Sim2Real Learning With Domain Randomization for Autonomous Guidewire Navigation in Robotic-Assisted Endovascular Procedures

Over the past decade, significant advancements have been made in the research and industrialization of robotic systems for endovascular procedures, yet their clinical application remains relatively limited. Physicians commonly report that these robots lack certain intelligent assistive capabilities during procedures. There has been increasing interest and attempts to apply learning-centered algorithms to the training and enhancement of surgical robot skills. This paper proposes an autonomous navigation algorithm for interventional guidewires that is initially trained solely in a virtual simulation environment and subsequently deployed to a real-world robot. Experimental results demonstrate the feasibility of this approach for real-world applications. The proposed approach can help physicians reduce the learning curve for guidewire manipulation and elevate the robot to a higher level of autonomous operation, thereby breaking through the current bottleneck in the level of intelligence for clinical applications of interventional robots. It also holds promise for bringing intelligent transformation to future interventional procedures. Note to Practitioners—This work is motivated by the emerging need to increase the level of autonomy in robotic-assisted endovascular procedures, which has the potential to improve procedural efficiency, standardize procedures, and broaden the adoption of robotic systems in clinical practice. The proposed simulation-based reinforcement learning provides a safe and efficient method for training robotic systems, enabling them to master complex tasks in simulation environments prior to real-world application. The successful deployment of models trained in simulation onto physical robotic platforms demonstrates the feasibility of this method for real-world applications. The proposed simulation-based reinforcement learning method offers a promising and viable pathway for enhancing skill acquisition in endovascular interventional robots.