Estimation of wall shear stress using 4D flow cardiovascular MRI and computational fluid dynamics

Electronic version of an article published as Journal of mechanics in medicine and biology, 0, 1750046 (2016), 16 pages. DOI:10.1142/S0219519417500464 © World Scientific Publishing CompanyIn the last few years, wall shear stress (WSS) has arisen as a new diagnostic indicator in patients with arterial disease. There is a substantial evidence that the WSS plays a significant role, together with hemodynamic indicators, in initiation and progression of the vascular diseases. Estimation of WSS values, therefore, may be of clinical significance and the methods employed for its measurement are crucial for clinical community. Recently, four-dimensional (4D) flow cardiovascular magnetic resonance (CMR) has been widely used in a number of applications for visualization and quantification of blood flow, and although the sensitivity to blood flow measurement has increased, it is not yet able to provide an accurate three-dimensional (3D) WSS distribution. The aim of this work is to evaluate the aortic blood flow features and the associated WSS by the combination of 4D flow cardiovascular magnetic resonance (4D CMR) and computational fluid dynamics technique. In particular, in this work, we used the 4D CMR to obtain the spatial domain and the boundary conditions needed to estimate the WSS within the entire thoracic aorta using computational fluid dynamics. Similar WSS distributions were found for cases simulated. A sensitivity analysis was done to check the accuracy of the method. 4D CMR begins to be a reliable tool to estimate the WSS within the entire thoracic aorta using computational fluid dynamics. The combination of both techniques may provide the ideal tool to help tackle these and other problems related to wall shear estimation.Peer ReviewedPostprint (author's final draft

Local implicit modeling of blood vessels for interactive simulation

International audienceIn the context of computer-based simulation, contact management requires an accurate, smooth, but still efficient surface model for the blood vessels. A new implicit model is proposed, consisting of a tree of local implicit surfaces generated by skeletons ({\em blobby models}). The surface is reconstructed from data points by minimizing an energy, alternating with an original blob selection and subdivision scheme. The reconstructed models are very efficient for simulation and were shown to provide a sub-voxel approximation of the vessel surface on 5 patients

Accurate geometry reconstruction of vascular structures using implicit splines

3-D visualization of blood vessel from standard medical datasets (e.g. CT or MRI) play an important role in many clinical situations, including the diagnosis of vessel stenosis, virtual angioscopy, vascular surgery planning and computer aided vascular surgery. However, unlike other human organs, the vasculature system is a very complex network of vessel, which makes it a very challenging task to perform its 3-D visualization. Conventional techniques of medical volume data visualization are in general not well-suited for the above-mentioned tasks. This problem can be solved by reconstructing vascular geometry. Although various methods have been proposed for reconstructing vascular structures, most of these approaches are model-based, and are usually too ideal to correctly represent the actual variation presented by the cross-sections of a vascular structure. In addition, the underlying shape is usually expressed as polygonal meshes or in parametric forms, which is very inconvenient for implementing ramification of branching. As a result, the reconstructed geometries are not suitable for computer aided diagnosis and computer guided minimally invasive vascular surgery. In this research, we develop a set of techniques associated with the geometry reconstruction of vasculatures, including segmentation, modelling, reconstruction, exploration and rendering of vascular structures. The reconstructed geometry can not only help to greatly enhance the visual quality of 3-D vascular structures, but also provide an actual geometric representation of vasculatures, which can provide various benefits. The key findings of this research are as follows: 1. A localized hybrid level-set method of segmentation has been developed to extract the vascular structures from 3-D medical datasets. 2. A skeleton-based implicit modelling technique has been proposed and applied to the reconstruction of vasculatures, which can achieve an accurate geometric reconstruction of the vascular structures as implicit surfaces in an analytical form. 3. An accelerating technique using modern GPU (Graphics Processing Unit) is devised and applied to rendering the implicitly represented vasculatures. 4. The implicitly modelled vasculature is investigated for the application of virtual angioscopy

