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Aljassam Y, Caputo M, Biglino G. Surgical Patching in Congenital Heart Disease: The Role of Imaging and Modelling. Life (Basel) 2023; 13:2295. [PMID: 38137896 PMCID: PMC10745019 DOI: 10.3390/life13122295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 11/28/2023] [Accepted: 11/29/2023] [Indexed: 12/24/2023] Open
Abstract
In congenital heart disease, patches are not tailored to patient-specific anatomies, leading to shape mismatch with likely functional implications. The design of patches through imaging and modelling may be beneficial, as it could improve clinical outcomes and reduce the costs associated with redo procedures. Whilst attention has been paid to the material of the patches used in congenital surgery, this review outlines the current knowledge on this subject and isolated experimental work that uses modelling and imaging-derived information (including 3D printing) to inform the design of the surgical patch.
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Affiliation(s)
- Yousef Aljassam
- Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol BS2 8HW, UK;
| | - Massimo Caputo
- Bristol Heart Institute, Bristol Medical School, University of Bristol, Bristol BS2 8HW, UK;
- Cardiac Surgery, University Hospitals Bristol & Weston, NHS Foundation Trust, Bristol BS2 8HW, UK
| | - Giovanni Biglino
- Bristol Heart Institute, Bristol Medical School, University of Bristol, Bristol BS2 8HW, UK;
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2
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Iyer K, Elhabian S. Mesh2SSM: From Surface Meshes to Statistical Shape Models of Anatomy. MEDICAL IMAGE COMPUTING AND COMPUTER-ASSISTED INTERVENTION : MICCAI ... INTERNATIONAL CONFERENCE ON MEDICAL IMAGE COMPUTING AND COMPUTER-ASSISTED INTERVENTION 2023; 14220:615-625. [PMID: 38659613 PMCID: PMC11036176 DOI: 10.1007/978-3-031-43907-0_59] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
Statistical shape modeling is the computational process of discovering significant shape parameters from segmented anatomies captured by medical images (such as MRI and CT scans), which can fully describe subject-specific anatomy in the context of a population. The presence of substantial non-linear variability in human anatomy often makes the traditional shape modeling process challenging. Deep learning techniques can learn complex non-linear representations of shapes and generate statistical shape models that are more faithful to the underlying population-level variability. However, existing deep learning models still have limitations and require established/optimized shape models for training. We propose Mesh2SSM, a new approach that leverages unsupervised, permutation-invariant representation learning to estimate how to deform a template point cloud to subject-specific meshes, forming a correspondence-based shape model. Mesh2SSM can also learn a population-specific template, reducing any bias due to template selection. The proposed method operates directly on meshes and is computationally efficient, making it an attractive alternative to traditional and deep learning-based SSM approaches.
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Affiliation(s)
- Krithika Iyer
- Scientific Computing and Imaging Institute, University of Utah, SLC, UT, US
- Kahlert School of Computing, University of Utah, Salt Lake City, UT, USA
| | - Shireen Elhabian
- Scientific Computing and Imaging Institute, University of Utah, SLC, UT, US
- Kahlert School of Computing, University of Utah, Salt Lake City, UT, USA
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Scarpolini MA, Mazzoli M, Celi S. Enabling supra-aortic vessels inclusion in statistical shape models of the aorta: a novel non-rigid registration method. Front Physiol 2023; 14:1211461. [PMID: 37637150 PMCID: PMC10450506 DOI: 10.3389/fphys.2023.1211461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 07/11/2023] [Indexed: 08/29/2023] Open
Abstract
Statistical Shape Models (SSMs) are well-established tools for assessing the variability of 3D geometry and for broadening a limited set of shapes. They are widely used in medical imaging due to their ability to model complex geometries and their high efficiency as generative models. The principal step behind these techniques is a registration phase, which, in the case of complex geometries, can be a critical issue due to the correspondence problem, as it necessitates the development of correspondence mapping between shapes. The thoracic aorta, with its high level of morphological complexity, poses a multi-scale deformation problem due to the presence of several branch vessels with varying diameters. Moreover, branch vessels exhibit significant variability in shape, making the correspondence optimization even more challenging. Consequently, existing studies have focused on developing SSMs based only on the main body of the aorta, excluding the supra-aortic vessels from the analysis. In this work, we present a novel non-rigid registration algorithm based on optimizing a differentiable distance function through a modified gradient descent approach. This strategy enables the inclusion of custom, domain-specific constraints in the objective function, which act as landmarks during the registration phase. The algorithm's registration performance was tested and compared to an alternative Statistical Shape modeling framework, and subsequently used for the development of a comprehensive SSM of the thoracic aorta, including the supra-aortic vessels. The developed SSM was further evaluated against the alternative framework in terms of generalisation, specificity, and compactness to assess its effectiveness.
