real-time end-to-end CBCT slice updating and physically plausible deformation estimation, enabling dynamic refinement of static CBCT guidance during robotic ultrasound-assisted interventions. The source code is publicly available at https://github.com/anonymous-codebase/us-cbct-demo.

cs.CV↗

arXiv2026

DAISS: Phase-Aware Imitation Learning for Dual-Arm Robotic Ultrasound-Guided Interventions

Imitation learning has shown strong potential for automating complex robotic manipulation. In medical robotics, ultrasound-guided needle insertion demands precise bimanual coordination, as clinicians must simultaneously manipulate an ultrasound probe to maintain an optimal acoustic view while steering an interventional needle. Automating this asymmetric workflow -- and reliably transferring expert strategies to robots -- remains highly challenging. In this paper, we present the Dual-Arm Interventional Surgical System (DAISS), a teleoperated platform that collects high-fidelity dual-arm demonstrations and learns a phase-aware imitation policy for ultrasound-guided interventions. To avoid constraining the operator's natural behavior, DAISS uses a flexible NDI-based leader interface for teleoperating two coordinated follower arms. To support robust execution under real-time ultrasound feedback, we develop a lightweight, data-efficient imitation policy. Specifically, the policy incorporates a phase-aware architecture and a dynamic mask loss tailored to asymmetric bimanual control. Conditioned on a planned trajectory, the network fuses real-time ultrasound with external visual observations to generate smooth, coordinated dual-arm motions. Experimental results show that DAISS can learn personalized expert strategies from limited demonstrations. Overall, these findings highlight the promise of phase-aware imitation-learning-driven dual-arm robots for improving precision and reducing cognitive workload in image-guided interventions.

cs.RO↗

arXiv2026

Ultrasound-Guided Real-Time Spinal Motion Visualization for Spinal Instability Assessment

Purpose: Spinal instability is a widespread condition that causes pain, fatigue, and restricted mobility, profoundly affecting patients' quality of life. In clinical practice, the gold standard for diagnosis is dynamic X-ray imaging. However, X-ray provides only 2D motion information, while 3D modalities such as computed tomography (CT) or cone beam computed tomography (CBCT) cannot efficiently capture motion. Therefore, there is a need for a system capable of visualizing real-time 3D spinal motion while minimizing radiation exposure. Methods: We propose ultrasound as an auxiliary modality for 3D spine visualization. Due to acoustic limitations, ultrasound captures only the superficial spinal surface. Therefore, the partially compounded ultrasound volume is registered to preoperative 3D imaging. In this study, CBCT provides the neutral spine configuration, while robotic ultrasound acquisition is performed at maximal spinal bending. A kinematic model is applied to the CBCT-derived spine model for coarse registration, followed by ICP for fine registration, with kinematic parameters optimized based on the registration results. Real-time ultrasound motion tracking is then used to estimate continuous 3D spinal motion by interpolating between the neutral and maximally bent states. Results: The pipeline was evaluated on a bendable 3D-printed lumbar spine phantom. The registration error was $1.941 \pm 0.199$ mm and the interpolated spinal motion error was $2.01 \pm 0.309$ mm (median). Conclusion: The proposed robotic ultrasound framework enables radiation-reduced, real-time 3D visualization of spinal motion, offering a promising 3D alternative to conventional dynamic X-ray imaging for assessing spinal instability.

physics.med-ph↗

arXiv2026

Comparative Study of Ultrasound Shape Completion and CBCT-Based AR Workflows for Spinal Needle Interventions

Purpose: This study compares two augmented reality (AR)-guided imaging workflows, one based on ultrasound shape completion and the other on cone-beam computed tomography (CBCT), for planning and executing lumbar needle interventions. The aim is to assess how imaging modality influences user performance, usability, and trust during AR-assisted spinal procedures. Methods: Both imaging systems were integrated into an AR framework, enabling in situ visualization and trajectory guidance. The ultrasound-based workflow combined AR-guided robotic scanning, probabilistic shape completion, and AR visualization. The CBCT-based workflow used AR-assisted scan volume planning, CBCT acquisition, and AR visualization. A between-subject user study was conducted and evaluated in two phases: (1) planning and image acquisition, and (2) needle insertion. Results: Planning time was significantly shorter with the CBCT-based workflow, while SUS, SEQ, and NASA-TLX were comparable between modalities. In the needle insertion phase, the CBCT-based workflow yielded marginally faster insertion times, lower placement error, and better subjective ratings with higher Trust. The ultrasound-based workflow achieved adequate accuracy for facet joint insertion, but showed larger errors for lumbar puncture, where reconstructions depended more heavily on shape completion. Conclusion: The findings indicate that both AR-guided imaging pipelines are viable for spinal intervention support. CBCT-based AR offers advantages in efficiency, precision, usability, and user confidence during insertion, whereas ultrasound-based AR provides adaptive, radiation-free imaging but is limited by shape completion in deeper spinal regions. These complementary characteristics motivate hybrid AR guidance that uses CBCT for global anatomical context and planning, augmented by ultrasound for adaptive intraoperative updates.

