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Ultrasound (US) imaging is commonly used to assist in the diagnosis and interventions of spine diseases, while the standardized US acquisitions performed by manually operating the probe require substantial experience and training of sonographers. In this work, we propose a novel dual-agent framework that integrates a reinforcement learning (RL) agent and a deep learning (DL) agent to jointly determine the movement of the US probe based on the real-time US images, in order to mimic the decision-making process of an expert sonographer to achieve autonomous standard view acquisitions in spinal sonography. Moreover, inspired by the nature of US propagation and the characteristics of the spinal anatomy, we introduce a view-specific acoustic shadow reward to utilize the shadow information to implicitly guide the navigation of the probe toward different standard views of the spine. Our method is validated in both quantitative and qualitative experiments in a simulation environment built with US data acquired from 17 volunteers. The average navigation accuracy toward different standard views achieves <inline-formula> <tex-math notation="LaTeX">$5.18mm/5.25^{\circ }$ </tex-math></inline-formula> and <inline-formula> <tex-math notation="LaTeX">$12.87mm/17.49^{\circ }$ </tex-math></inline-formula> in the intra- and inter-subject settings, respectively. The results demonstrate that our method can effectively interpret the US images and navigate the probe to acquire multiple standard views of the spine.

Image-Guided Navigation of a Robotic Ultrasound Probe for Autonomous Spinal Sonography Using a Shadow-Aware Dual-Agent Framework