Etude de la méthode de Boltzmann sur réseau pour la segmentation d'anévrismes cérébraux

Cerebral aneurysm is a fragile area on the wall of a blood vessel in the brain, which can rupture and cause major bleeding and cerebrovascular accident. The segmentation of cerebral aneurysm is a primordial step for diagnosis assistance, treatment and surgery planning. Unfortunately, manual segmentation is still an important part in clinical angiography but has become a burden given the huge amount of data generated by medical imaging systems. Automatic image segmentation techniques provides an essential way to easy and speed up clinical examinations, reduce the amount of manual interaction and lower inter operator variability. The main purpose of this PhD work is to develop automatic methods for cerebral aneurysm segmentation and measurement. The present work consists of three main parts. The first part deals with giant aneurysm segmentation containing lumen and thrombus. The methodology consists of first extracting the lumen and thrombus using a two-step procedure based on the LBM, and then refining the shape of the thrombus using level set technique. In this part the proposed method is also compared with manual segmentation, demonstrating its good segmentation accuracy. The second part concerns a LBM approach to vessel segmentation in 2D+t images and to cerebral aneurysm segmentation in 3D medical images through introducing a LBM D3Q27 model, which allows achieving a good segmentation and high robustness to noise. The last part investigates a true 4D segmentation model by considering the 3D+t data as a 4D hypervolume and using a D4Q81 lattice in LBM where time is considered in the same manner as for other three dimensions for the definition of particle moving directions in the LBM model.L'anévrisme cérébral est une région fragile de la paroi d'un vaisseau sanguin dans le cerveau, qui peut se rompre et provoquer des saignements importants et des accidents vasculaires cérébraux. La segmentation de l'anévrisme cérébral est une étape primordiale pour l'aide au diagnostic, le traitement et la planification chirurgicale. Malheureusement, la segmentation manuelle prend encore une part importante dans l'angiographie clinique et elle est devenue couteuse en temps de traitement étant donné la gigantesque quantité de données générées par les systèmes d'imagerie médicale. Les méthodes de segmentation automatique d'image constituent un moyen essentiel pour faciliter et accélérer l'examen clinique et pour réduire l'interaction manuelle et la variabilité inter-opérateurs. L'objectif principal de ce travail de thèse est de développer des méthodes automatiques pour la segmentation et la mesure des anévrismes. Le présent travail de thèse est constitué de trois parties principales. La première partie concerne la segmentation des anévrismes géants qui contiennent à la fois la lumière et le thrombus. La méthode consiste d'abord à extraire la lumière et le thrombus en utilisant une procédure en deux étapes, puis à affiner la forme du thrombus à l'aide de la méthode des courbes de niveaux. Dans cette partie, la méthode proposée est également comparée à la segmentation manuelle, démontrant sa bonne précision. La deuxième partie concerne une approche LBM pour la segmentation des vaisseaux dans des images 2D+t et de l'anévrisme cérébral dans les images en 3D. La dernière partie étudie un modèle de segmentation 4D en considérant les images 3D+t comme un hypervolume 4D et en utilisant un réseau LBM D4Q81, dans lequel le temps est considéré de la même manière que les trois autres dimensions pour la définition des directions de mouvement des particules dans la LBM, considérant les données 3D+t comme un hypervolume 4D et en utilisant un réseau LBM D4Q81. Des expériences sont réalisées sur des images synthétiques d'hypercube 4D et d'hypersphere 4D. La valeur de Dice sur l'image de l'hypercube avec et sans bruit montre que la méthode proposée est prometteuse pour la segmentation 4D et le débruitage