cs.HC↗

arXiv2025

Intelligent Virtual Sonographer (IVS): Enhancing Physician-Robot-Patient Communication

The advancement and maturity of large language models (LLMs) and robotics have unlocked vast potential for human-computer interaction, particularly in the field of robotic ultrasound. While existing research primarily focuses on either patient-robot or physician-robot interaction, the role of an intelligent virtual sonographer (IVS) bridging physician-robot-patient communication remains underexplored. This work introduces a conversational virtual agent in Extended Reality (XR) that facilitates real-time interaction between physicians, a robotic ultrasound system(RUS), and patients. The IVS agent communicates with physicians in a professional manner while offering empathetic explanations and reassurance to patients. Furthermore, it actively controls the RUS by executing physician commands and transparently relays these actions to the patient. By integrating LLM-powered dialogue with speech-to-text, text-to-speech, and robotic control, our system enhances the efficiency, clarity, and accessibility of robotic ultrasound acquisition. This work constitutes a first step toward understanding how IVS can bridge communication gaps in physician-robot-patient interaction, providing more control and therefore trust into physician-robot interaction while improving patient experience and acceptance of robotic ultrasound.

cs.HC↗

arXiv2025

UltraAD: Fine-Grained Ultrasound Anomaly Classification via Few-Shot CLIP Adaptation

Precise anomaly detection in medical images is critical for clinical decision-making. While recent unsupervised or semi-supervised anomaly detection methods trained on large-scale normal data show promising results, they lack fine-grained differentiation, such as benign vs. malignant tumors. Additionally, ultrasound (US) imaging is highly sensitive to devices and acquisition parameter variations, creating significant domain gaps in the resulting US images. To address these challenges, we propose UltraAD, a vision-language model (VLM)-based approach that leverages few-shot US examples for generalized anomaly localization and fine-grained classification. To enhance localization performance, the image-level token of query visual prototypes is first fused with learnable text embeddings. This image-informed prompt feature is then further integrated with patch-level tokens, refining local representations for improved accuracy. For fine-grained classification, a memory bank is constructed from few-shot image samples and corresponding text descriptions that capture anatomical and abnormality-specific features. During training, the stored text embeddings remain frozen, while image features are adapted to better align with medical data. UltraAD has been extensively evaluated on three breast US datasets, outperforming state-of-the-art methods in both lesion localization and fine-grained medical classification. The code will be released upon acceptance.

cs.CV↗

arXiv2025

Does Machine Unlearning Truly Remove Knowledge?

In recent years, Large Language Models (LLMs) have achieved remarkable advancements, drawing significant attention from the research community. Their capabilities are largely attributed to large-scale architectures, which require extensive training on massive datasets. However, such datasets often contain sensitive or copyrighted content sourced from the public internet, raising concerns about data privacy and ownership. Regulatory frameworks, such as the General Data Protection Regulation (GDPR), grant individuals the right to request the removal of such sensitive information. This has motivated the development of machine unlearning algorithms that aim to remove specific knowledge from models without the need for costly retraining. Despite these advancements, evaluating the efficacy of unlearning algorithms remains a challenge due to the inherent complexity and generative nature of LLMs. In this work, we introduce a comprehensive auditing framework for unlearning evaluation, comprising three benchmark datasets, six unlearning algorithms, and five prompt-based auditing methods. By using various auditing algorithms, we evaluate the effectiveness and robustness of different unlearning strategies. To explore alternatives beyond prompt-based auditing, we propose a novel technique that leverages intermediate activation perturbations, addressing the limitations of auditing methods that rely solely on model inputs and outputs.

