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Qiu Y, Tai Y, Lei J, Zeng Y, Wu H, Li K. Modelling the liver region as porous media to noninvasively measure portal vein pressure gradient (PPG) with numerical methods. J Biomech 2023; 155:111660. [PMID: 37285779 DOI: 10.1016/j.jbiomech.2023.111660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 05/11/2023] [Accepted: 05/23/2023] [Indexed: 06/09/2023]
Abstract
Portal hypertension is the initial and main consequence of liver cirrhosis. Currently the diagnosis relies on invasive and complex operation. This study proposed a new computational method in computational fluid dynamics (CFD) analysis to noninvasively measure the portal pressure gradient (PPG) by considering the liver region as porous media to account for the patient-specific liver resistance. Patient-specific computational models based on the CT scan images and the ultrasound (US) velocity measurement was established. The results show that the PPG derived from CFD analysis is in great agreement with clinical measured data (23.93 mmHg vs 23 mmHg). Validation of the numerical method and was performed by post-TIPS PPG measurement (10.69 mmHg vs 11 mmHg). Then the range of porous media parameters is investigated in a validation group of three patients. The computational method proposed in this study is promising in more accurately measuring the PPG noninvasively.
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Affiliation(s)
- Yue Qiu
- Department of Gastroenterology and Hepatology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, PR China; West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, PR China; Med-X Center for Informatics, Sichuan University, Chengdu, Sichuan 610041, PR China; West China Hospital-SenseTime Joint Lab, Chengdu, Sichuan 610041, PR China
| | - Yang Tai
- Department of Gastroenterology and Hepatology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, PR China
| | - Jianguo Lei
- Med-X Center for Informatics, Sichuan University, Chengdu, Sichuan 610041, PR China; West China Hospital-SenseTime Joint Lab, Chengdu, Sichuan 610041, PR China
| | - Yi Zeng
- Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, PR China
| | - Hao Wu
- Department of Gastroenterology and Hepatology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, PR China.
| | - Kang Li
- West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, PR China; Med-X Center for Informatics, Sichuan University, Chengdu, Sichuan 610041, PR China; West China Hospital-SenseTime Joint Lab, Chengdu, Sichuan 610041, PR China.
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Torres Rojas AM, Lorente S, Hautefeuille M, Sanchez-Cedillo A. Hierarchical Modeling of the Liver Vascular System. Front Physiol 2021; 12:733165. [PMID: 34867439 PMCID: PMC8637164 DOI: 10.3389/fphys.2021.733165] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 10/13/2021] [Indexed: 02/05/2023] Open
Abstract
The liver plays a key role in the metabolic homeostasis of the whole organism. To carry out its functions, it is endowed with a peculiar circulatory system, made of three main dendritic flow structures and lobules. Understanding the vascular anatomy of the liver is clinically relevant since various liver pathologies are related to vascular disorders. Here, we develop a novel liver circulation model with a deterministic architecture based on the constructal law of design over the entire scale range (from macrocirculation to microcirculation). In this framework, the liver vascular structure is a combination of superimposed tree-shaped networks and porous system, where the main geometrical features of the dendritic fluid networks and the permeability of the porous medium, are defined from the constructal viewpoint. With this model, we are able to emulate physiological scenarios and to predict changes in blood pressure and flow rates throughout the hepatic vasculature due to resection or thrombosis in certain portions of the organ, simulated as deliberate blockages in the blood supply to these sections. This work sheds light on the critical impact of the vascular network on mechanics-related processes occurring in hepatic diseases, healing and regeneration that involve blood flow redistribution and are at the core of liver resilience.
