Image‐based computational fluid dynamics in the lung: virtual reality or new clinical practice?

Burrowes, Kelly; Backer, Jan De; Kumar, Haribalan

doi:10.1002/wsbm.1392

Cited by 22 publications

(13 citation statements)

References 72 publications

(162 reference statements)

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“…Computational Fluid Dynamics (CFD) represents an attractive tool to overcome the drawbacks of the current clinical approaches, providing quantitative information on regional ventilation, lobar flow rate, and local properties at every location in the airways. 8 , 13 , 14 , 15 The geometrical model of the airways can be reconstructed from the CT‐images of the patient, 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 allowing to replicate the anatomical peculiarities of a subject and to study the effects of lung pathologies. Burrowes et al modeled the morphological changes due to asthma and chronic obstructive pulmonary disease (COPD), 22 , 23 while De Backer et al showed the fluid dynamic consequences of such pathologies.…”

Section: Introductionmentioning

confidence: 99%

Computational fluid dynamics of the airways after left‐upper pulmonary lobectomy: A case study

Tullio

Aliboni

Pennati

et al. 2021

Numer Methods Biomed Eng

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Pulmonary lobectomy is the gold standard intervention for lung cancer removal and consists of the complete resection of the affected lung lobe, which, coupled with the re-adaptation of the remaining thoracic structures, decreases the postoperative pulmonary function of the patient. Current clinical practice, based on spirometry and cardiopulmonary exercise tests, does not consider local changes, providing an average at-the-mouth estimation of residual functionality. Computational Fluid Dynamics (CFD) has proved a valuable solution to obtain quantitative and local information about airways airflow dynamics. A CFD investigation was performed on the airway tree of a leftupper pulmonary lobectomy patient, to quantify the effects of the postoperative alterations. The patient-specific bronchial models were reconstructed from pre-and postoperative CT scans. A parametric laryngeal model was merged to the geometries to account for physiological-like inlet conditions. Numerical simulations were performed in Fluent. The postoperative configuration revealed fluid dynamic variations in terms of global velocity (+23%), wall pressure (+48%), and wall shear stress (+39%). Local flow disturbances emerged at the resection site: a high-velocity peak of 4.92 m/s was found at the left-lower lobe entrance, with a local increase of pressure at the suture zone (18 Pa). The magnitude of pressure and secondary flows increased in the trachea and flow dynamics variations were observed also in the contralateral lung, causing altered lobar ventilation. The results confirmed that CFD is a patient-specific approach for a quantitative evaluation of fluid dynamics parameters and local ventilation providing additional information with respect to current clinical approaches. K E Y W O R D Scomputational fluid dynamics, imaged-based, pulmonary lobectomy, tracheobronchial tree modeling Marta Tullio and Lorenzo Aliboni equally contributed to this study.

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Section: Introductionmentioning

confidence: 99%

Computational fluid dynamics of the airways after left‐upper pulmonary lobectomy: A case study

Tullio

Aliboni

Pennati

et al. 2021

Numer Methods Biomed Eng

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“…Depending on the individualized structural models of the tracheobronchial tree extracted from CT images, the computational fluid dynamics (CFD) simulation can provide physiologically significant ventilation information including the airflow velocity, wall pressure, wall shear stress, pressure drop and lobular airflow rate, which may complement the results of anatomy and pulmonary function [14–17]. Walters et al proposed to use the reduced geometry model to reduce the complexity [18].…”

Section: Introductionmentioning

confidence: 99%

Structural and functional alterations of the tracheobronchial tree after left upper pulmonary lobectomy for lung cancer

