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Muñoz R, Dazeo N, Estevez-Areco S, Janot K, Narata AP, Rouchaud A, Larrabide I. Modification of Woven Endo-Bridge After Intracranial Aneurysm Treatment: A Methodology for Three-Dimensional Analysis of Shape and Relative Position Changes. Ann Biomed Eng 2024; 52:1403-1414. [PMID: 38402315 DOI: 10.1007/s10439-024-03465-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 01/31/2024] [Indexed: 02/26/2024]
Abstract
During follow-up of patients treated with WEB devices, shape changes have been observed. The quantitative three-dimensional measurement of the WEB shape modification (WSM) would offer useful information to be studied in association with the anatomical results and try to better understand mechanisms implicated in this modification phenomenon. We present a methodology to quantify the morphology and position of the WEB device in relation to the vascular anatomy. Three-dimensional rotational angiography (3DRA) images of seven aneurysms patients treated with WEBs were used, which also accompanied by a post-treatment 3DRA image and a follow-up 3DRA image. The device was manually segmented, obtaining the 3D models after treatment and at the follow-up. Volume, surface area, height, maximum diameter and WSM ratio of both surfaces were calculated. Position changes were evaluated measuring WEB axis and relative position between post-treatment and follow-up. Changes in WEB volume and surface area were observed with a mean modification of - 5.04 % ( ± 14.19 ) and - 1.68 % ( ± 8.29 ) , respectively. The positional variables also showed differences, mean change of device axis direction was 26.25 % ( ± 24.09 ) and mean change of distance l b was 5.87 % ( ± 10.59 ) . Inter-observer and intra-observer variability analyses did not show differences (ANOVA p > 0.05 ). This methodology allows quantifying the morphological and position changes suffered by the WEB device after treatment, offering new information to be studied in relation to the occurrence of WEB shape modification.
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Affiliation(s)
- Romina Muñoz
- Instituto PLADEMA - CONICET, Universidad Nacional del Centro de la Provincia de Buenos Aires, Tandil, Argentina.
| | - Nicolás Dazeo
- Instituto PLADEMA - CONICET, Universidad Nacional del Centro de la Provincia de Buenos Aires, Tandil, Argentina
| | - Santiago Estevez-Areco
- Instituto PLADEMA - CONICET, Universidad Nacional del Centro de la Provincia de Buenos Aires, Tandil, Argentina
| | - Kevin Janot
- Neuroradiology Department, University Hospital of Tours, 2, boulevard Tonnellé, 37000, Tours, France
| | - Ana Paula Narata
- University Hospital of Southampton, Neuroradiology Department, Southampton, UK
| | - Aymeric Rouchaud
- University Hospital of Limoges, Neuroradiology Department, 2, avenue Martin Luther King, 87000, Limoges, France
| | - Ignacio Larrabide
- Instituto PLADEMA - CONICET, Universidad Nacional del Centro de la Provincia de Buenos Aires, Tandil, Argentina
- Mentice S.L, Barcelona, Spain
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Kan I, Oishi H, Hyodo A, Nemoto S, Fujimura S, Ishibashi T, Sumita K, Takigawa T, Teranishi K, Kodama T, Kato N, Takao H, Murayama Y. A Novel Braided Stent With Customized Simulation Software for Treatment of Intracranial Aneurysms: Multicenter Prospective Trial Before Unrestricted Clinical Application. Oper Neurosurg (Hagerstown) 2024; 26:180-187. [PMID: 37819087 DOI: 10.1227/ons.0000000000000928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 08/03/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Planning/guidance software became important tools for physicians' presurgical optimal decision-making. However, there are no intracranial stent products with specifically associated simulation software. We report the "premarket" clinical trial of a new braided stent with a customized simulation software. METHODS A stent system with 3 mesh density types (16, 24, and 32 wire mesh) was designed based on computational flow dynamics technology, and a simulation software (virtual stent planner [VSP]) was developed for the optimal stent deployment planning. Stents were selected after simulation on preoperative 3D-processed angioimages, and accuracy of the VSP was evaluated. RESULTS Thirty-three unruptured intracranial aneurysms were successfully treated with VSP guidance. Twenty aneurysms (61%) were anterior circulation aneurysms, and 13 (39%) were posterior circulation aneurysms. The average aneurysm size was 7.1 mm, and the mean follow-up period was 19.2 months (11-39.0). There was no major recurrence or retreatment during follow-up, 2 morbidity cases, and no mortality. VSP planning presented slightly smaller stent dimensions compared with postdeployment: 24.2 vs 25.5 mm average, error -1.3 mm, and difference rate-5.46%. CONCLUSION Based on this result, the new stents and software guidance system were approved by the Ministry of Health and Welfare as a combined medical device. VSP provided precise deployment with minimal error compared with actual stent and can contribute to better stent deployment even for less experienced physicians.