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Affiliation(s)
- Martino Andrea Scarpolini
- BioCardioLab, Bioengineering Unit, Fondazione Toscana G. Monasterio, Ospedale del Cuore, Massa, Italy
- Department of Industrial Engineering, University of Rome “Tor Vergata”, Roma, Italy
| | - Marilena Mazzoli
- BioCardioLab, Bioengineering Unit, Fondazione Toscana G. Monasterio, Ospedale del Cuore, Massa, Italy
- Department of Information Engineering, University of Pisa, Pisa, Italy
| | - Simona Celi
- BioCardioLab, Bioengineering Unit, Fondazione Toscana G. Monasterio, Ospedale del Cuore, Massa, Italy
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Geronzi L, Martinez A, Rochette M, Yan K, Bel-Brunon A, Haigron P, Escrig P, Tomasi J, Daniel M, Lalande A, Lin S, Marin-Castrillon DM, Bouchot O, Porterie J, Valentini PP, Biancolini ME. Computer-aided shape features extraction and regression models for predicting the ascending aortic aneurysm growth rate. Comput Biol Med 2023; 162:107052. [PMID: 37263151 DOI: 10.1016/j.compbiomed.2023.107052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 04/27/2023] [Accepted: 05/20/2023] [Indexed: 06/03/2023]
Abstract
OBJECTIVE ascending aortic aneurysm growth prediction is still challenging in clinics. In this study, we evaluate and compare the ability of local and global shape features to predict the ascending aortic aneurysm growth. MATERIAL AND METHODS 70 patients with aneurysm, for which two 3D acquisitions were available, are included. Following segmentation, three local shape features are computed: (1) the ratio between maximum diameter and length of the ascending aorta centerline, (2) the ratio between the length of external and internal lines on the ascending aorta and (3) the tortuosity of the ascending tract. By exploiting longitudinal data, the aneurysm growth rate is derived. Using radial basis function mesh morphing, iso-topological surface meshes are created. Statistical shape analysis is performed through unsupervised principal component analysis (PCA) and supervised partial least squares (PLS). Two types of global shape features are identified: three PCA-derived and three PLS-based shape modes. Three regression models are set for growth prediction: two based on gaussian support vector machine using local and PCA-derived global shape features; the third is a PLS linear regression model based on the related global shape features. The prediction results are assessed and the aortic shapes most prone to growth are identified. RESULTS the prediction root mean square error from leave-one-out cross-validation is: 0.112 mm/month, 0.083 mm/month and 0.066 mm/month for local, PCA-based and PLS-derived shape features, respectively. Aneurysms close to the root with a large initial diameter report faster growth. CONCLUSION global shape features might provide an important contribution for predicting the aneurysm growth.
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Affiliation(s)
- Leonardo Geronzi
- University of Rome Tor Vergata, Department of Enterprise Engineering "Mario Lucertini", Rome, Italy; Ansys France, Villeurbanne, France.
| | - Antonio Martinez
- University of Rome Tor Vergata, Department of Enterprise Engineering "Mario Lucertini", Rome, Italy; Ansys France, Villeurbanne, France
| | | | - Kexin Yan
- Ansys France, Villeurbanne, France; University of Lyon, INSA Lyon, CNRS, LaMCoS, UMR5259, 69621 Villeurbanne, France
| | - Aline Bel-Brunon
- University of Lyon, INSA Lyon, CNRS, LaMCoS, UMR5259, 69621 Villeurbanne, France
| | - Pascal Haigron
- University of Rennes, CHU Rennes, Inserm, LTSI - UMR 1099, F-35000, Rennes, France
| | - Pierre Escrig
- University of Rennes, CHU Rennes, Inserm, LTSI - UMR 1099, F-35000, Rennes, France
| | - Jacques Tomasi
- University of Rennes, CHU Rennes, Inserm, LTSI - UMR 1099, F-35000, Rennes, France
| | - Morgan Daniel
- University of Rennes, CHU Rennes, Inserm, LTSI - UMR 1099, F-35000, Rennes, France
| | - Alain Lalande
- ICMUB Laboratory, CNRS 6302, University of Burgundy, 21078 Dijon, France; Medical Imaging Department, University Hospital of Dijon, Dijon, France
| | - Siyu Lin
- ICMUB Laboratory, CNRS 6302, University of Burgundy, 21078 Dijon, France; Medical Imaging Department, University Hospital of Dijon, Dijon, France
| | - Diana Marcela Marin-Castrillon
- ICMUB Laboratory, CNRS 6302, University of Burgundy, 21078 Dijon, France; Medical Imaging Department, University Hospital of Dijon, Dijon, France
| | - Olivier Bouchot
- Department of Cardio-Vascular and Thoracic Surgery, University Hospital of Dijon, Dijon, France
| | - Jean Porterie
- Cardiac Surgery Department, Rangueil University Hospital, Toulouse, France
| | - Pier Paolo Valentini
- University of Rome Tor Vergata, Department of Enterprise Engineering "Mario Lucertini", Rome, Italy
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de Souza P, Silva D, de Andrade I, Dias J, Lima JP, Teichrieb V, Quintino JP, da Silva FQB, Santos ALM. A Study on the Influence of Sensors in Frequency and Time Domains on Context Recognition. SENSORS (BASEL, SWITZERLAND) 2023; 23:5756. [PMID: 37420921 DOI: 10.3390/s23125756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 06/02/2023] [Accepted: 06/09/2023] [Indexed: 07/09/2023]
Abstract
Adaptive AI for context and activity recognition remains a relatively unexplored field due to difficulty in collecting sufficient information to develop supervised models. Additionally, building a dataset for human context activities "in the wild" demands time and human resources, which explains the lack of public datasets available. Some of the available datasets for activity recognition were collected using wearable sensors, since they are less invasive than images and precisely capture a user's movements in time series. However, frequency series contain more information about sensors' signals. In this paper, we investigate the use of feature engineering to improve the performance of a Deep Learning model. Thus, we propose using Fast Fourier Transform algorithms to extract features from frequency series instead of time series. We evaluated our approach on the ExtraSensory and WISDM datasets. The results show that using Fast Fourier Transform algorithms to extract features performed better than using statistics measures to extract features from temporal series. Additionally, we examined the impact of individual sensors on identifying specific labels and proved that incorporating more sensors enhances the model's effectiveness. On the ExtraSensory dataset, the use of frequency features outperformed that of time-domain features by 8.9 p.p., 0.2 p.p., 39.5 p.p., and 0.4 p.p. in Standing, Sitting, Lying Down, and Walking activities, respectively, and on the WISDM dataset, the model performance improved by 1.7 p.p., just by using feature engineering.
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Affiliation(s)
- Pedro de Souza
- Centro de Informática, Universidade Federal de Pernambuco, Recife 50740-560, PE, Brazil
| | - Diógenes Silva
- Centro de Informática, Universidade Federal de Pernambuco, Recife 50740-560, PE, Brazil
| | - Isabella de Andrade
- Centro de Informática, Universidade Federal de Pernambuco, Recife 50740-560, PE, Brazil
| | - Júlia Dias
- Centro de Informática, Universidade Federal de Pernambuco, Recife 50740-560, PE, Brazil
| | - João Paulo Lima
- Centro de Informática, Universidade Federal de Pernambuco, Recife 50740-560, PE, Brazil
- Visual Computing Lab, Departamento de Computação, Universidade Federal Rural de Pernambuco, Recife 52171-900, PE, Brazil
| | - Veronica Teichrieb
- Centro de Informática, Universidade Federal de Pernambuco, Recife 50740-560, PE, Brazil
| | - Jonysberg P Quintino
- Projeto CIn-UFPE Samsung, Centro de Informática, Av. Jorn. Anibal Fernandes, s/n, Recife 50740-560, PE, Brazil
| | - Fabio Q B da Silva
- Centro de Informática, Universidade Federal de Pernambuco, Recife 50740-560, PE, Brazil
| | - Andre L M Santos
- Centro de Informática, Universidade Federal de Pernambuco, Recife 50740-560, PE, Brazil
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Arya N, Schievano S, Caputo M, Taylor AM, Biglino G. Relationship between Pulmonary Regurgitation and Ventriculo-Arterial Interactions in Patients with Post-Early Repair of Tetralogy of Fallot: Insights from Wave-Intensity Analysis. J Clin Med 2022; 11:jcm11206186. [PMID: 36294505 PMCID: PMC9604580 DOI: 10.3390/jcm11206186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 10/07/2022] [Accepted: 10/18/2022] [Indexed: 11/16/2022] Open
Abstract
This study aimed to investigate the effect of pulmonary regurgitation (PR) on left ventricular ventriculo-arterial (VA) coupling in patients with repaired tetralogy of Fallot (ToF). It was hypothesised that increasing PR severity results in a smaller forward compression wave (FCW) peak in the aortic wave intensity, because of right-to-left ventricular interactions. The use of cardiovascular magnetic resonance (CMR)-derived wave-intensity analysis provided a non-invasive comparison between patients with varying PR degrees. A total of n = 201 patients were studied and both hemodynamic and wave-intensity data were compared. Wave-intensity peaks and areas of the forward compression and forward expansion waves were calculated as surrogates of ventricular function. Any extent of PR resulted in a significant reduction in the FCW peak. A correlation was found between aortic distensibility and the FCW peak, suggesting unfavourable (VA) coupling in patients that also present stiffer ascending aortas. Data suggest that VA coupling is affected by increased impedance.
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Affiliation(s)
- Nikesh Arya
- Faculty of Mathematical and Physical Sciences, University College London, London WC1E 6BT, UK
| | - Silvia Schievano
- Institute of Cardiovascular Science, University College London, London WC1E 6BT, UK
- Centre for Cardiovascular Imaging, Great Ormond Street Hospital for Children NHS Foundation Trust, London WC1N 3HJ, UK
| | - Massimo Caputo
- Bristol Medical School, Faculty of Health Sciences, University of Bristol, Bristol BS8 1TH, UK
- Bristol Heart Institute, University Hospitals Bristol & Weston NHS Foundation Trust, Bristol, BS2 8HW, UK
| | - Andrew M. Taylor
- Institute of Cardiovascular Science, University College London, London WC1E 6BT, UK
- Centre for Cardiovascular Imaging, Great Ormond Street Hospital for Children NHS Foundation Trust, London WC1N 3HJ, UK
| | - Giovanni Biglino
- Bristol Medical School, Faculty of Health Sciences, University of Bristol, Bristol BS8 1TH, UK
- National Heart and Lung Institute, Imperial College London, London SW7 2BX, UK
- Correspondence: ; Tel.: +44-117-342-3287
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Iacobazzi D, Alvino VV, Caputo M, Madeddu P. Accelerated Cardiac Aging in Patients With Congenital Heart Disease. Front Cardiovasc Med 2022; 9:892861. [PMID: 35694664 PMCID: PMC9177956 DOI: 10.3389/fcvm.2022.892861] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 04/11/2022] [Indexed: 01/03/2023] Open
Abstract
An increasing number of patients with congenital heart disease (CHD) survive into adulthood but develop long-term complications including heart failure (HF). Cellular senescence, classically defined as stable cell cycle arrest, is implicated in biological processes such as embryogenesis, wound healing, and aging. Senescent cells have a complex senescence-associated secretory phenotype (SASP), involving a range of pro-inflammatory factors with important paracrine and autocrine effects on cell and tissue biology. While senescence has been mainly considered as a cause of diseases in the adulthood, it may be also implicated in some of the poor outcomes seen in patients with complex CHD. We propose that patients with CHD suffer from multiple repeated stress from an early stage of the life, which wear out homeostatic mechanisms and cause premature cardiac aging, with this term referring to the time-related irreversible deterioration of the organ physiological functions and integrity. In this review article, we gathered evidence from the literature indicating that growing up with CHD leads to abnormal inflammatory response, loss of proteostasis, and precocious age in cardiac cells. Novel research on this topic may inspire new therapies preventing HF in adult CHD patients.