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Affiliation(s)
- Aimee M Torres Rojas
- Department of Mechanical Engineering, Villanova University, Villanova, PA, United States
| | - Sylvie Lorente
- Department of Mechanical Engineering, Villanova University, Villanova, PA, United States
| | - Mathieu Hautefeuille
- Departamento de Física, Facultad de Ciencias, Universidad Nacional Autónoma de México, Ciudad de México, Mexico
| | - Aczel Sanchez-Cedillo
- Laboratorio de Trasplantes, Centro Médico Nacional 20 de Noviembre, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE), Ciudad de México, Mexico
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Christ B, Collatz M, Dahmen U, Herrmann KH, Höpfl S, König M, Lambers L, Marz M, Meyer D, Radde N, Reichenbach JR, Ricken T, Tautenhahn HM. Hepatectomy-Induced Alterations in Hepatic Perfusion and Function - Toward Multi-Scale Computational Modeling for a Better Prediction of Post-hepatectomy Liver Function. Front Physiol 2021; 12:733868. [PMID: 34867441 PMCID: PMC8637208 DOI: 10.3389/fphys.2021.733868] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 10/26/2021] [Indexed: 01/17/2023] Open
Abstract
Liver resection causes marked perfusion alterations in the liver remnant both on the organ scale (vascular anatomy) and on the microscale (sinusoidal blood flow on tissue level). These changes in perfusion affect hepatic functions via direct alterations in blood supply and drainage, followed by indirect changes of biomechanical tissue properties and cellular function. Changes in blood flow impose compression, tension and shear forces on the liver tissue. These forces are perceived by mechanosensors on parenchymal and non-parenchymal cells of the liver and regulate cell-cell and cell-matrix interactions as well as cellular signaling and metabolism. These interactions are key players in tissue growth and remodeling, a prerequisite to restore tissue function after PHx. Their dysregulation is associated with metabolic impairment of the liver eventually leading to liver failure, a serious post-hepatectomy complication with high morbidity and mortality. Though certain links are known, the overall functional change after liver surgery is not understood due to complex feedback loops, non-linearities, spatial heterogeneities and different time-scales of events. Computational modeling is a unique approach to gain a better understanding of complex biomedical systems. This approach allows (i) integration of heterogeneous data and knowledge on multiple scales into a consistent view of how perfusion is related to hepatic function; (ii) testing and generating hypotheses based on predictive models, which must be validated experimentally and clinically. In the long term, computational modeling will (iii) support surgical planning by predicting surgery-induced perfusion perturbations and their functional (metabolic) consequences; and thereby (iv) allow minimizing surgical risks for the individual patient. Here, we review the alterations of hepatic perfusion, biomechanical properties and function associated with hepatectomy. Specifically, we provide an overview over the clinical problem, preoperative diagnostics, functional imaging approaches, experimental approaches in animal models, mechanoperception in the liver and impact on cellular metabolism, omics approaches with a focus on transcriptomics, data integration and uncertainty analysis, and computational modeling on multiple scales. Finally, we provide a perspective on how multi-scale computational models, which couple perfusion changes to hepatic function, could become part of clinical workflows to predict and optimize patient outcome after complex liver surgery.
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Affiliation(s)
- Bruno Christ
- Cell Transplantation/Molecular Hepatology Lab, Department of Visceral, Transplant, Thoracic and Vascular Surgery, University of Leipzig Medical Center, Leipzig, Germany
| | - Maximilian Collatz
- RNA Bioinformatics and High-Throughput Analysis, Faculty of Mathematics and Computer Science, Friedrich Schiller University Jena, Jena, Germany
- Optisch-Molekulare Diagnostik und Systemtechnologié, Leibniz Institute of Photonic Technology (IPHT), Jena, Germany
- InfectoGnostics Research Campus Jena, Jena, Germany
| | - Uta Dahmen
- Experimental Transplantation Surgery, Department of General, Visceral and Vascular Surgery, Jena University Hospital, Jena, Germany
| | - Karl-Heinz Herrmann
- Medical Physics Group, Institute of Diagnostic and Interventional Radiology, Jena University Hospital, Jena, Germany
| | - Sebastian Höpfl
- Faculty of Engineering Design, Production Engineering and Automotive Engineering, Institute for Systems Theory and Automatic Control, University of Stuttgart, Stuttgart, Germany
| | - Matthias König
- Systems Medicine of the Liver Lab, Institute for Theoretical Biology, Humboldt-University Berlin, Berlin, Germany
| | - Lena Lambers
- Faculty of Aerospace Engineering and Geodesy, Institute of Mechanics, Structural Analysis and Dynamics, University of Stuttgart, Stuttgart, Germany
| | - Manja Marz
- RNA Bioinformatics and High-Throughput Analysis, Faculty of Mathematics and Computer Science, Friedrich Schiller University Jena, Jena, Germany
| | - Daria Meyer
- RNA Bioinformatics and High-Throughput Analysis, Faculty of Mathematics and Computer Science, Friedrich Schiller University Jena, Jena, Germany
| | - Nicole Radde
- Faculty of Engineering Design, Production Engineering and Automotive Engineering, Institute for Systems Theory and Automatic Control, University of Stuttgart, Stuttgart, Germany
| | - Jürgen R. Reichenbach
- Medical Physics Group, Institute of Diagnostic and Interventional Radiology, Jena University Hospital, Jena, Germany
| | - Tim Ricken
- Faculty of Aerospace Engineering and Geodesy, Institute of Mechanics, Structural Analysis and Dynamics, University of Stuttgart, Stuttgart, Germany
| | - Hans-Michael Tautenhahn
- Department of General, Visceral and Vascular Surgery, Jena University Hospital, Jena, Germany
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Lin Z, Chen R, Gao B, Qin S, Wu B, Liu J, Cai XC. A highly parallel simulation of patient-specific hepatic flows. INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN BIOMEDICAL ENGINEERING 2021; 37:e3451. [PMID: 33609008 DOI: 10.1002/cnm.3451] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 01/29/2021] [Accepted: 02/13/2021] [Indexed: 06/12/2023]
Abstract
Computational hemodynamics is being developed as an alternative approach for assisting clinical diagnosis and treatment planning for liver diseases. The technology is non-invasive, but the computational time could be high when the full geometry of the blood vessels is taken into account. Existing approaches use either one-dimensional model of the artery or simplified three-dimensional tubular geometry in order to reduce the computational time, but the accuracy is sometime compromised, for example, when simulating blood flows in arteries with plaque. In this work, we study a highly parallel method for the transient incompressible Navier-Stokes equations for the simulation of the blood flows in the full three-dimensional patient-specific hepatic artery, portal vein and hepatic vein. As applications, we also simulate the flow in a patient with hepatectomy and calculate the S (PPG). One of the advantages of simulating blood flows in all hepatic vessels is that it provides a direct estimate of the PPG, which is a gold standard value to assess the portal hypertension. Moreover, the robustness and scalability of the algorithm are also investigated. A 83% parallel efficiency is achieved for solving a problem with 7 million elements on a supercomputer with more than 1000 processor cores.