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Affiliation(s)
- Issei Kan
- Department of Neurosurgery, The Jikei University School of Medicine, Tokyo , Japan
| | - Hidenori Oishi
- Department of Neuroendovascular Therapy and Neurosurgery, Juntendo University Faculty of Medicine, Tokyo , Japan
| | - Akio Hyodo
- Department of Neurosurgery, Dokkyo Medical University Saitama Medical Center, Saitama , Japan
| | - Shigeru Nemoto
- Department of Endovascular surgery, Tokyo Medical and Dental University, Tokyo , Japan
| | - Soichiro Fujimura
- Department of Mechanical Engineering, Tokyo University of Science, Tokyo , Japan
- Division of Innovation for Medical Information Technology, Jikei University School of Medicine, Tokyo , Japan
| | - Toshihiro Ishibashi
- Department of Neurosurgery, The Jikei University School of Medicine, Tokyo , Japan
| | - Kazutaka Sumita
- Department of Endovascular surgery, Tokyo Medical and Dental University, Tokyo , Japan
| | - Tomoji Takigawa
- Department of Neurosurgery, Dokkyo Medical University Saitama Medical Center, Saitama , Japan
| | - Kohsuke Teranishi
- Department of Neuroendovascular Therapy and Neurosurgery, Juntendo University Faculty of Medicine, Tokyo , Japan
| | - Tomonobu Kodama
- Department of Neurosurgery, The Jikei University School of Medicine, Tokyo , Japan
| | - Naoki Kato
- Department of Neurosurgery, The Jikei University School of Medicine, Tokyo , Japan
| | - Hiroyuki Takao
- Department of Neurosurgery, The Jikei University School of Medicine, Tokyo , Japan
- Division of Innovation for Medical Information Technology, Jikei University School of Medicine, Tokyo , Japan
| | - Yuichi Murayama
- Department of Neurosurgery, The Jikei University School of Medicine, Tokyo , Japan
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Philip NT, Bolem S, Sudhir BJ, Patnaik BSV. Hemodynamics and bio-mechanics of morphologically distinct saccular intracranial aneurysms at bifurcations: Idealised vs Patient-specific geometries. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2022; 227:107237. [PMID: 36413819 DOI: 10.1016/j.cmpb.2022.107237] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 11/01/2022] [Accepted: 11/07/2022] [Indexed: 06/16/2023]
Abstract
Understanding the factors that influence the rupture of aneurysms is of primary concern to the clinicians, who are grappled with patient management. It is important to know how the relation between morphological features of the cerebral aneurysm, and the mechanical stresses on the containing arterial walls are influenced by the hemodynamic forces. Present study investigates three different shapes, which have been identified correspondingly in patient-specific scenarios as well. The primary objective is to categorize the bifurcation aneurysms into standard shapes such as, spherical, beehive and pear-shaped, based on patient-specific clinical studies and further compare and contrast the model aneurysms with the patient specific configurations, for their hemodynamic factors as well as the attendant stresses on the wall. MethodsComputational fluid dynamic simulations are performed accounting for the fluid-structure interaction (FSI) effects between the flowing fluid and the containing vessel wall. Blood is assumed to be Newtonian, while the arterial walls are assumed to be linearly elastic. A commercial solver is used for performing detailed calculations. Hemodynamic and bio-mechanical rupture predictions are carried out for the three different shapes. Observations derived from the idealised simulations are compared and contrasted against their patient-specific counterparts. ResultsFrom detailed numerical simulations, it was observed that pear-shaped aneurysms exhibit large re-circulation bubble and flow stagnation zone, with higher residence time for the particles, which may lead to atherosclerotic lesions. Beehive shape allows for maximum flow into the aneurysmal sac with concentrated jet impinging on the dome, leading to high values of maximum WSS (MWSS) resulting in great propensity to form a secondary bleb. However, flow field inside a spherical aneurysm is found to be stable with fewer vortices, and nearly uniform distribution of wall stresses are observed though-out the sac, which perhaps signifies hemodynamically and bio-mechanically stable condition. ConclusionCategorizing patient-specific intracranial aneurysms into standard shapes viz, spherical, beehive and pear could generalize the process of prediction of hemodynamic and bio-mechanical rupture indicators. Comparative assessment of the flow field and stresses reported from the simulations on idealised models, with corresponding patient-specific simulations reveal that, these studies could aid in understanding the generalised shape dependence of hemodynamic and bio-mechanical behaviour of aneurysms.