cs.LG↗

arXiv2025

Robotic CBCT Meets Robotic Ultrasound

The multi-modality imaging system offers optimal fused images for safe and precise interventions in modern clinical practices, such as computed tomography - ultrasound (CT-US) guidance for needle insertion. However, the limited dexterity and mobility of current imaging devices hinder their integration into standardized workflows and the advancement toward fully autonomous intervention systems. In this paper, we present a novel clinical setup where robotic cone beam computed tomography (CBCT) and robotic US are pre-calibrated and dynamically co-registered, enabling new clinical applications. This setup allows registration-free rigid registration, facilitating multi-modal guided procedures in the absence of tissue deformation. First, a one-time pre-calibration is performed between the systems. To ensure a safe insertion path by highlighting critical vasculature on the 3D CBCT, SAM2 segments vessels from B-mode images, using the Doppler signal as an autonomously generated prompt. Based on the registration, the Doppler image or segmented vessel masks are then mapped onto the CBCT, creating an optimally fused image with comprehensive detail. To validate the system, we used a specially designed phantom, featuring lesions covered by ribs and multiple vessels with simulated moving flow. The mapping error between US and CBCT resulted in an average deviation of 1.72+-0.62 mm. A user study demonstrated the effectiveness of CBCT-US fusion for needle insertion guidance, showing significant improvements in time efficiency, accuracy, and success rate. Needle intervention performance improved by approximately 50% compared to the conventional US-guided workflow. We present the first robotic dual-modality imaging system designed to guide clinical applications. The results show significant performance improvements compared to traditional manual interventions.

cs.RO↗

arXiv2025

Gaze-Guided Robotic Vascular Ultrasound Leveraging Human Intention Estimation

Medical ultrasound has been widely used to examine vascular structure in modern clinical practice. However, traditional ultrasound examination often faces challenges related to inter- and intra-operator variation. The robotic ultrasound system (RUSS) appears as a potential solution for such challenges because of its superiority in stability and reproducibility. Given the complex anatomy of human vasculature, multiple vessels often appear in ultrasound images, or a single vessel bifurcates into branches, complicating the examination process. To tackle this challenge, this work presents a gaze-guided RUSS for vascular applications. A gaze tracker captures the eye movements of the operator. The extracted gaze signal guides the RUSS to follow the correct vessel when it bifurcates. Additionally, a gaze-guided segmentation network is proposed to enhance segmentation robustness by exploiting gaze information. However, gaze signals are often noisy, requiring interpretation to accurately discern the operator's true intentions. To this end, this study proposes a stabilization module to process raw gaze data. The inferred attention heatmap is utilized as a region proposal to aid segmentation and serve as a trigger signal when the operator needs to adjust the scanning target, such as when a bifurcation appears. To ensure appropriate contact between the probe and surface during scanning, an automatic ultrasound confidence-based orientation correction method is developed. In experiments, we demonstrated the efficiency of the proposed gaze-guided segmentation pipeline by comparing it with other methods. Besides, the performance of the proposed gaze-guided RUSS was also validated as a whole on a realistic arm phantom with an uneven surface.

cs.RO↗

arXiv2024

Synomaly Noise and Multi-Stage Diffusion: A Novel Approach for Unsupervised Anomaly Detection in Medical Images

Anomaly detection in medical imaging plays a crucial role in identifying pathological regions across various imaging modalities, such as brain MRI, liver CT, and carotid ultrasound (US). However, training fully supervised segmentation models is often hindered by the scarcity of expert annotations and the complexity of diverse anatomical structures. To address these issues, we propose a novel unsupervised anomaly detection framework based on a diffusion model that incorporates a synthetic anomaly (Synomaly) noise function and a multi-stage diffusion process. Synomaly noise introduces synthetic anomalies into healthy images during training, allowing the model to effectively learn anomaly removal. The multi-stage diffusion process is introduced to progressively denoise images, preserving fine details while improving the quality of anomaly-free reconstructions. The generated high-fidelity counterfactual healthy images can further enhance the interpretability of the segmentation models, as well as provide a reliable baseline for evaluating the extent of anomalies and supporting clinical decision-making. Notably, the unsupervised anomaly detection model is trained purely on healthy images, eliminating the need for anomalous training samples and pixel-level annotations. We validate the proposed approach on brain MRI, liver CT datasets, and carotid US. The experimental results demonstrate that the proposed framework outperforms existing state-of-the-art unsupervised anomaly detection methods, achieving performance comparable to fully supervised segmentation models in the US dataset. Ablation studies further highlight the contributions of Synomaly noise and the multi-stage diffusion process in improving anomaly segmentation. These findings underscore the potential of our approach as a robust and annotation-efficient alternative for medical anomaly detection.

eess.IV↗

arXiv2024

Needle Segmentation Using GAN: Restoring Thin Instrument Visibility in Robotic Ultrasound