Constrained estimation of intracranial aneurysm surface deformation using 4D-CTA

Background and objective Intracranial aneurysms are relatively common life-threatening diseases, and assessing aneurysm rupture risk and identifying the associated risk factors is essential. Parameters such as the Oscillatory Shear Index, Pressure Loss Coefficient, and Wall Shear Stress are reliable indicators of intracranial aneurysm development and rupture risk, but aneurysm surface irregular pulsation has also received attention in aneurysm rupture risk assessment. Methods The present paper proposed a new approach to estimate aneurysm surface deformation. This method transforms the estimation of aneurysm surface deformation into a constrained optimization problem, which minimizes the error between the displacement estimated by the model and the sparse data point displacements from the four-dimensional CT angiography (4D-CTA) imaging data. Results The effect of the number of sparse data points on the results has been discussed in both simulation and experimental results, and it shows that the proposed method can accurately estimate the surface deformation of intracranial aneurysms when using sufficient sparse data points. Conclusions Due to a potential association between aneurysm rupture and surface irregular pulsation, the estimation of aneurysm surface deformation is needed. This paper proposed a method based on 4D-CTA imaging data, offering a novel solution for the estimation of intracranial aneurysm surface deformation

Volumetric Lattice Boltzmann Method for Wall Stresses of Image-Based Pulsatile Flows

Image-based computational fluid dynamics (CFD) has become a new capability for determining wall stresses of pulsatile flows. However, a computational platform that directly connects image information to pulsatile wall stresses is lacking. Prevailing methods rely on manual crafting of a hodgepodge of multidisciplinary software packages, which is usually laborious and error-prone. We present a new computational platform, to compute wall stresses in image-based pulsatile flows using the volumetric lattice Boltzmann method (VLBM). The novelty includes: (1) a unique image processing to extract flow domain and local wall normality, (2) a seamless connection between image extraction and VLBM, (3) an en-route calculation of strain-rate tensor, and (4) GPU acceleration (not included here). We first generalize the streaming operation in the VLBM and then conduct application studies to demonstrate its reliability and applicability. A benchmark study is for laminar and turbulent pulsatile flows in an image-based pipe (Reynolds number: 10 to 5000). The computed pulsatile velocity and shear stress are in good agreements with Womersley\u27s analytical solutions for laminar pulsatile flows and concurrent laboratory measurements for turbulent pulsatile flows. An application study is to quantify the pulsatile hemodynamics in image-based human vertebral and carotid arteries including velocity vector, pressure, and wall-shear stress. The computed velocity vector fields are in reasonably well agreement with MRA (magnetic resonance angiography) measured ones. This computational platform is good for image-based CFD with medical applications and pore-scale porous media flows in various natural and engineering systems

In-silico clinical trials for assessment of intracranial flow diverters

In-silico trials refer to pre-clinical trials performed, entirely or in part, using individualised computer models that simulate some aspect of drug effect, medical device, or clinical intervention. Such virtual trials reduce and optimise animal and clinical trials, and enable exploring a wider range of anatomies and physiologies. In the context of endovascular treatment of intracranial aneurysms, in-silico trials can be used to evaluate the effectiveness of endovascular devices over virtual populations of patients with different aneurysm morphologies and physiologies. However, this requires (i) a virtual endovascular treatment model to evaluate device performance based on a reliable performance indicator, (ii) models that represent intra- and inter-subject variations of a virtual population, and (iii) creation of cost-effective and fully-automatic workflows to enable a large number of simulations at a reasonable computational cost and time. Flow-diverting stents have been proven safe and effective in the treatment of large wide-necked intracranial aneurysms. The presented thesis aims to provide the ingredient models of a workflow for in-silico trials of flow-diverting stents and to enhance the general knowledge of how the ingredient models can be streamlined and accelerated to allow large-scale trials. This work contributed to the following aspects: 1) To understand the key ingredient models of a virtual treatment workflow for evaluation of the flow-diverter performance. 2) To understand the effect of input uncertainty and variability on the workflow outputs, 3) To develop generative statistical models that describe variability in internal carotid artery flow waveforms, and investigate the effect of uncertainties on quantification of aneurysmal wall shear stress, 4) As part of a metric to evaluate success of flow diversion, to develop and validate a thrombosis model to assess FD-induced clot stability, and 5) To understand how a fully-automatic aneurysm flow modelling workflow can be built and how computationally inexpensive models can reduce the computational costs

