VA-Adapter: Adapting Ultrasound Foundation Model to Echocardiography Probe Guidance

Echocardiography is a critical tool for detecting heart diseases, yet its steep operational difficulty causes a shortage of skilled personnel. Probe guidance systems, which assist in acquiring high-quality images, offer a promising solution to lower this operational barrier. However, robust probe guidance remains challenging due to significant individual variability. This variability manifests as differences in low-level features within two-dimensional (2D) images, which complicates image feature understanding, and differences in individual three-dimensional (3D) structures, which poses challenges for precise navigation. To address these challenges, we first propose leveraging the robust image representations learned by ultrasound foundation models from vast datasets. Yet, applying these models to probe navigation is non-trivial due to their lack of understanding of individual 3D structures. To this end, we meticulously design a Vision-Action Adapter (VA-Adapter) to online inject the capability of understanding individual 3D structures. Specifically, by embedding the VA-Adapter into the foundation model's image encoder, the model can infer cardiac anatomy from historical vision-action sequences, mimicking the cognitive process of a sonographer. Extensive experiments on a dataset with over 1.31M samples demonstrate that the VA-Adapter outperforms strong probe guidance models while requiring approximately 33 times fewer trained parameters.