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Affiliation(s)
- Nimmy Thankom Philip
- Department of Applied Mechanics, Indian Institute of Technology Madras, Chennai, 600036, India
| | - Srinivas Bolem
- Department of Applied Mechanics, Indian Institute of Technology Madras, Chennai, 600036, India
| | - B J Sudhir
- Department of Neurosurgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, 695011, Kerala, India.
| | - B S V Patnaik
- Department of Applied Mechanics, Indian Institute of Technology Madras, Chennai, 600036, India.
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Simulation of intra-saccular devices for pre-operative device size selection: Method and validation for sizing and porosity simulation. Comput Biol Med 2022; 147:105744. [PMID: 35763930 DOI: 10.1016/j.compbiomed.2022.105744] [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: 03/22/2022] [Revised: 05/24/2022] [Accepted: 06/11/2022] [Indexed: 11/24/2022]
Abstract
Intra-saccular devices (ID) are novel braided devices used for complex intracranial aneurysms treatment. Treatment success is associated with correct device size selection. A technique that predicts the ID size within the aneurysm before intervention will provide a powerful computational tool to aid the interventionist during device selection. We present a method to calculate the device's final height, radial expansion and porosity within the patient's anatomy, which allows assessing different device sizes before treatment takes place. The proposed sizing technique was tested in-vitro and in real patient's geometries obtained from 3DRA angiographic images of 8 unruptured aneurysms previously treated with IDs. The obtained simulated height was compared to the real height, with a mean error of less than 0.28 mm (±0.44). The porosity calculation method was tested in-vitro with an error of 0.02 (±0.022). The results of both sizing and porosity experiments resemble well measures from real patients. This methodology could be used before treatment to provide the interventionist with additional information that allows selecting the device that best fits the patient's aneurysm to be treated.
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Dazeo N, Muñoz R, Narata AP, Fernandez H, Larrabide I. Intra-saccular device modeling for treatment planning of intracranial aneurysms: from morphology to hemodynamics. Int J Comput Assist Radiol Surg 2021; 16:1663-1673. [PMID: 34195929 DOI: 10.1007/s11548-021-02427-9] [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: 02/09/2021] [Accepted: 05/28/2021] [Indexed: 10/21/2022]
Abstract
MOTIVATION Intra-saccular devices (ID), developed for the treatment of bifurcation aneurysms, offer new alternatives for treating complex terminal and bifurcation aneurysms. In this work, a complete workflow going from medical images to post-treatment CFD analysis is described and used in the assessment of a concrete clinical problem. MATERIALS AND METHODS Two different intra-saccular device sizes were virtually implanted in 3D models of the patient vasculature using the ID-Fit method. After deployment, the local porosity at the closed end of the device in contact with the blood flow was computed. This porosity was then used to produce a CFD porous medium model of the device. Velocities and wall shear stress were assessed for each model. RESULTS Six patients treated with intra-saccular devices were included in this work. For each case, 2 different device sizes were virtually implanted and 3 CFD simulations were performed: after deployment simulation with each size and before deployment simulation (untreated). A visible reduction in velocities was observed after device implantation. Velocity and WSS reduction was statistically significant (K-S statistics, [Formula: see text]). CONCLUSIONS Placement of different device size can lead to a partial filling of the aneurysm, either at the dome or at the neck, depending on the particular positioning by the interventionist. The methodology used in this work can have a strong clinical impact, since it provides additional information in the process of device selection using preoperative data.
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Affiliation(s)
- Nicolás Dazeo
- Instituto Pladema - CONICET, Universidad Nacional del Centro de la Provincia de Buenos Aires, Tandil, Argentina.