Towards patient-speci�fic modelling of cerebral blood flow using lattice-Boltzmann methods

Patient-specifi�c Computational fluid dynamics (CFD) studies of cerebral blood flow have the potential to help plan neurosurgery, but developing realistic simulation methods that deliver results quickly enough presents a major challenge. The majority of CFD studies assume that the arterial walls are rigid. Since the lattice-Boltzmann method (LBM) is computationally efficient on multicore machines, some methods for carrying out lattice-Boltzmann simulations of time-dependent fluid flow in elastic vessels are developed. They involve integrating the equations of motion for a number of points on the wall. The calculations at every lattice site and point on the wall depend only on information from neighbouring lattice sites or wall points, so they are suitable for efficient computation on multicore machines. The �first method is suitable for three-dimensional axisymmetric vessels. The steady-state solutions for the wall displacement and flow �fields in a cylinder at realistic parameters for cerebral blood ow agree closely with the analytical solutions. Compared to simulations with rigid walls, simulations with elastic walls require 13% more computational e�ffort at the parameters chosen in this study. A scheme is then developed for a more complex geometry in two dimensions, which applies the full theory of linear elasticity. The steady-state wall pro�files obtained from simulations of a Starling resistor agree closely with those from existing computational studies. I �find that it is essential to change the lattice sites from solid to fluid and vice versa if the wall crosses any of them during the simulation. Simple tests of the dynamics show that when the mass of the wall is much greater than that of the fluid, the period of oscillation of the wall agrees within 7% of the expected period. This method could be extended to three dimensions for use in cerebral blood ow simulations

Approximation anatomischer Strukturen und biomedizinischer Prozesse zur rechnergestützten Untersuchung der Hämodynamik in Aneurysmen