Yue

et al. 2019

BioMed Eng OnLine

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BackgroundPulmonary lobectomy has been a well-established curative treatment method for localized lung cancer. After left upper pulmonary lobectomy, the upward displacement of remaining lower lobe causes the distortion or kink of bronchus, which is associated with intractable cough and breathless. However, the quantitative study on structural and functional alterations of the tracheobronchial tree after lobectomy has not been reported. We sought to investigate these alterations using CT imaging analysis and computational fluid dynamics (CFD) method.MethodsBoth preoperative and postoperative CT images of 18 patients who underwent left upper pulmonary lobectomy are collected. After the tracheobronchial tree models are extracted, the angles between trachea and bronchi, the surface area and volume of the tree, and the cross-sectional area of left lower lobar bronchus are investigated. CFD method is further used to describe the airflow characteristics by the wall pressure, airflow velocity, lobar flow rate, etc.ResultsIt is found that the angle between the trachea and the right main bronchus increases after operation, but the angle with the left main bronchus decreases. No significant alteration is observed for the surface area or volume of the tree between pre-operation and post-operation. After left upper pulmonary lobectomy, the cross-sectional area of left lower lobar bronchus is reduced for most of the patients (15/18) by 15–75%, especially for 4 patients by more than 50%. The wall pressure, airflow velocity and pressure drop significantly increase after the operation. The flow rate to the right lung increases significantly by 2–30% (but there is no significant difference between each lobe), and the flow rate to the left lung drops accordingly. Many vortices are found in various places with severe distortions.ConclusionsThe favorable and unfavorable adaptive alterations of tracheobronchial tree will occur after left upper pulmonary lobectomy, and these alterations can be clarified through CT imaging and CFD analysis. The severe distortions at left lower lobar bronchus might exacerbate postoperative shortness of breath.

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“…Computational Fluid Dynamics (CFD) represents a feasible solution to overcome the drawbacks of the current clinical approaches. From image-based patient-specific bronchial tree reconstructions, CFD can provide quantitative information on regional ventilation and local airflow properties in the bronchial tree 14 – 17 . CFD has been applied to several pathologies of the lower respiratory tract, such as tracheal stenosis 18 , asthma, chronic obstructive pulmonary disease 19 , 20 , and cystic fibrosis 21 .…”

Section: Introductionmentioning

confidence: 99%

Functional analysis of the airways after pulmonary lobectomy through computational fluid dynamics

Aliboni

Tullio

Pennati

et al. 2022

Sci Rep

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Pulmonary lobectomy, which consists of the partial or complete resection of a lung lobe, is the gold standard intervention for lung cancer removal. The removal of functional tissue during the surgery and the re-adaptation of the remaining thoracic structures decrease the patient's post-operative pulmonary function. Residual functionality is evaluated through pulmonary function tests, which account for the number of resected segments without considering local structural alterations and provide an average at-the-mouth estimation. Computational Fluid Dynamics (CFD) has been demonstrated to provide patient-specific, quantitative, and local information about airways airflow dynamics. A CFD investigation was performed on image-based airway trees reconstructed before and after the surgery for twelve patients who underwent lobectomy at different lobes. The geometrical alterations and the variations in fluid dynamics parameters and in lobar ventilation between the pre and post-operative conditions were evaluated. The post-operative function was estimated and compared with current clinical algorithms and with actual clinical data. The post-operative configuration revealed a high intersubject variability: regardless of the lobectomy site, an increment of global velocity, wall pressure, and wall shear stress was observed. Local flow disturbances also emerged at, and downstream of, the resection site. The analysis of lobar ventilation showed severe variations in the volume flow rate distribution, highlighting the compensatory effects in the contralateral lung with an increment of inflow. The estimation of post-operative function through CFD was comparable with the current clinical algorithm and the actual spirometric measurements. The results confirmed that CFD could provide additional information to support the current clinical approaches both in the operability assessment and in the prescription of personalized respiratory rehabilitation.

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Image‐based computational fluid dynamics in the lung: virtual reality or new clinical practice?

Cited by 22 publications

References 72 publications

Computational fluid dynamics of the airways after left‐upper pulmonary lobectomy: A case study

Computational fluid dynamics of the airways after left‐upper pulmonary lobectomy: A case study

Structural and functional alterations of the tracheobronchial tree after left upper pulmonary lobectomy for lung cancer

Functional analysis of the airways after pulmonary lobectomy through computational fluid dynamics

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