| | - Romina Muñoz
- Instituto Pladema - CONICET, Universidad Nacional del Centro de la Provincia de Buenos Aires, Tandil, Argentina
| | - Ana Paula Narata
- Neuroradiology Department, University Hospital of Southampton, Southampton, UK
| | | | - Ignacio Larrabide
- Instituto Pladema - CONICET, Universidad Nacional del Centro de la Provincia de Buenos Aires, Tandil, Argentina.,Galgo Medical S.L., Barcelona, Spain
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Dazeo N, Dottori J, Boroni G, Narata AP, Larrabide I. Stenting as porous media in anatomically accurate geometries. A comparison of models and spatial heterogeneity. J Biomech 2020; 110:109945. [PMID: 32827768 DOI: 10.1016/j.jbiomech.2020.109945] [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] [Received: 01/03/2020] [Revised: 07/03/2020] [Accepted: 07/08/2020] [Indexed: 10/23/2022]
Abstract
Modelling intracranial aneurysm blood flow after flow diverter treatment has proven to be of great scientific and clinical interest. One of the reasons for not having CFD as an everyday clinical tool yet is the time required to set-up such simulations plus the required computational time. The speed-up of these simulations can have a considerable impact during treatment planning and device selection. Modelling flow diverters as a porous medium (PM) can considerably improve the computational time. Many models have been presented in literature, but quantitative comparisons between models are scarce. In this study, the untreated case, the explicit definition of the flow diverter wires as no-slip boundary condition and five different porous medium models were chosen for comparison, and evaluated on intracranial aneurysm of 14 patients with different shapes, sizes, and locations. CFD simulations were made using finite volume method on steady flow conditions. Velocities, kinetic energy, wall shear stress, and computational time were assessed for each model. Then, all models are compared against the no-slip boundary condition using non parametric Kolmogorov-Smirnov test. The model with least performance showed a mean K-S statistic of 0.31 and deviance of 0.2, while the model with best values always gave K-S statistics below 0.2. Kinetic energy between PM models varied between an over estimation of 218.3% and an under estimation of 73.06%. Also, speedups were between 4.75x and 5.3x (stdev: 0.38x and 0.15x) when using PM models. Flow diverters can be simulated with PM with a good agreement to standard CFD simulations were FD wires are represented with no-slip boundary condition in less than a quarter of the time. Best results were obtained on PM models based on geometrical properties, in particular, when using a heterogeneous medium based on equations for flat rhomboidal wire frames.
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Affiliation(s)
- Nicolás Dazeo
- Pladema - CONICET, Universidad Nacional del Centro de la Provincia de Buenos Aires, Buenos Aires, Argentina.
| | - Javier Dottori
- Pladema - CONICET, Universidad Nacional del Centro de la Provincia de Buenos Aires, Buenos Aires, Argentina
| | - Gustavo Boroni
- Pladema - CONICET, Universidad Nacional del Centro de la Provincia de Buenos Aires, Buenos Aires, Argentina
| | - Ana Paula Narata
- University Hospital of Tours, UMR Imagerie et Cerveau, Inserm U930, Université François-Rabelais, Tours, France
| | - Ignacio Larrabide
- Pladema - CONICET, Universidad Nacional del Centro de la Provincia de Buenos Aires, Buenos Aires, Argentina
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Geng J, Hu P, Ji Z, Li C, Li L, Shen J, Feng X, Wang W, Yang G, Li J, Zhang H. Accuracy and reliability of computer-assisted semi-automated morphological analysis of intracranial aneurysms: an experimental study with digital phantoms and clinical aneurysm cases. Int J Comput Assist Radiol Surg 2020; 15:1749-1759. [DOI: 10.1007/s11548-020-02218-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 06/15/2020] [Indexed: 10/23/2022]
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Dottori J, Casciaro M, Craiem D, El-Batti S, Mousseaux E, Alsac JM, Larrabide I. Regional assessment of vascular morphology and hemodynamics: methodology and evaluation for abdominal aortic aneurysms after endovascular repair. Comput Methods Biomech Biomed Engin 2020; 23:1060-1070. [DOI: 10.1080/10255842.2020.1786073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Javier Dottori
- Pladema - CONICET, Universidad Nacional del Centro de la Provincia de Buenos Aires, Tandil, Argentina
| | - Mariano Casciaro
- Instituto de Medicina Traslacional, Trasplante y Bioingeniería (IMeTTyB), Universidad Favaloro - CONICET, Buenos Aires, Argentina
| | - Damian Craiem
- Instituto de Medicina Traslacional, Trasplante y Bioingeniería (IMeTTyB), Universidad Favaloro - CONICET, Buenos Aires, Argentina
| | | | | | | | - Ignacio Larrabide
