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Djukic T, Tomasevic S, Saveljic I, Vukicevic A, Stankovic G, Filipovic N. Software for optimized virtual stenting of patient-specific coronary arteries reconstructed from angiography images. Comput Biol Med 2024; 183:109311. [PMID: 39467375 DOI: 10.1016/j.compbiomed.2024.109311] [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: 03/27/2024] [Revised: 10/02/2024] [Accepted: 10/18/2024] [Indexed: 10/30/2024]
Abstract
Detection of clinically relevant stenosis within coronary arteries as well as planning of treatment (stent implantation) are important topics in clinical cardiology. In this study a thorough methodology for virtual stenting assistance is proposed, that includes the 3D reconstruction of a patient-specific coronary artery from X-ray angiography images, hemodynamic simulations of blood flow, computation of a fractional flow reserve (FFR) equivalent, virtual stenting procedure and an optimization of the virtual stenting, by considering not only the value of computed FFR, but also the low and high WSS regions and the state of arterial wall after stenting. The evaluation of the proposed methodology is performed in two ways: the calculated values of FFR are compared with clinically measured values; and the results obtained for automated optimized virtual stenting are compared with virtual stenting performed manually by an expert clinician for the whole considered dataset. The agreement of the results in almost all cases demonstrates the accuracy of the proposed approach, and the small discrepancies only show the capabilities and benefits this approach can offer. The automated optimized virtual stenting technique can provide information about the most optimal stent position that ensures the maximum achievable FFR, while also considering the distribution of WSS and the state of arterial wall. The proposed methodology and developed software can therefore be used as a noninvasive method for planning of optimal patient-specific treatment strategies before invasive procedures and thus help to improve the clinical outcome of interventions and provide better treatment planning adapted to the particular patient.
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Affiliation(s)
- Tijana Djukic
- Institute for Information Technologies, University of Kragujevac, Jovana Cvijica bb, 34000, Kragujevac, Serbia; Bioengineering Research and Development Center, BioIRC, Prvoslava Stojanovica 6, 34000, Kragujevac, Serbia.
| | - Smiljana Tomasevic
- Bioengineering Research and Development Center, BioIRC, Prvoslava Stojanovica 6, 34000, Kragujevac, Serbia; Faculty of Engineering, University of Kragujevac, Serbia.
| | - Igor Saveljic
- Institute for Information Technologies, University of Kragujevac, Jovana Cvijica bb, 34000, Kragujevac, Serbia; Bioengineering Research and Development Center, BioIRC, Prvoslava Stojanovica 6, 34000, Kragujevac, Serbia.
| | - Arso Vukicevic
- Faculty of Engineering, University of Kragujevac, Serbia.
| | - Goran Stankovic
- Faculty of Medicine, University of Belgrade, Cardiology Department, University Clinical Center of Serbia, Visegradska 26, 11000, Belgrade, Serbia.
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Lashgari M, Choudhury RP, Banerjee A. Patient-specific in silico 3D coronary model in cardiac catheterisation laboratories. Front Cardiovasc Med 2024; 11:1398290. [PMID: 39036504 PMCID: PMC11257904 DOI: 10.3389/fcvm.2024.1398290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2024] [Accepted: 06/06/2024] [Indexed: 07/23/2024] Open
Abstract
Coronary artery disease is caused by the buildup of atherosclerotic plaque in the coronary arteries, affecting the blood supply to the heart, one of the leading causes of death around the world. X-ray coronary angiography is the most common procedure for diagnosing coronary artery disease, which uses contrast material and x-rays to observe vascular lesions. With this type of procedure, blood flow in coronary arteries is viewed in real-time, making it possible to detect stenoses precisely and control percutaneous coronary interventions and stent insertions. Angiograms of coronary arteries are used to plan the necessary revascularisation procedures based on the calculation of occlusions and the affected segments. However, their interpretation in cardiac catheterisation laboratories presently relies on sequentially evaluating multiple 2D image projections, which limits measuring lesion severity, identifying the true shape of vessels, and analysing quantitative data. In silico modelling, which involves computational simulations of patient-specific data, can revolutionise interventional cardiology by providing valuable insights and optimising treatment methods. This paper explores the challenges and future directions associated with applying patient-specific in silico models in catheterisation laboratories. We discuss the implications of the lack of patient-specific in silico models and how their absence hinders the ability to accurately predict and assess the behaviour of individual patients during interventional procedures. Then, we introduce the different components of a typical patient-specific in silico model and explore the potential future directions to bridge this gap and promote the development and utilisation of patient-specific in silico models in the catheterisation laboratories.
