Predictive medicine: Computational techniques in therapeutic decision‐making

Taylor, Charles; Draney, Mary T.; Ku, Joy P.; Parker, David; Steele, Brooke N.; Wang, Ken; Zarins, Christopher K.

doi:10.1002/(sici)1097-0150(1999)4:5<231::aid-igs1>3.3.co;2-q

Cited by 51 publications

(54 citation statements)

References 28 publications

(33 reference statements)

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“…Researchers and physicians are beginning to demonstrate the benefits of cerebral hemodynamic simulations to acquire a more profound understanding of why CVDs occur, better plan endovascular interventions such as bypass surgery (3,4), or assess aneurysm (5) and arteriovenous malformation rupture risk (6). All CFD studies require subject-specific computational meshes delineating local features such as the carotid bifurcation (7–10), or extending to larger portions of the arterial tree, such as the Circle of Willis (11–13).…”

Section: Introductionmentioning

confidence: 99%

Automatic recognition of subject‐specific cerebrovascular trees

Hsu

Schneller

Alaraj

et al. 2016

Magnetic Resonance in Med

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Purpose An image filter designed for reconstructing cerebrovascular trees from MR images is described. Current imaging techniques capture major cerebral vessels reliably, but often fail to detect small vessels, whose contrast is suppressed due to limited resolution, slow blood flow rate, and distortions around bifurcations or non-vascular structures. An incomplete view of angioarchitecture limits the information available to physicians. Methods A novel Hessian-based filter for contrast-enhancement in MR angiography and venography for blood vessel reconstruction without introducing dangling segments is presented. We quantify filter performance with receiver-operating-characteristic and dice-similarity-coefficient analysis. Total extracted vascular length, number-of-segments, volume, surface-to-distance, and positional error are calculated for validation. Results Reconstruction of cerebrovascular trees from MR images of six volunteers show that the new filter renders more complete representations of subject-specific cerebrovascular networks. Validation with phantom models shows the filter correctly detects blood vessels across all length scales without failing at bifurcations or distorting diameters. Conclusion The novel filter can potentially improve the diagnosis of cerebrovascular diseases by delivering metrics and anatomy of the vasculature. It also facilitates the automated analysis of large datasets by computing biometrics free of operator subjectivity. The high quality reconstruction enables computational mesh generation for subject-specific hemodynamic simulations.

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Section: Introductionmentioning

confidence: 99%

Automatic recognition of subject‐specific cerebrovascular trees

Hsu

Schneller

Alaraj

et al. 2016

Magnetic Resonance in Med

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“…A number of investigators have recently conducted numerical simulations of the flow in intracranial aneurysms using patient-specific geometries 2, 3, 6, 10, 18, 25, 31. Various image recognition and segmentation algorithms have been successfully used to extract lumenal geometries from clinical data, such as CT or MR angiography 14–16, 24, 27, 29, 33, 34. Steinman et al demonstrated the capabilities of CFD in providing information on hemodynamic parameters that are difficult to accurately measure with in vivo methods24, 25.…”

Section: Introductionmentioning

confidence: 99%

Numerical Modeling of the Flow in Intracranial Aneurysms: Prediction of Regions Prone to Thrombus Formation

et al. 2008

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The deposition of intralumenal thrombus in intracranial aneurysms adds a risk of thrombo-embolism over and above that posed by mass-effect and rupture. In addition to biochemical factors, hemodynamic factors that are governed by lumenal geometry and blood flow rates likely play an important role in the thrombus formation and deposition process. In this study, patient-specific computational fluid dynamics (CFD) models of blood flow were constructed from MRA data for three patients who had fusiform basilar aneurysms that were thrombus-free and then proceeded to develop intra-lumenal thrombus. In order to determine whether features of the flow fields could suggest which regions had an elevated potential for thrombus deposition, the flow was modeled in the baseline, thrombus-free geometries. Pulsatile flow simulations were carried out using patientspecific inlet flow conditions measured with MR velocimetry. Newtonian and non-Newtonian blood behavior was considered. A strong similarity was found between the intra-aneurysmal regions with CFD-predicted slow, recirculating flows and the regions of thrombus deposition observed in vivo in the follow-up MR studies. In two cases with larger aneurysms, the agreement between the low velocity zones and clotted off regions improved when non-Newtonian blood behavior was taken into account. A similarity was also found between the calculated low shear stress regions and the regions that were later observed to clot.

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“…Development of image-based modeling technologies for simulating blood flow began in the late 1990s [45, 66, 67]. Since that time, many groups have developed and utilized these techniques to investigate the pathogenesis of occlusive or aneurysmal disease in the carotid artery [68, 69], coronary arteries [70], aorta [71], and cerebral circulation [72-74].…”

Section: Open Problemsmentioning

confidence: 99%

Open problems in computational vascular biomechanics: Hemodynamics and arterial wall mechanics

Taylor

Humphrey

2009

Computer Methods in Applied Mechanics and Engineering

129

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The vasculature consists of a complex network of vessels ranging from large arteries to arterioles, capillaries, venules, and veins. This network is vital for the supply of oxygen and nutrients to tissues and the removal of carbon dioxide and waste products from tissues. Because of its primary role as a pressure-driven chemomechanical transport system, it should not be surprising that mechanics plays a vital role in the development and maintenance of the normal vasculature as well as in the progression and treatment of vascular disease. This review highlights some past successes of vascular biomechanics, but emphasizes the need for research that synthesizes complementary advances in molecular biology, biomechanics, medical imaging, computational methods, and computing power for purposes of increasing our understanding of vascular physiology and pathophysiology as well as improving the design of medical devices and clinical interventions, including surgical procedures. That is, computational mechanics has great promise to contribute to the continued improvement of vascular health.

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Predictive medicine: Computational techniques in therapeutic decision‐making

Cited by 51 publications

References 28 publications

Automatic recognition of subject‐specific cerebrovascular trees

Automatic recognition of subject‐specific cerebrovascular trees

Numerical Modeling of the Flow in Intracranial Aneurysms: Prediction of Regions Prone to Thrombus Formation

Open problems in computational vascular biomechanics: Hemodynamics and arterial wall mechanics

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