- Pladema - CONICET, Universidad Nacional del Centro de la Provincia de Buenos Aires, Tandil, Argentina
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Casciaro ME, Dottori J, El-Batti S, Alsac JM, Mousseaux E, Larrabide I, Craiem D. Effects on Aortoiliac Fluid Dynamics After Endovascular Sealing of Abdominal Aneurysms. Vasc Endovascular Surg 2018; 52:621-628. [PMID: 30058480 DOI: 10.1177/1538574418791059] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES: To evaluate the effects on aortoiliac fluid dynamics after the implantation of an endograft based on endovascular aneurysm sealing (EVAS) versus endovascular aneurysm repair (EVAR) strategy. METHODS: An adaptive geometrical deformable model was used for aortic lumen segmentation in 8 patients before and after the surgery. Abdominal aneurysms were treated with an endograft based on the EVAS system (Nellix, n = 4) and with a device based on an anatomical fixation technology (n = 4). Pressure, blood velocity, and wall shear stress (WSS) were estimated at different aortic regions using computational fluid dynamics methods. Physiologic inlet/outlet flow values at the abdominal aorta, the celiac trunk, and the mesenteric and the renal arteries were set. Pressure references were set at iliac arteries outlet. RESULTS: Maximum aneurysm sizes were similar for both groups in the preoperative scans. The lumen area was lower after EVAR ( P < .05) and EVAS ( P < .01) compared to preoperative aortic lumen sizes. Pressure increase was higher in the proximal abdominal aorta after EVAS compared to EVAR (2.3 ± 0.3 mm Hg vs 0.9 ± 0.3 mm Hg, P < .001). Peak blood velocities inside the endografts were 3-fold higher for EVAS compared to EVAR (54 ± 5 cm/s vs 17 ± 4 cm/s, P < .01). Velocities at the iliac arteries also remained higher for EVAS (38 ± 4 cm/s vs 24 ± 4 cm/s, P < .05). Peak WSS at the iliac arteries remained higher for EVAS compared to EVAR group ( P < .05). CONCLUSION: The significant modification of the aortic bifurcation anatomy after EVAS alters aortoiliac fluid dynamics, showing a pressure impact at the renal arteries level and an acceleration of the blood velocity at the iliac region with a concomitant increase in peak WSS.
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Affiliation(s)
- Mariano E Casciaro
- 1 Instituto de Medicina Traslacional, Trasplante y Bioingeniería (IMeTTyB), Universidad Favaloro-CONICET, Buenos Aires, Argentina
| | | | - Salma El-Batti
- 3 APHP, Hôpital Européen Georges Pompidou, Paris, France
| | | | - Elie Mousseaux
- 3 APHP, Hôpital Européen Georges Pompidou, Paris, France
| | | | - Damian Craiem
- 1 Instituto de Medicina Traslacional, Trasplante y Bioingeniería (IMeTTyB), Universidad Favaloro-CONICET, Buenos Aires, Argentina.,3 APHP, Hôpital Européen Georges Pompidou, Paris, France
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Paliwal N, Damiano RJ, Varble NA, Tutino VM, Dou Z, Siddiqui AH, Meng H. Methodology for Computational Fluid Dynamic Validation for Medical Use: Application to Intracranial Aneurysm. J Biomech Eng 2017; 139:2653365. [PMID: 28857116 PMCID: PMC5686786 DOI: 10.1115/1.4037792] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Revised: 08/28/2017] [Indexed: 11/08/2022]
Abstract
Computational fluid dynamics (CFD) is a promising tool to aid in clinical diagnoses of cardiovascular diseases. However, it uses assumptions that simplify the complexities of the real cardiovascular flow. Due to high-stakes in the clinical setting, it is critical to calculate the effect of these assumptions in the CFD simulation results. However, existing CFD validation approaches do not quantify error in the simulation results due to the CFD solver's modeling assumptions. Instead, they directly compare CFD simulation results against validation data. Thus, to quantify the accuracy of a CFD solver, we developed a validation methodology that calculates the CFD model error (arising from modeling assumptions). Our methodology identifies independent error sources in CFD and validation experiments, and calculates the model error by parsing out other sources of error inherent in simulation and experiments. To demonstrate the method, we simulated the flow field of a patient-specific intracranial aneurysm (IA) in the commercial CFD software star-ccm+. Particle image velocimetry (PIV) provided validation datasets for the flow field on two orthogonal planes. The average model error in the star-ccm+ solver was 5.63 ± 5.49% along the intersecting validation line of the orthogonal planes. Furthermore, we demonstrated that our validation method is superior to existing validation approaches by applying three representative existing validation techniques to our CFD and experimental dataset, and comparing the validation results. Our validation methodology offers a streamlined workflow to extract the "true" accuracy of a CFD solver.
