MRI‐based computational fluid dynamics for diagnosis and treatment prediction: Clinical validation study in patients with coarctation of aorta

Goubergrits, Leonid; Riesenkampff, Eugénie; Yevtushenko, Pavlo; Schaller, J.; Kertzscher, Ulrich; Hennemuth, Anja; Berger, Felix; Schubert, Stephan; Küehne, Titus

doi:10.1002/jmri.24639

Cited by 89 publications

(78 citation statements)

References 30 publications

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“…Such assessments can be easily made based on the flow ratio between the descending and the ascending aorta and may already provide a Class II / Level C treatment indication . Figure summarizes the existing diagnostic options with the focus on a time‐effective noninvasive diagnostic process, and based on the results of our study as well as previous CFD‐based validation studies …”

Section: Discussionmentioning

confidence: 91%

Patient‐specific requirements and clinical validation of MRI‐based pressure mapping: A two‐center study in patients with aortic coarctation

Goubergrits

Hellmeier

Neumann

et al. 2018

Magnetic Resonance Imaging

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Background Invasive peak‐to‐peak pressure gradients are the current clinical reference standard for assessing aortic coarctation. To obtain them, patients need to undergo arterial heart catheterization. Unless an intervention is performed, the procedure remains purely diagnostic, while the concomitant risks remain. Purpose To validate MRI‐based pressure mapping against pressure drop derived from heart catheterization and to define minimal clinical requirements. Study Type Prospective clinical validation study. Population Twenty‐seven coarctation patients with an indicated heart catheterization were enrolled at two clinical centers. MRI Sequences 1.5T including 4D velocity‐encoded MRI and 3D anatomical imaging of the aorta. Assessment Pressure drop across the stenosis was calculated by pressure mapping based on the pressure Poisson equation. Calculated pressure drops were compared with catheter measured data. Spatial and temporal resolution were analyzed using in silico phantom‐based data as well as in vivo measurements. Statistics Pressure drop was compared to peak‐to‐peak measurements. A two‐sample paired mean equivalence test was used. Results In patients without imaging artifacts and a required spatial resolution ≥5 voxel/diameter, significant equivalence of pressure mapping compared to heart catheterization was found (17.5 ± 6.49 vs. 16.6 ± 6.53 mmHg, P < 0.001). Data Conclusion Pressure mapping provides equivalent accuracy to pressure drop obtained from heart catheterization in patients 1) without previous stenting and 2) with sufficient spatial image resolution (at least 5 voxels/diameter). In these patients the method can reliably be performed prior to the actual procedure, and thus allows safe noninvasive treatment planning based on MRI. Level of Evidence: 2 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2019;49:81–89.

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Section: Discussionmentioning

confidence: 91%

Patient‐specific requirements and clinical validation of MRI‐based pressure mapping: A two‐center study in patients with aortic coarctation

Goubergrits

Hellmeier

Neumann

et al. 2018

Magnetic Resonance Imaging

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“…Thus, the area of interest is barely visible in MRI scans. While intensity-based segmentation algorithms cannot be applied, medical experts are able to reconstruct the stented vessel segment in the MRI datasets with additional aid of biplane angiography images [27]. Eight preinterventional datasets (voxel size: 0.66 × 0.66 × 1.6 mm) were acquired with a whole-body 1.5T MR scanner Achieva R 3.2.2.0 (Philips Medical System, Best, Netherlands).…”

Section: Discussionmentioning

confidence: 99%

Interactive virtual stent planning for the treatment of coarctation of the aorta

et al. 2015

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“…[80] Others have focused on the use of simulation to avoid unnecessary catheterization in surgical evaluation, achieving significant correlation between pressure drops measured by CFD and catheterization both pre- and post-treatment. [81] Szopos et al also showed statistically significant higher wall shear stress in patients with “Gothic” compared to “Romanesque” arch repair using CFD with fluid structure interaction. [82]…”

Section: Aortic and Coronary Diseasementioning

confidence: 99%

Computational modeling and engineering in pediatric and congenital heart disease

Marsden¹,

Feinstein

2015

Current Opinion in Pediatrics

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Purpose of review Recent methodological advances in computational simulations are enabling increasingly realistic simulations of hemodynamics and physiology, driving increased clinical utility. We review recent developments in the use of computational simulations in pediatric and congenital heart disease, describe the clinical impact in modeling in single ventricle patients, and provide an overview of emerging areas. Recent Findings Multiscale modeling combining patient specific hemodynamics with reduced order (i.e. mathematically and computationally simplified) circulatory models has become the defacto standard for modeling local hemodynamics and “global” circulatory physiology. We review recent advances that have enabled faster solutions, discuss new methods, (e.g. fluid structure interaction and uncertainty quantification), which lend realism both computationally and clinically to results, highlight novel computationally-derived surgical methods for single ventricle patients, and discuss areas in which modeling has begun to exert its influence including Kawasaki disease, fetal circulation, tetralogy of Fallot, (and pulmonary tree), and circulatory support. Summary Computational modeling is emerging as a crucial tool for clinical decision-making and evaluation of novel surgical methods and interventions in pediatric cardiology and beyond. Continued development of modeling methods, with an eye towards clinical needs, will enable clinical adoption in a wide range of pediatric and congenital heart diseases.

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MRI‐based computational fluid dynamics for diagnosis and treatment prediction: Clinical validation study in patients with coarctation of aorta

Abstract: Peak systolic pressure drops can be reliably calculated using MRI-based CFD in a clinical setting. Therefore, CFD might be an attractive noninvasive alternative to diagnostic catheterization.

Cited by 89 publications

References 30 publications

Patient‐specific requirements and clinical validation of MRI‐based pressure mapping: A two‐center study in patients with aortic coarctation

Patient‐specific requirements and clinical validation of MRI‐based pressure mapping: A two‐center study in patients with aortic coarctation

Interactive virtual stent planning for the treatment of coarctation of the aorta

Computational modeling and engineering in pediatric and congenital heart disease

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