Ultrasound-guided percutaneous needle insertion is a standard procedure employed in both biopsy and ablation in clinical practices. However, due to the complex interaction between tissue and instrument, the needle may deviate from the in-plane view, resulting in a lack of close monitoring of the percutaneous needle. To address this challenge, we introduce a robot-assisted ultrasound (US) imaging system designed to seamlessly monitor the insertion process and autonomously restore the visibility of the inserted instrument when misalignment happens. To this end, the adversarial structure is presented to encourage the generation of segmentation masks that align consistently with the ground truth in high-order space. This study also systematically investigates the effects on segmentation performance by exploring various training loss functions and their combinations. When misalignment between the probe and the percutaneous needle is detected, the robot is triggered to perform transverse searching to optimize the positional and rotational adjustment to restore needle visibility. The experimental results on ex-vivo porcine samples demonstrate that the proposed method can precisely segment the percutaneous needle (with a tip error of $0.37\pm0.29mm$ and an angle error of $1.19\pm 0.29^{\circ}$). Furthermore, the needle appearance can be successfully restored under the repositioned probe pose in all 45 trials, with repositioning errors of $1.51\pm0.95mm$ and $1.25\pm0.79^{\circ}$. from latex to text with math symbols

cs.RO↗

arXiv2024

Class-Aware Cartilage Segmentation for Autonomous US-CT Registration in Robotic Intercostal Ultrasound Imaging

Ultrasound imaging has been widely used in clinical examinations owing to the advantages of being portable, real-time, and radiation-free. Considering the potential of extensive deployment of autonomous examination systems in hospitals, robotic US imaging has attracted increased attention. However, due to the inter-patient variations, it is still challenging to have an optimal path for each patient, particularly for thoracic applications with limited acoustic windows, e.g., intercostal liver imaging. To address this problem, a class-aware cartilage bone segmentation network with geometry-constraint post-processing is presented to capture patient-specific rib skeletons. Then, a dense skeleton graph-based non-rigid registration is presented to map the intercostal scanning path from a generic template to individual patients. By explicitly considering the high-acoustic impedance bone structures, the transferred scanning path can be precisely located in the intercostal space, enhancing the visibility of internal organs by reducing the acoustic shadow. To evaluate the proposed approach, the final path mapping performance is validated on five distinct CTs and two volunteer US data, resulting in ten pairs of CT-US combinations. Results demonstrate that the proposed graph-based registration method can robustly and precisely map the path from CT template to individual patients (Euclidean error: $2.21\pm1.11~mm$).

cs.CV↗

arXiv2024

Autonomous Path Planning for Intercostal Robotic Ultrasound Imaging Using Reinforcement Learning

Ultrasound (US) has been widely used in daily clinical practice for screening internal organs and guiding interventions. However, due to the acoustic shadow cast by the subcutaneous rib cage, the US examination for thoracic application is still challenging. To fully cover and reconstruct the region of interest in US for diagnosis, an intercostal scanning path is necessary. To tackle this challenge, we present a reinforcement learning (RL) approach for planning scanning paths between ribs to monitor changes in lesions on internal organs, such as the liver and heart, which are covered by rib cages. Structured anatomical information of the human skeleton is crucial for planning these intercostal paths. To obtain such anatomical insight, an RL agent is trained in a virtual environment constructed using computational tomography (CT) templates with randomly initialized tumors of various shapes and locations. In addition, task-specific state representation and reward functions are introduced to ensure the convergence of the training process while minimizing the effects of acoustic attenuation and shadows during scanning. To validate the effectiveness of the proposed approach, experiments have been carried out on unseen CTs with randomly defined single or multiple scanning targets. The results demonstrate the efficiency of the proposed RL framework in planning non-shadowed US scanning trajectories in areas with limited acoustic access.

cs.RO↗

arXiv2024

Machine Learning in Robotic Ultrasound Imaging: Challenges and Perspectives

This article reviews the recent advances in intelligent robotic ultrasound (US) imaging systems. We commence by presenting the commonly employed robotic mechanisms and control techniques in robotic US imaging, along with their clinical applications. Subsequently, we focus on the deployment of machine learning techniques in the development of robotic sonographers, emphasizing crucial developments aimed at enhancing the intelligence of these systems. The methods for achieving autonomous action reasoning are categorized into two sets of approaches: those relying on implicit environmental data interpretation and those using explicit interpretation. Throughout this exploration, we also discuss practical challenges, including those related to the scarcity of medical data, the need for a deeper understanding of the physical aspects involved, and effective data representation approaches. Moreover, we conclude by highlighting the open problems in the field and analyzing different possible perspectives on how the community could move forward in this research area.

cs.RO↗