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Affiliation(s)
| | | | | | - Paolo Madeddu
- Bristol Medical School, Faculty of Health Sciences, University of Bristol, Bristol, United Kingdom
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Goodarzi Ardakani V, Goordoyal H, Ordonez MV, Sophocleous F, Curtis S, Bedair R, Caputo M, Gambaruto A, Biglino G. Isolating the Effect of Arch Architecture on Aortic Hemodynamics Late After Coarctation Repair: A Computational Study. Front Cardiovasc Med 2022; 9:855118. [PMID: 35811705 PMCID: PMC9263195 DOI: 10.3389/fcvm.2022.855118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 05/30/2022] [Indexed: 11/16/2022] Open
Abstract
Objectives Effective management of aortic coarctation (CoA) affects long-term cardiovascular outcomes. Full appreciation of CoA hemodynamics is important. This study aimed to analyze the relationship between aortic shape and hemodynamic parameters by means of computational simulations, purposely isolating the morphological variable. Methods Computational simulations were run in three aortic models. MRI-derived aortic geometries were generated using a statistical shape modeling methodology. Starting from n = 108 patients, the mean aortic configuration was derived in patients without CoA (n = 37, "no-CoA"), with surgically repaired CoA (n = 58, "r-CoA") and with unrepaired CoA (n = 13, "CoA"). As such, the aortic models represented average configurations for each scenario. Key hemodynamic parameters (i.e., pressure drop, aortic velocity, vorticity, wall shear stress WSS, and length and number of strong flow separations in the descending aorta) were measured in the three models at three time points (peak systole, end systole, end diastole). Results Comparing no-CoA and CoA revealed substantial differences in all hemodynamic parameters. However, simulations revealed significant increases in vorticity at the site of CoA repair, higher WSS in the descending aorta and a 12% increase in power loss, in r-CoA compared to no-CoA, despite no clinically significant narrowing (CoA index >0.8) in the r-CoA model. Conclusions Small alterations in aortic morphology impact on key hemodynamic indices. This may contribute to explaining phenomena such as persistent hypertension in the absence of any clinically significant narrowing. Whilst cardiovascular events in these patients may be related to hypertension, the role of arch geometry may be a contributory factor.
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Affiliation(s)
| | - Harshinee Goordoyal
- Department of Mechanical Engineering, University of Bristol, Bristol, United Kingdom
| | | | - Froso Sophocleous
- University Hospitals Bristol and Weston, NHS Foundation Trust, Bristol, United Kingdom.,Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Stephanie Curtis
- University Hospitals Bristol and Weston, NHS Foundation Trust, Bristol, United Kingdom
| | - Radwa Bedair
- University Hospitals Bristol and Weston, NHS Foundation Trust, Bristol, United Kingdom
| | - Massimo Caputo
- University Hospitals Bristol and Weston, NHS Foundation Trust, Bristol, United Kingdom.,Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Alberto Gambaruto
- Department of Mechanical Engineering, University of Bristol, Bristol, United Kingdom
| | - Giovanni Biglino
- University Hospitals Bristol and Weston, NHS Foundation Trust, Bristol, United Kingdom.,Bristol Medical School, University of Bristol, Bristol, United Kingdom.,National Heart and Lung Institute, Imperial College London, London, United Kingdom
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