Customizable tubular model for n-furcating blood vessels and its application to 3D reconstruction of the cerebrovascular system

Understanding the 3D cerebral vascular network is one of the pressing issues impacting the diagnostics of various systemic disorders and is helpful in clinical therapeutic strategies. Unfortunately, the existing software in the radiological workstation does not meet the expectations of radiologists who require a computerized system for detailed, quantitative analysis of the human cerebrovascular system in 3D and a standardized geometric description of its components. In this study, we show a method that uses 3D image data from magnetic resonance imaging with contrast to create a geometrical reconstruction of the vessels and a parametric description of the reconstructed segments of the vessels. First, the method isolates the vascular system using controlled morphological growing and performs skeleton extraction and optimization. Then, around the optimized skeleton branches, it creates tubular objects optimized for quality and accuracy of matching with the originally isolated vascular data. Finally, it optimizes the joints on n-furcating vessel segments. As a result, the algorithm gives a complete description of shape, position in space, position relative to other segments, and other anatomical structures of each cerebrovascular system segment. Our method is highly customizable and in principle allows reconstructing vascular structures from any 2D or 3D data. The algorithm solves shortcomings of currently available methods including failures to reconstruct the vessel mesh in the proximity of junctions and is free of mesh collisions in high curvature vessels. It also introduces a number of optimizations in the vessel skeletonization leading to a more smooth and more accurate model of the vessel network. We have tested the method on 20 datasets from the public magnetic resonance angiography image database and show that the method allows for repeatable and robust segmentation of the vessel network and allows to compute vascular lateralization indices. Graphical abstract: [Figure not available: see fulltext.]</p

A Deep Learning Approach to Evaluating Disease Risk in Coronary Bifurcations

Cardiovascular disease represents a large burden on modern healthcare systems, requiring significant resources for patient monitoring and clinical interventions. It has been shown that the blood flow through coronary arteries, shaped by the artery geometry unique to each patient, plays a critical role in the development and progression of heart disease. However, the popular and well tested risk models such as Framingham and QRISK3 current cardiovascular disease risk models are not able to take these differences when predicting disease risk. Over the last decade, medical imaging and image processing have advanced to the point that non-invasive high-resolution 3D imaging is routinely performed for any patient suspected of coronary artery disease. This allows for the construction of virtual 3D models of the coronary anatomy, and in-silico analysis of blood flow within the coronaries. However, several challenges still exist which preclude large scale patient-specific simulations, necessary for incorporating haemodynamic risk metrics as part of disease risk prediction. In particular, despite a large amount of available coronary medical imaging, extraction of the structures of interest from medical images remains a manual and laborious task. There is significant variation in how geometric features of the coronary arteries are measured, which makes comparisons between different studies difficult. Modelling blood flow conditions in the coronary arteries likewise requires manual preparation of the simulations and significant computational cost. This thesis aims to solve these challenges. The "Automated Segmentation of Coronary Arteries (ASOCA)" establishes a benchmark dataset of coronary arteries and their associated 3D reconstructions, which is currently the largest openly available dataset of coronary artery models and offers a wide range of applications such as computational modelling, 3D printed for experiments, developing, and testing medical devices such as stents, and Virtual Reality applications for education and training. An automated computational modelling workflow is developed to set up, run and postprocess simulations on the Left Main Bifurcation and calculate relevant shape metrics. A convolutional neural network model is developed to replace the computational fluid dynamics process, which can predict haemodynamic metrics such as wall shear stress in minutes, compared to several hours using traditional computational modelling reducing the computation and labour cost involved in performing such simulations

Artificial Intelligence in Image-Based Screening, Diagnostics, and Clinical Care of Cardiopulmonary Diseases

Cardiothoracic and pulmonary diseases are a significant cause of mortality and morbidity worldwide. The COVID-19 pandemic has highlighted the lack of access to clinical care, the overburdened medical system, and the potential of artificial intelligence (AI) in improving medicine. There are a variety of diseases affecting the cardiopulmonary system including lung cancers, heart disease, tuberculosis (TB), etc., in addition to COVID-19-related diseases. Screening, diagnosis, and management of cardiopulmonary diseases has become difficult owing to the limited availability of diagnostic tools and experts, particularly in resource-limited regions. Early screening, accurate diagnosis and staging of these diseases could play a crucial role in treatment and care, and potentially aid in reducing mortality. Radiographic imaging methods such as computed tomography (CT), chest X-rays (CXRs), and echo ultrasound (US) are widely used in screening and diagnosis. Research on using image-based AI and machine learning (ML) methods can help in rapid assessment, serve as surrogates for expert assessment, and reduce variability in human performance. In this Special Issue, “Artificial Intelligence in Image-Based Screening, Diagnostics, and Clinical Care of Cardiopulmonary Diseases”, we have highlighted exemplary primary research studies and literature reviews focusing on novel AI/ML methods and their application in image-based screening, diagnosis, and clinical management of cardiopulmonary diseases. We hope that these articles will help establish the advancements in AI