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Affiliation(s)
- Mojtaba Lashgari
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford, United Kingdom
| | - Robin P. Choudhury
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Abhirup Banerjee
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford, United Kingdom
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
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Chen C, Fu Z, Ye S, Zhao C, Golovko V, Ye S, Bai Z. Study on high-precision three-dimensional reconstruction of pulmonary lesions and surrounding blood vessels based on CT images. OPTICS EXPRESS 2024; 32:1371-1390. [PMID: 38297691 DOI: 10.1364/oe.510398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 12/15/2023] [Indexed: 02/02/2024]
Abstract
The adoption of computerized tomography (CT) technology has significantly elevated the role of pulmonary CT imaging in diagnosing and treating pulmonary diseases. However, challenges persist due to the complex relationship between lesions within pulmonary tissue and the surrounding blood vessels. These challenges involve achieving precise three-dimensional reconstruction while maintaining accurate relative positioning of these elements. To effectively address this issue, this study employs a semi-automatic precise labeling process for the target region. This procedure ensures a high level of consistency in the relative positions of lesions and the surrounding blood vessels. Additionally, a morphological gradient interpolation algorithm, combined with Gaussian filtering, is applied to facilitate high-precision three-dimensional reconstruction of both lesions and blood vessels. Furthermore, this technique enables post-reconstruction slicing at any layer, facilitating intuitive exploration of the correlation between blood vessels and lesion layers. Moreover, the study utilizes physiological knowledge to simulate real-world blood vessel intersections, determining the range of blood vessel branch angles and achieving seamless continuity at internal blood vessel branch points. The experimental results achieved a satisfactory reconstruction with an average Hausdorff distance of 1.5 mm and an average Dice coefficient of 92%, obtained by comparing the reconstructed shape with the original shape,the approach also achieves a high level of accuracy in three-dimensional reconstruction and visualization. In conclusion, this study is a valuable source of technical support for the diagnosis and treatment of pulmonary diseases and holds promising potential for widespread adoption in clinical practice.
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Bohoran TA, Parke KS, Graham-Brown MPM, Meisuria M, Singh A, Wormleighton J, Adlam D, Gopalan D, Davies MJ, Williams B, Brown M, McCann GP, Giannakidis A. Resource efficient aortic distensibility calculation by end to end spatiotemporal learning of aortic lumen from multicentre multivendor multidisease CMR images. Sci Rep 2023; 13:21794. [PMID: 38066222 PMCID: PMC10709583 DOI: 10.1038/s41598-023-48986-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 12/02/2023] [Indexed: 12/18/2023] Open
Abstract
Aortic distensibility (AD) is important for the prognosis of multiple cardiovascular diseases. We propose a novel resource-efficient deep learning (DL) model, inspired by the bi-directional ConvLSTM U-Net with densely connected convolutions, to perform end-to-end hierarchical learning of the aorta from cine cardiovascular MRI towards streamlining AD quantification. Unlike current DL aortic segmentation approaches, our pipeline: (i) performs simultaneous spatio-temporal learning of the video input, (ii) combines the feature maps from the encoder and decoder using non-linear functions, and (iii) takes into account the high class imbalance. By using multi-centre multi-vendor data from a highly heterogeneous patient cohort, we demonstrate that the proposed method outperforms the state-of-the-art method in terms of accuracy and at the same time it consumes [Formula: see text] 3.9 times less fuel and generates [Formula: see text] 2.8 less carbon emissions. Our model could provide a valuable tool for exploring genome-wide associations of the AD with the cognitive performance in large-scale biomedical databases. By making energy usage and carbon emissions explicit, the presented work aligns with efforts to keep DL's energy requirements and carbon cost in check. The improved resource efficiency of our pipeline might open up the more systematic DL-powered evaluation of the MRI-derived aortic stiffness.
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Affiliation(s)
- Tuan Aqeel Bohoran
- School of Science and Technology, Nottingham Trent University, Nottingham, NG11 8NS, UK
| | - Kelly S Parke
- Department of Cardiovascular Sciences, University of Leicester and the NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, LE3 9QP, UK
| | - Matthew P M Graham-Brown
- Department of Cardiovascular Sciences, University of Leicester and the NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, LE3 9QP, UK
| | - Mitul Meisuria
- Department of Cardiovascular Sciences, University of Leicester and the NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, LE3 9QP, UK
| | - Anvesha Singh
- Department of Cardiovascular Sciences, University of Leicester and the NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, LE3 9QP, UK
| | - Joanne Wormleighton
- Department of Cardiovascular Sciences, University of Leicester and the NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, LE3 9QP, UK
| | - David Adlam
- Department of Cardiovascular Sciences, University of Leicester and the NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, LE3 9QP, UK
| | - Deepa Gopalan
- Imperial College London & Cambridge University Hospitals, Cambridge, CB2 0QQ, UK
| | - Melanie J Davies
- Leicester Diabetes Centre, University of Leicester and the NIHR Leicester Biomedical Research Centre, Leicester General Hospital, Leicester, LE5 4PW, UK
| | - Bryan Williams
- Institute of Cardiovascular Science, University College London (UCL), National Institute for Health Research (NIHR), UCL Hospitals Biomedical Research Centre, London, WC1E 6DD, UK
| | - Morris Brown
- Department of Clinical Pharmacology, William Harvey Research Institute, Queen Mary University of London, London, EC1M 6BQ, UK
| | - Gerry P McCann
- Department of Cardiovascular Sciences, University of Leicester and the NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, LE3 9QP, UK
| | - Archontis Giannakidis
- School of Science and Technology, Nottingham Trent University, Nottingham, NG11 8NS, UK.
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