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Affiliation(s)
- Nikhil Paliwal
- Department of Mechanical and Aerospace Engineering,
University at Buffalo,
Buffalo, NY 14260
- Toshiba Stroke and Vascular Research Center,
University at Buffalo,
Buffalo, NY 14203
| | - Robert J. Damiano
- Department of Mechanical and Aerospace Engineering,
University at Buffalo,
Buffalo, NY 14260
- Toshiba Stroke and Vascular Research Center,
University at Buffalo,
Buffalo, NY 14203
| | - Nicole A. Varble
- Department of Mechanical and Aerospace Engineering,
University at Buffalo,
Buffalo, NY 14260
- Toshiba Stroke and Vascular Research Center,
University at Buffalo,
Buffalo, NY 14203
| | - Vincent M. Tutino
- Toshiba Stroke and Vascular Research Center,
University at Buffalo,
Buffalo, NY 14203
- Department of Biomedical Engineering,
University at Buffalo,
Buffalo, NY 14260
| | - Zhongwang Dou
- Department of Mechanical and Aerospace Engineering,
University at Buffalo,
Buffalo, NY 14260
| | - Adnan H. Siddiqui
- Toshiba Stroke and Vascular Research Center,
University at Buffalo,
Buffalo, NY 14260
- Department of Neurosurgery,
University at Buffalo,
Buffalo, NY 14226
| | - Hui Meng
- Department of Mechanical and Aerospace Engineering,
University at Buffalo,
324 Jarvis Hall,
Buffalo, NY 14260
- Toshiba Stroke and Vascular Research Center,
University at Buffalo,
Buffalo, NY 14203
- Department of Biomedical Engineering,
University at Buffalo,
Buffalo, NY 14260
- Department of Neurosurgery,
University at Buffalo,
Buffalo, NY 14226
e-mail:
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Illies T, Saering D, Kinoshita M, Fujinaka T, Bester M, Fiehler J, Tomiyama N, Watanabe Y. Feasibility of Quantification of Intracranial Aneurysm Pulsation with 4D CTA with Manual and Computer-Aided Post-Processing. PLoS One 2016; 11:e0166810. [PMID: 27880805 PMCID: PMC5120820 DOI: 10.1371/journal.pone.0166810] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Accepted: 11/04/2016] [Indexed: 11/20/2022] Open
Abstract
Background and Purpose The analysis of the pulsation of unruptured intracranial aneurysms might improve the assessment of their stability and risk of rupture. Pulsations can easily be concealed due to the small movements of the aneurysm wall, making post-processing highly demanding. We hypothesized that the quantification of aneurysm pulsation is technically feasible and can be improved by computer-aided post-processing. Materials and Methods Images of 14 cerebral aneurysms were acquired with an ECG-triggered 4D CTA. Aneurysms were post-processed manually and computer-aided on a 3D model. Volume curves and random noise-curves were compared with the arterial pulse wave and volume curves were compared between both post-processing modalities. Results The aneurysm volume curves showed higher similarity with the pulse wave than the random curves (Hausdorff-distances 0.12 vs 0.25, p<0.01). Both post-processing methods did not differ in intra- (r = 0.45 vs r = 0.54, p>0.05) and inter-observer (r = 0.45 vs r = 0.54, p>0.05) reliability. Time needed for segmentation was significantly reduced in the computer-aided group (3.9 ± 1.8 min vs 20.8 ± 7.8 min, p<0.01). Conclusion Our results show pulsatile changes in a subset of the studied aneurysms with the final prove of underlying volume changes remaining unsettled. Semi-automatic post-processing significantly reduces post-processing time but cannot yet replace manual segmentation.
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Affiliation(s)
- Till Illies
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- * E-mail:
| | - Dennis Saering
- Information Technology and Image Processing, University of Applied Sciences, Wedel, Germany
| | - Manabu Kinoshita
- Department of Neurosurgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Toshiyuki Fujinaka
- Department of Neurosurgery, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Maxim Bester
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jens Fiehler
- Department of Diagnostic and Interventional Neuroradiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Noriyuki Tomiyama
- Department of Radiology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Yoshiyuki Watanabe
- Department of Radiology, Osaka University Graduate School of Medicine, Osaka, Japan
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12
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Larrabide I, Geers AJ, Morales HG, Bijlenga P, Rüfenacht DA. Change in aneurysmal flow pulsatility after flow diverter treatment. Comput Med Imaging Graph 2016; 50:2-8. [DOI: 10.1016/j.compmedimag.2015.01.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2014] [Revised: 12/16/2014] [Accepted: 01/19/2015] [Indexed: 11/30/2022]
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13
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Li X, Wang X, Dai Y, Zhang P. Supervised recursive segmentation of volumetric CT images for 3D reconstruction of lung and vessel tree. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2015; 122:316-329. [PMID: 26362225 DOI: 10.1016/j.cmpb.2015.08.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/11/2015] [Revised: 07/17/2015] [Accepted: 08/24/2015] [Indexed: 06/05/2023]
Abstract
Three dimensional reconstruction of lung and vessel tree has great significance to 3D observation and quantitative analysis for lung diseases. This paper presents non-sheltered 3D models of lung and vessel tree based on a supervised semi-3D lung tissues segmentation method. A recursive strategy based on geometric active contour is proposed instead of the "coarse-to-fine" framework in existing literature to extract lung tissues from the volumetric CT slices. In this model, the segmentation of the current slice is supervised by the result of the previous one slice due to the slight changes between adjacent slice of lung tissues. Through this mechanism, lung tissues in all the slices are segmented fast and accurately. The serious problems of left and right lungs fusion, caused by partial volume effects, and segmentation of pleural nodules can be settled meanwhile during the semi-3D process. The proposed scheme is evaluated by fifteen scans, from eight healthy participants and seven participants suffering from early-stage lung tumors. The results validate the good performance of the proposed method compared with the "coarse-to-fine" framework. The segmented datasets are utilized to reconstruct the non-sheltered 3D models of lung and vessel tree.