Arterien des Menschen können Aneurysmen aufweisen, deren Ruptur zu lebensbedrohenden inneren Blutungen wie Schlaganfällen führen kann. Ein Therapieansatz ist das Einsetzen von sogenannten Stents. Eine Ruptur oder der Einfluss eines Stents kann mit dem momentanen Stand der Technik nicht exakt vorhergesagt werden. Für eine optimale Behandlung von Patienten wäre dies allerdings eine wichtige Zusatzinformation für den behandelnden Arzt. Zur Bestimmung dieser Zusatzinformation sollen zukünftig Simulationen der Hämodynamik in pathologischen Arterien eingesetzt werden. In dieser Arbeit werden Strömungsgeschwindigkeiten in Arterien ohne beziehungsweise mit Einbringung von Einbauten wie Stents berechnet und die entstehenden Wandscherspannungen im Hinblick auf eine Rupturvorhersage untersucht. Weiterhin wird der Massentransfer zwischen Arterie und Aneurysma charakterisiert und eine Analyse des Thrombosierungsverhaltens unter Strömungseinfluss vorgenommen. Bei letztgenanntem Thema werden insbesondere der Verschluss von Aneurysmen durch Thromben, die Ortseindämmung der Thrombenbildung und das Verhalten von wandanhaftenden Thromben auch in Bezug auf eine Ablösung untersucht. Um hierfür geeignete Simulationen durchführen zu können, wird eine Analyse der biomedizinischen Grundlagen durchgeführt. Für die Untersuchung der komplexen Dynamik sind aus methodischer Sicht zwei grundlegende Aspekte zu bearbeiten: die geometrische und die funktionelle Approximation. Die funktionelle Approximation biomedizinischer Prozesse umfasst die Untersuchung der Blutströmung, des Transports von passiven Stoffen und der Thrombosierung. Hierfür werden entsprechende Modelle identifiziert, in entsprechende Lattice-Boltzmann-Verfahren umgewandelt, simuliert und untersucht. Durch die Erarbeitung geeigneter Konzepte für eine Umsetzung der hier beschriebenen Simulationen auf einzelnen oder mehreren, miteinander kommunizierenden Grafikprozessoren kann eine effiziente Simulation der gekoppelten Multi-Physik-Probleme mit Lattice-Boltzmann-Verfahren erreicht werden. Insgesamt stellt diese Vorgehensweise ein Novum dar und unterstreicht die Praktikabilität der Methode. Die geometrische Approximation anatomischer Strukturen wird in dieser Arbeit mit Level-Set-Darstellungen gelöst. Mit ihnen können vielfältige Problemstellungen im Umfeld der Simulation bearbeitet werden, dies umfasst beispielsweise die Konstruktion einer Simulationsdomäne aus unterschiedlichen Tomographiedaten und die Einbringung von Einbauten wie Stents in das Untersuchungsgebiet. Durch die Kombination mit der Lattice-Boltzmann-Methode können Vorteile gegenüber dem Stand der Technik erreicht werden, etwa bei der effizienten Berechnung der Wandscherspannungen. Eine Validierung der Strömungs- und Transportsimulationen wird mit hochaufgelöster Magnetresonanztomographie vorgenommen. Dazu wird ein Modell des Aufnahmevorgangs unter Einfluss von Radiofrequenz-Magnetfeldern und Gradienten erstellt und der Magnetisierungstransport sowie die Relaxation simuliert. Die bestimmten Abweichungen zwischen Simulation und Messung sind insgesamt gering. Für die Messexperimente werden erstmals 3D-Druckverfahren für die Konstruktion von physischen Modellen eingesetzt und deren Güte untersucht. Durch die Ergebnisse dieser Arbeit steht eine effiziente und umfassende Verarbeitungspipeline für Blutströmungs-, Transport- und Thrombosierungsprozesse für weitere Untersuchungen bereit. Sie kann ebenfalls leicht um neue Modelle erweitert werden. Die Simulation der Magnetresonanztomographie für Flussbildgebung ermöglicht ebenfalls zukünftige Anwendungen im Bereich der Sequenzentwicklung

Computational investigations of a shape‐memory polymer foam embolization device for intracranial aneurysms

The objective of this research is to determine the efficacy of an intracranial aneurysm treatment option. An open‐source computational fluid dynamics software is used to simulate blood flow through 6 patient‐specific intracranial aneurysm geometries for 42 different cases. Virtual shape memory polymer foam embolization devices are created and implanted into the geometries. Different porous media parameters are considered for the embolic devices, and it is found that devices with a permeability of ∼5e-9 m2 can reduce aneurysmal inflow by 90% for various geometries of the treated aneurysm and its surrounding parent arterial vessel. For a wide‐necked aneurysm, devices with a permeability of 60%, indicating that they may be able to provide that level of performance for most aneurysm morphologies. As such, a permeability range of 5e-9–5e-8 m2 is recommended for the device. Furthermore, material removal from the center of the device is found to be feasible for larger aneurysm devices if compressibility is deemed a concern. For a high‐inflow case, the average aneurysmal velocity reduction is within 2% of the uncored device for all cored devices with a material thickness of at least 1.5 mm occluding the inlet area. Convective heat transfer is also modeled to determine the safety of the thermally stimulated shape memory polymer device. Steady‐state simulations identify the worst‐case geometry, a deep aneurysm with little opportunity for convection. Transient heat transfer during the device deployment process for 2 stimulus temperatures is modeled with this aneurysm, demonstrating that the vessel walls can reach the stimulus temperature of 40 °C and 45 °C within seconds and take over a minute to cool back to near body temperature. The threshold for brain tissue damage is not reached, but nonetheless, it is suggested that the temperature and heating time be kept as low as possible. Full model validation is not available, but general verification of the flow fields in untreated aneurysms is achieved by comparing simulation results to those obtained by other research groups in a modeling competition