Modeling and hexahedral meshing of cerebral arterial networks from centerlines

Computational fluid dynamics (CFD) simulation provides valuable information on blood flow from the vascular geometry. However, it requires extracting precise models of arteries from low-resolution medical images, which remains challenging. Centerline-based representation is widely used to model large vascular networks with small vessels, as it encodes both the geometric and topological information and facilitates manual editing. In this work, we propose an automatic method to generate a structured hexahedral mesh suitable for CFD directly from centerlines. We addressed both the modeling and meshing tasks. We proposed a vessel model based on penalized splines to overcome the limitations inherent to the centerline representation, such as noise and sparsity. The bifurcations are reconstructed using a parametric model based on the anatomy that we extended to planar n-furcations. Finally, we developed a method to produce a volume mesh with structured, hexahedral, and flow-oriented cells from the proposed vascular network model. The proposed method offers better robustness to the common defects of centerlines and increases the mesh quality compared to state-of-the-art methods. As it relies on centerlines alone, it can be applied to edit the vascular model effortlessly to study the impact of vascular geometry and topology on hemodynamics. We demonstrate the efficiency of our method by entirely meshing a dataset of 60 cerebral vascular networks. 92% of the vessels and 83% of the bifurcations were meshed without defects needing manual intervention, despite the challenging aspect of the input data. The source code is released publicly

Mechanistic and pathological study of the genesis, growth, and rupture of abdominal aortic aneurysms

Postprint (published version

Novel Algorithms for Merging Computational Fluid Dynamics and 4D Flow MRI

Time-resolved three-dimensional spatial encoding combined with three-directional velocity-encoded phase contrast magnetic resonance imaging (termed as 4D flow MRI), can provide valuable information for diagnosis, treatment, and monitoring of vascular diseases. The accuracy of this technique, however, is limited by errors in flow estimation due to acquisition noise as well as systematic errors. Furthermore, available spatial resolution is limited to 1.5mm - 3mm and temporal resolution is limited to 30-40ms. This is often grossly inadequate to resolve flow details in small arteries, such as those in cerebral circulation. Recently, there have been efforts to address the limitations of the spatial and temporal resolution of MR flow imaging through the use of computational fluid dynamics (CFD). While CFD is capable of providing essentially unlimited spatial and temporal resolution, numerical results are very sensitive to errors in estimation of the flow boundary conditions. In this work, we present three novel techniques that combine CFD with 4D flow MRI measurements in order to address the resolution and noise issues. The first technique is a variant of the Kalman Filter state estimator called the Ensemble Kalman Filter (EnKF). In this technique, an ensemble of patient-specific CFD solutions are used to compute filter gains. These gains are then used in a predictor-corrector scheme to not only denoise the data but also increase its temporal and spatial resolution. The second technique is based on proper orthogonal decomposition and ridge regression (POD-rr). The POD method is typically used to generate reduced order models (ROMs) in closed control applications of large degree of freedom systems that result from discretization of governing partial differential equations (PDE). The POD-rr process results in a set of basis functions (vectors), that capture the local space of solutions of the PDE in question. In our application, the basis functions are generated from an ensemble of patient-specific CFD solutions whose boundary conditions are estimated from 4D flow MRI data. The CFD solution that should be most closely representing the actual flow is generated by projecting 4D flow MRI data onto the basis vectors followed by reconstruction in both MRI and CFD resolution. The rr algorithm was used for between resolution mapping. Despite the accuracy of using rr as the mapping step, due to manual adjustment of a coefficient in the algorithm we developed the third algorithm. In this step, the rr algorithm was substituded with a dynamic mode decomposition algorithm to preserve the robustness. These algorithms have been implemented and tested using a numerical model of the flow in a cerebral aneurysm. Solutions at time intervals corresponding to the 4D flow MRI temporal resolution were collected and downsampled to the spatial resolution of the imaging data. A simulated acquisition noise was then added in k-space. Finally, the simulated data affected by noise were used as an input to the merging algorithms. Rigorous comparison to state-of-the-art techniques were conducted to assess the accuracy and performance of the proposed method. The results provided denoised flow fields with less than 1\% overall error for different signal-to-noise ratios. At the end, a small cohort of three patients were corrected and the data were reconstructed using different methods, the wall shear stress (WSS) was calculated using different reconstructed data and the results were compared. As it has been shown in chapter 5, the calculated WSS using different methods results in mutual high and low shear stress regions, however, the exact value and patterns are significantly different

Grid simulation services for the medical community

The first part of this paper presents a selection of medical simulation applications, including image reconstruction, near real-time registration for neuro-surgery, enhanced dose distribution calculation for radio-therapy, inhaled drug delivery prediction, plastic surgery planning and cardio-vascular system simulation. The latter two topics are discussed in some detail. In the second part, we show how such services can be made available to the clinical practitioner using Grid technology. We discuss the developments and experience made during the EU project GEMSS, which provides reliable, efficient, secure and lawful medical Grid services

A (Near) Real-Time Simulation Method of Aneurysm Coil Embolization

International audienceA (Near) Real-Time Simulation Method of Aneurysm Coil Embolizatio