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Affiliation(s)
- Zeng Lin
- Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
- Shenzhen Key Laboratory for Exascale Engineering and Scientific Computing, Shenzhen, China
| | - Rongliang Chen
- Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
- Shenzhen Key Laboratory for Exascale Engineering and Scientific Computing, Shenzhen, China
| | - Beibei Gao
- Department of Cardiology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Shanlin Qin
- Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Bokai Wu
- Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Jia Liu
- Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
- Shenzhen Key Laboratory for Exascale Engineering and Scientific Computing, Shenzhen, China
| | - Xiao-Chuan Cai
- Department of Mathematics, University of Macau, Macau, China
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Taebi A, Pillai RM, S. Roudsari B, Vu CT, Roncali E. Computational Modeling of the Liver Arterial Blood Flow for Microsphere Therapy: Effect of Boundary Conditions. Bioengineering (Basel) 2020; 7:E64. [PMID: 32610459 PMCID: PMC7552664 DOI: 10.3390/bioengineering7030064] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 06/24/2020] [Accepted: 06/25/2020] [Indexed: 12/11/2022] Open
Abstract
Transarterial embolization is a minimally invasive treatment for advanced liver cancer using microspheres loaded with a chemotherapeutic drug or radioactive yttrium-90 (90Y) that are injected into the hepatic arterial tree through a catheter. For personalized treatment, the microsphere distribution in the liver should be optimized through the injection volume and location. Computational fluid dynamics (CFD) simulations of the blood flow in the hepatic artery can help estimate this distribution if carefully parameterized. An important aspect is the choice of the boundary conditions imposed at the inlet and outlets of the computational domain. In this study, the effect of boundary conditions on the hepatic arterial tree hemodynamics was investigated. The outlet boundary conditions were modeled with three-element Windkessel circuits, representative of the downstream vasculature resistance. Results demonstrated that the downstream vasculature resistance affected the hepatic artery hemodynamics such as the velocity field, the pressure field and the blood flow streamline trajectories. Moreover, the number of microspheres received by the tumor significantly changed (more than 10% of the total injected microspheres) with downstream resistance variations. These findings suggest that patient-specific boundary conditions should be used in order to achieve a more accurate drug distribution estimation with CFD in transarterial embolization treatment planning.
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Affiliation(s)
- Amirtahà Taebi
- Department of Biomedical Engineering, University of California Davis, One Shields Ave., Davis, CA 95616, USA
| | - Rex M. Pillai
- Department of Radiology, University of California Davis, 4860 Y Street, Suite 3100, Sacramento, CA 95817, USA; (R.M.P.); (C.T.V.)
| | | | - Catherine T. Vu
- Department of Radiology, University of California Davis, 4860 Y Street, Suite 3100, Sacramento, CA 95817, USA; (R.M.P.); (C.T.V.)
| | - Emilie Roncali
- Department of Biomedical Engineering, University of California Davis, One Shields Ave., Davis, CA 95616, USA
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Ho H, Yu HB, Bartlett A, Hunter P. An in silico pipeline for subject-specific hemodynamics analysis in liver surgery planning. Comput Methods Biomech Biomed Engin 2020; 23:138-142. [PMID: 31928213 DOI: 10.1080/10255842.2019.1708335] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The progresses in fast simulations of the hepatic flow in subject-specific vascular tree have created new toolkits for pre-surgical planning. The aim of this short communication is to introduce a computational pipeline that integrates several recently developed in silico liver models and algorithms. Firstly, a semi-automatic segmentation pipeline is used to digitise hepatic vessels. Then, a constructive constraint optimisation (CCO) algorithm is used to extend the digitised vascular tree, and also to compute the blood pressure and flow velocity in the tree. Couinaud segments are simulated from the diffusion zones of the portal venous tree. The constructed surgical planning model is then deployed cross-platform for use in various scenarios.
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Affiliation(s)
- H Ho
- Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand
| | - H B Yu
- Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand
| | - A Bartlett
- New Zealand Liver Transplant Unit, Auckland City Hospital, Auckland, New Zealand
| | - P Hunter
- Auckland Bioengineering Institute, The University of Auckland, Auckland, New Zealand
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