Intracardiac echocardiography (ICE) catheters enable high-quality ultrasound imaging within the heart, but their use in guiding procedures is limited due to the difficulty of manually pointing them at structures of interest. This paper presents the design and testing of a catheter steering model for robotic control of commercial ICE catheters. The four actuated degrees of freedom (4-DOF) are two catheter handle knobs to produce bi-directional bending in combination with rotation and translation of the handle. An extra degree of freedom in the system allows the imaging plane (dependent on orientation) to be directed at an object of interest. A closed form solution for forward and inverse kinematics enables control of the catheter tip position and the imaging plane orientation. The proposed algorithms were validated with a robotic test bed using electromagnetic sensor tracking of the catheter tip. The ability to automatically acquire imaging targets in the heart may improve the efficiency and effectiveness of intracardiac catheter interventions by allowing visualization of soft tissue structures that are not visible using standard fluoroscopic guidance. Although the system has been developed and tested for manipulating ICE catheters, the methods described here are applicable to any long thin tendon-driven tool (with single or bi-directional bending) requiring accurate tip position and orientation control.

A system for automatically pointing ultrasound (US) imaging catheters will enable clinicians to monitor anatomical structures and track instruments during interventional procedures. Off-the-shelf US catheters provide high quality US images from within the patient. While this method of imaging has been proven to be effective for guiding many interventional treatments, significant training is required to overcome the difficulty in manually steering the imager to point at desired structures. Our system uses closed-form four degree of freedom (DOF) kinematic solutions to automatically position the US catheter and point the imager. Algorithms for steering and imager pointing were developed for a range of useful diagnostic and interventional motions. The system was validated on a robotic test bed by steering the catheter within a water environment containing phantom objects. While the system described here was designed for pointing ultrasound catheters, these algorithms are applicable to accurate 4-DOF steering and orientation control of any long thin tendon-driven tool with single or bi-directional bending.

Cardiac catheterization with ultrasound (US) imaging catheters provides real time US imaging from within the heart, but manually navigating a four degree of freedom (DOF) imaging catheter is difficult and requires extensive training. Existing work has demonstrated robotic catheter steering in constrained bench top environments. Closed-loop control in an unconstrained setting, such as patient vasculature, remains a significant challenge due to friction, backlash, and physiological disturbances. In this paper we present a new method for closed-loop control of the catheter tip that can accurately and robustly steer 4-DOF cardiac catheters and other flexible manipulators despite these effects. The performance of the system is demonstrated in a vasculature phantom and an in vivo porcine animal model. During bench top studies the robotic system converged to the desired US imager pose with sub-millimeter and sub-degree-level accuracy. During animal trials the system achieved 2.0 mm and 0.65° accuracy. Accurate and robust robotic navigation of flexible manipulators will enable enhanced visualization and treatment during procedures.

Abstract. This paper presents a modified controller and expanded algorithms for automatically positioning cardiac ultrasound imaging catheters within the heart to improve treatment of cardiac arrhythmias such as atrial fibrillation. Presented here are a new method for controlling the position and orientation of a catheter, smoother and more accurate automated catheter motion, and initial results of image processing into clinically use-ful displays. Ultrasound imaging (intracardiac echo, or ICE) catheters are steered by four actuated degrees of freedom (DOF) to produce bi-directional bending in combination with handle rotation and translation. Closed form solutions for forward and inverse kinematics enable position control of the catheter tip. Additional kinematic calculations enable 1-DOF angular control of the imaging plane. The combination of positioning with imager rotation enables a wide range of visualization capabilities, such as recording a sequence of ultrasound images and reconstructing them into 3D or 4D volumes for diagnosis and treatment. The algorithms were validated with a robotic test bed and the resulting images were reconstructed into 3D volumes. This capability may improve the efficiency and effectiveness of intracardiac catheter interventions by allowing visualization of soft tissues or working instruments. The methods described here are applicable to any long thin tendon-driven tool (with single or bi-directional bending) requiring accurate tip position and orientation control.

In this paper, we present the design, fabrication, and testing of a robot for automatically positioning ultrasound (US) imaging catheters. Our system will point US catheters to provide real-time imaging of anatomical structures and working instruments during minimally invasive procedures. Manually navigating US catheters is difficult and requires extensive training in order to aim the US imager at desired targets. Therefore, a four-degree-of-freedom (4DOF) robotic system was developed to automatically navigate US imaging catheters for enhanced imaging. A rotational transmission enables 3DOF for pitch, yaw, and roll of the imager. This transmission is translated by the 4DOF. An accuracy analysis calculated the maximum allowable joint motion error. Rotational joints must be accurate to within 1.5 deg, and the translational joint must be accurate within 1.4 mm. Motion tests then validated the accuracy of the robot. The average resulting errors in positioning of the rotational joints were 0.04-0.22 deg. The average measured backlash was 0.18-0.86 deg. Measurements of average translational positioning and backlash errors were negligible. The resulting joint motion errors were well within the required specifications for accurate robot motion. The output of the catheter was then tested to verify the effectiveness of the handle motions to transmit torques and translations to the catheter tip. The catheter tip was navigated to desired target poses with average error 1.3 mm and 0.71 deg. Such effective manipulation of US imaging catheters will enable better visualization in various procedures ranging from cardiac arrhythmia treatment to tumor removal in urological cases.