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Affiliation(s)
- Xuanping Li
- State Key Laboratory of Precision Measurement Technology and Instruments, and Department of Precision Instrument, Tsinghua University, Beijing, China
| | - Xue Wang
- State Key Laboratory of Precision Measurement Technology and Instruments, and Department of Precision Instrument, Tsinghua University, Beijing, China.
| | - Yixiang Dai
- State Key Laboratory of Precision Measurement Technology and Instruments, and Department of Precision Instrument, Tsinghua University, Beijing, China
| | - Pengbo Zhang
- State Key Laboratory of Precision Measurement Technology and Instruments, and Department of Precision Instrument, Tsinghua University, Beijing, China
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AView: An Image-based Clinical Computational Tool for Intracranial Aneurysm Flow Visualization and Clinical Management. Ann Biomed Eng 2015; 44:1085-96. [PMID: 26101034 DOI: 10.1007/s10439-015-1363-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Accepted: 06/11/2015] [Indexed: 10/23/2022]
Abstract
Intracranial aneurysms (IAs) occur in around 3% of the entire population. IA rupture is responsible for the most devastating type of hemorrhagic strokes, with high fatality and disability rates as well as healthcare costs. With increasing detection of unruptured aneurysms, clinicians are routinely faced with the dilemma whether to treat IA patients and how to best treat them. Hemodynamic and morphological characteristics are increasingly considered in aneurysm rupture risk assessment and treatment planning, but currently no computational tools allow routine integration of flow visualization and quantitation of these parameters in clinical workflow. In this paper, we introduce AView, a prototype of a clinician-oriented, integrated computation tool for aneurysm hemodynamics, morphology, and risk and data management to aid in treatment decisions and treatment planning in or near the procedure room. Specifically, we describe how we have designed the AView structure from the end-user's point of view, performed a pilot study and gathered clinical feedback. The positive results demonstrate AView's potential clinical value on enhancing aneurysm treatment decision and treatment planning.
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15
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Clarkson MJ, Zombori G, Thompson S, Totz J, Song Y, Espak M, Johnsen S, Hawkes D, Ourselin S. The NifTK software platform for image-guided interventions: platform overview and NiftyLink messaging. Int J Comput Assist Radiol Surg 2014; 10:301-16. [PMID: 25408304 PMCID: PMC4338364 DOI: 10.1007/s11548-014-1124-7] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2014] [Accepted: 10/17/2014] [Indexed: 11/24/2022]
Abstract
PURPOSE To perform research in image-guided interventions, researchers need a wide variety of software components, and assembling these components into a flexible and reliable system can be a challenging task. In this paper, the NifTK software platform is presented. A key focus has been high-performance streaming of stereo laparoscopic video data, ultrasound data and tracking data simultaneously. METHODS A new messaging library called NiftyLink is introduced that uses the OpenIGTLink protocol and provides the user with easy-to-use asynchronous two-way messaging, high reliability and comprehensive error reporting. A small suite of applications called NiftyGuide has been developed, containing lightweight applications for grabbing data, currently from position trackers and ultrasound scanners. These applications use NiftyLink to stream data into NiftyIGI, which is a workstation-based application, built on top of MITK, for visualisation and user interaction. Design decisions, performance characteristics and initial applications are described in detail. NiftyLink was tested for latency when transmitting images, tracking data, and interleaved imaging and tracking data. RESULTS NiftyLink can transmit tracking data at 1,024 frames per second (fps) with latency of 0.31 milliseconds, and 512 KB images with latency of 6.06 milliseconds at 32 fps. NiftyIGI was tested, receiving stereo high-definition laparoscopic video at 30 fps, tracking data from 4 rigid bodies at 20-30 fps and ultrasound data at 20 fps with rendering refresh rates between 2 and 20 Hz with no loss of user interaction. CONCLUSION These packages form part of the NifTK platform and have proven to be successful in a variety of image-guided surgery projects. Code and documentation for the NifTK platform are available from http://www.niftk.org . NiftyLink is provided open-source under a BSD license and available from http://github.com/NifTK/NiftyLink . The code for this paper is tagged IJCARS-2014.
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Affiliation(s)
- Matthew J Clarkson
- Centre For Medical Image Computing, University College London, Engineering Front Building, Malet Place, London, UK,
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16
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Peach TW, Ngoepe M, Spranger K, Zajarias-Fainsod D, Ventikos Y. Personalizing flow-diverter intervention for cerebral aneurysms: from computational hemodynamics to biochemical modeling. INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN BIOMEDICAL ENGINEERING 2014; 30:1387-1407. [PMID: 25045060 DOI: 10.1002/cnm.2663] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2012] [Revised: 06/11/2014] [Accepted: 07/07/2014] [Indexed: 06/03/2023]
Abstract
This paper presents the computational modeling of a variety of flow-diverting stents, deployed in a number of patient-specific aneurysm geometries. We consider virtual device deployment and hemodynamics as well as thrombus formation, with the scope to assess pre-operatively the efficacy of specific devices in treating particular aneurysms. An algorithm based on a linear and torsional spring analogy is developed for the fast virtual deployment of stents and similar minimally invasive devices in patient-specific vessel geometries. The virtual deployment algorithm is used to accurately deploy a total of four stent designs in three aneurysm geometries. A variety of different flow-diverting stent designs, representing the commercially available and the entirely novel, are presented, varying in both mesh design and porosity. Transient computational hemodynamics simulations are performed on multiple patient-specific geometries to predict the reduction in aneurysm inflow after the deployment of each device. Further, a thrombosis initiation and growth model is implemented, coupled with the hemodynamic computations. Hemodynamic simulations show large variations in flow reduction between devices and across different aneurysm geometries. The industry standard of flow-diverters with 70% porosity, assumed to offer the best compromise in flexibility and flow reduction, is challenged in at least one aneurysm geometry.
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Affiliation(s)
- T W Peach
- Institute of Biomedical Engineering & Department of Engineering Science, University of Oxford, Parks Road, Oxford, OX1 3PJ
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17
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Larrabide I, Geers AJ, Morales HG, Aguilar ML, Rüfenacht DA. Effect of aneurysm and ICA morphology on hemodynamics before and after flow diverter treatment. J Neurointerv Surg 2014; 7:272-80. [DOI: 10.1136/neurintsurg-2014-011171] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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18
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Jin C, He Z, Liu J. MRI-based finite element simulation on radiofrequency ablation of thyroid cancer. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2014; 113:529-538. [PMID: 24411316 DOI: 10.1016/j.cmpb.2013.12.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2013] [Revised: 12/01/2013] [Accepted: 12/16/2013] [Indexed: 06/03/2023]
Abstract
In order to provide a quantitative disclosure on the RFA (radiofrequency ablation)-induced thermal ablation effects within thyroid tissues, this paper has developed a three-dimensional finite element simulation strategy based on a MRI (magnetic resonance imaging)-reconstructed model. The thermal lesion's growth was predicted and interpreted under two treatment conditions, i.e. single-cooled-electrode modality and two-cooled-electrode system. The results show that the thermal lesion's growth is significantly affected by two factors including the position of RF electrode and thermal-physiological behavior of the breathing airflow. Additional parametric studies revealed several valuable phenomena, e.g. with the electrode's movement, thermal injury with varying severity would happen to the trachea wall. Besides, the changes in airflow mass produced evident effects on the total heat flux of thyroid surface, while the changes in breathing frequency only generated minor effects that can be ignored. The present study provided a better understanding on the thermal lesions of RFA within thyroid domain, which will help guide future treatment of the thyroid cancer.
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Affiliation(s)
- Chao Jin
- Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing 100084, PR China
| | - Zhizhu He
- Beijing Key Laboratory of Cryo-Biomedical Engineering, and Key Laboratory of Cryogenics, Technical Institute of Physics and Chemistry, Chinese Academy of Sciences, Beijing 100190, PR China
| | - Jing Liu
- Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing 100084, PR China; Beijing Key Laboratory of Cryo-Biomedical Engineering, and Key Laboratory of Cryogenics, Technical Institute of Physics and Chemistry, Chinese Academy of Sciences, Beijing 100190, PR China.
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Frangi AF, Hose DR, Hunter PJ, Ayache N, Brooks D. Special issue on medical imaging and image computing in computational physiology. IEEE TRANSACTIONS ON MEDICAL IMAGING 2013; 32:1-7. [PMID: 23409282 DOI: 10.1109/tmi.2012.2234320] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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