Abstract
Abstract
Background
Cerebrovascular disease, in particular stroke, is a major public health challenge. An important biomarker is cerebral hemodynamics. To measure and quantify cerebral hemodynamics, however, only invasive, potentially harmful or time-to-treatment prolonging methods are available.
Results
We present a simulation-based approach which allows calculation of cerebral hemodynamics based on the patient-individual vessel configuration derived from structural vessel imaging. For this, we implemented a framework allowing segmentation and annotation of brain vessels from structural imaging followed by 0-dimensional lumped simulation modeling of cerebral hemodynamics. For annotation, a 3D-graphical user interface was implemented. For 0D-simulation, we used a modified nodal analysis, which was adapted for easy implementation by code. The simulation enables identification of areas vulnerable to stroke and simulation of changes due to different systemic blood pressures. Moreover, sensitivity analysis was implemented allowing the live simulation of changes to simulate procedures and disease progression. Beyond presentation of the framework, we demonstrated in an exploratory analysis in 67 patients that the simulation has a high specificity and low-to-moderate sensitivity to detect perfusion changes in classic perfusion imaging.
Conclusions
The presented precision medicine approach using novel biomarkers has the potential to make the application of harmful and complex perfusion methods obsolete.
Funder
Bundesministerium für Bildung und Forschung
H2020 Societal Challenges
Charité - Universitätsmedizin Berlin
Publisher
Springer Science and Business Media LLC
Subject
Radiology, Nuclear Medicine and imaging,Biomedical Engineering,General Medicine,Biomaterials,Radiological and Ultrasound Technology
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