Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Patient-Specific Left Ventricular Flow Simulations From Transthoracic Echocardiography: Robustness Evaluation and Validation Against Ultrasound Doppler and Magnetic Resonance Imaging
KTH, School of Technology and Health (STH), Medical Engineering, Medical Imaging. KTH.ORCID iD: 0000-0003-1002-2070
KTH, School of Computer Science and Communication (CSC), Computational Science and Technology (CST).ORCID iD: 0000-0002-7342-1987
Karolinska Universitetssjukhuset.
KTH, School of Technology and Health (STH), Medical Engineering, Medical Imaging.
Show others and affiliations
2017 (English)In: IEEE Transactions on Medical Imaging, ISSN 0278-0062, E-ISSN 1558-254X, Vol. 36, no 11, p. 2261-2275Article in journal (Refereed) Published
Abstract [en]

The combination of medical imaging with computational fluid dynamics (CFD) has enabled the study of 3D blood flow on a patient-specificlevel. However, with models based on gated high-resolution data, the study of transient flows, and any model implementation into routine cardiac care, is challenging. The present paper presents a novel pathway for patient-specific CFD modelling of the left ventricle (LV), using 4D transthoracic echocardiography (TTE) as input modality. To evaluate the clinical usability, two sub-studies were performed. First, a robustness evaluation was performed where repeated models with alternating input variables were generated for 6 subjects and changes in simulated output quantified. Second, a validation study was carried out where the pathway accuracy was evaluated against pulsed-wave Doppler (100 subjects), and 2D through-plane phase-contrast magnetic resonance imaging measurements over 7 intraventricular planes (6 subjects). The robustness evaluation indicated a model deviation of <12%, with highest regional and temporal deviations at apical segments and at peak systole, respectively. The validation study showed an error of < 11% (velocities < 10 cm/s) for all subjects, with no significant regional or temporal differences observed. With the patient-specific pathway shown to provide robust output with high accuracy, and with the pathway dependent only on 4DTTE, the method has a high potential to be used within future clinical studies on 3D intraventricular flowpatterns. To this, future model developments in the form of e.g. anatomically accurate LV valves may further enhance the clinical value of the simulations.

Place, publisher, year, edition, pages
Institute of Electrical and Electronics Engineers (IEEE), 2017. Vol. 36, no 11, p. 2261-2275
National Category
Medical Image Processing
Research subject
Medical Technology
Identifiers
URN: urn:nbn:se:kth:diva-215187DOI: 10.1109/TMI.2017.2718218ISI: 000414134200007OAI: oai:DiVA.org:kth-215187DiVA, id: diva2:1146829
Funder
Swedish Research Council, 2015-04237Swedish Foundation for Strategic Research , AM13-0049
Note

QC 20171006

Available from: 2017-10-04 Created: 2017-10-04 Last updated: 2017-12-12Bibliographically approved
In thesis
1. Patient-Specific Finite Element Modeling of the Blood Flow in the Left Ventricle of a Human Heart
Open this publication in new window or tab >>Patient-Specific Finite Element Modeling of the Blood Flow in the Left Ventricle of a Human Heart
2017 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Heart disease is the leading cause of death in the world. Therefore, numerous studies are undertaken to identify indicators which can be applied to discover cardiac dysfunctions at an early age. Among others, the fluid dynamics of the blood flow (hemodymanics) is considered to contain relevant information related to abnormal performance of the heart.This thesis presents a robust framework for numerical simulation of the fluid dynamics of the blood flow in the left ventricle of a human heart and the fluid-structure interaction of the blood and the aortic leaflets.We first describe a patient-specific model for simulating the intraventricular blood flow. The motion of the endocardial wall is extracted from data acquired with medical imaging and we use the incompressible Navier-Stokes equations to model the hemodynamics within the chamber. We set boundary conditions to model the opening and closing of the mitral and aortic valves respectively, and we apply a stabilized Arbitrary Lagrangian-Eulerian (ALE) space-time finite element method to simulate the blood flow. Even though it is difficult to collect in-vivo data for validation, the available data and results from other simulation models indicate that our approach possesses the potential and capability to provide relevant information about the intraventricular blood flow.To further demonstrate the robustness and clinical feasibility of our model, a semi-automatic pathway from 4D cardiac ultrasound imaging to patient-specific simulation of the blood flow in the left ventricle is developed. The outcome is promising and further simulations and analysis of large data sets are planned.In order to enhance our solver by introducing additional features, the fluid solver is extended by embedding different geometrical prototypes of both a native and a mechanical aortic valve in the outflow area of the left ventricle.Both, the contact as well as the fluid-structure interaction, are modeled as a unified continuum problem using conservation laws for mass and momentum. To use this ansatz for simulating the valvular dynamics is unique and has the expedient properties that the whole problem can be described with partial different equations and the same numerical methods for discretization are applicable.All algorithms are implemented in the high performance computing branch of Unicorn, which is part of the open source software framework FEniCS-HPC. The strong advantage of implementing the solvers in an open source software is the accessibility and reproducibility of the results which enhance the prospects of developing a method with clinical relevance.

Place, publisher, year, edition, pages
Stockholm: KTH Royal Institute of Technology, 2017. p. 51
Series
TRITA-CSC-A, ISSN 1653-5723 ; 2017:21
Keywords
Finite element method, Arbitrary Lagrangian-Eulerian method, Fluid-Structure interaction, Contact model, parallel algorithm, blood flow, left ventricle, aortic valves, patient-specific heart model
National Category
Computational Mathematics
Identifiers
urn:nbn:se:kth:diva-215277 (URN)978-91-7729-566-2 (ISBN)
Public defence
2017-10-27, Fantum, F-huset, plan 5, KTH Campus, Lindstedtsvägen 24, Stockholm, 10:00 (English)
Opponent
Supervisors
Funder
Swedish Foundation for Strategic Research Swedish Research CouncilEU, European Research Council, 202984
Note

QC 20171006

Available from: 2017-10-06 Created: 2017-10-05 Last updated: 2017-10-09Bibliographically approved

Open Access in DiVA

fulltext(5293 kB)27 downloads
File information
File name FULLTEXT01.pdfFile size 5293 kBChecksum SHA-512
659fac6acdacecd06e90c6ac41603ad35d1aebf61f9f5138e3d541e7af574cc31732ddf34775d2b4ad367df84d5e3daa0bb9d7b809872bc0f79c919bddca7a97
Type fulltextMimetype application/pdf

Other links

Publisher's full textPublishers web site

Search in DiVA

By author/editor
Larsson, DavidSpühler, Jeannette HiromiNordenfur, TimColarieti-Tosti, MassimilianoHoffman, JohanLarsson, Matilda
By organisation
Medical ImagingComputational Science and Technology (CST)
In the same journal
IEEE Transactions on Medical Imaging
Medical Image Processing

Search outside of DiVA

GoogleGoogle Scholar
Total: 27 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

doi
urn-nbn

Altmetric score

doi
urn-nbn
Total: 222 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf