Comprehensive Modeling and Visualization of Cardiac Anatomy and Physiology from CT Imaging and Computer Simulations

Cardiac biophysical detailed synergetic modality rendering and visible correlation

The heart is a vital organ in the human body. Research and treatment for the heart have made remarkable progress, and the functional mechanisms of the heart have been simulated and rendered through the construction of relevant models. The current methods for rendering cardiac functional mechanisms only consider one type of modality, which means they cannot show how different types of modality, such as physical and physiological, work together. To realistically represent the three-dimensional synergetic biological modality of the heart, this paper proposes a WebGL-based cardiac synergetic modality rendering framework to visualize the cardiac physical volume data and present synergetic correspondence rendering of the cardiac electrophysiological modality. By constructing the biological detailed interactive histogram, users can implement local details rendering for the heart, which could reveal the cardiac biology details more clearly. We also present cardiac physical-physiological correlation visualization to explore cardiac biological association characteristics. Experimental results show that the proposed framework can provide favorable cardiac biological detailed synergetic modality rendering results in terms of both effectiveness and efficiency. Compared with existing methods, the framework can facilitate the study of the internal mechanism of the heart and subsequently deduce the process of initiation, development, and transformation from a healthy heart to an ill one, and thereby improve the diagnosis and treatment of cardiac disorders.

A Heart Segmentation Algorithm Based on Dynamic Ultrasound

The heart is one of the most important organs of the human body. The role of the heart is to promote blood flow and provide sufficient blood flow to organs and tissues. The research on the heart has important theoretical and clinical significance. Because of the noninvasive and intuitive display of ultrasound image, it can dynamically obtain the heart state and has become the main means to detect the heart dynamics. We analyze the characteristics of cardiac ultrasound image from the medical point of view and signal processing. The heart movement is periodic and rhythmic. The image signal can be decomposed. Firstly, the image is decomposed into high- and low-frequency signals to highlight different dimensional information. Then, the attention model was introduced, focusing on the heart region. Finally, the multidimensional network carrying model was established to achieve cardiac segmentation. The experimental results show that the AOM of the algorithm proposed in this paper reaches 92%, which has a certain degree of advancement and can assist doctors to make accurate diagnosis.

Progress in Understanding Radiofrequency Heating and Burn Injuries for Safer MR Imaging

RF electromagnetic wave exposure during MRI scans induces heat and occasionally causes burn injuries to patients. Among all the types of physical injuries that have occurred during MRI examinations, RF burn injuries are the most common ones. The number of RF burn injuries increases as the static magnetic field of MRI systems increases because higher RFs lead to higher heating. The commonly believed mechanisms of RF burn injuries are the formation of a conductive loop by the patient's posture or cables, such as an electrocardiogram lead; however, the mechanisms of RF burn injuries that occur at the contact points, such as the bore wall and the elbow, remain unclear. A comprehensive understanding of RF heating is needed to address effective countermeasures against all RF burn injuries for safe MRI examinations. In this review, we summarize the occurrence of RF burn injury cases by categorizing RF burn injuries reported worldwide in recent decades. Safety standards and regulations governing RF heating that occurs during MRI examinations are presented, along with their theoretical and physiological backgrounds. The experimental assessment techniques for RF heating are then reviewed, and the development of numerical simulation techniques is explained. In addition, a comprehensive theoretical interpretation of RF burn injuries is presented. By including the results of recent experimental and numerical simulation studies on RF heating, this review describes the progress achieved in understanding RF heating from the standpoint of MRI burn injury prevention.

Interactive, Visual Simulation of a Spatio-Temporal Model of Gas Exchange in the Human Alveolus

In interdisciplinary fields such as systems biology, good communication between experimentalists and theorists is crucial for the success of a project. Theoretical modeling in physiology usually describes complex systems with many interdependencies. On one hand, these models have to be grounded on experimental data. On the other hand, experimenters must be able to understand the interdependent complexities of the theoretical model in order to interpret the model’s results in the physiological context. We promote interactive, visual simulations as an engaging way to present theoretical models in physiology and to make complex processes tangible. Based on a requirements analysis, we developed a new model for gas exchange in the human alveolus in combination with an interactive simulation software named Alvin. Alvin exceeds the current standard with its spatio-temporal resolution and a combination of visual and quantitative feedback. In Alvin, the course of the simulation can be traced in a three-dimensional rendering of an alveolus and dynamic plots. The user can interact by configuring essential model parameters. Alvin allows to run and compare multiple simulation instances simultaneously. We exemplified the use of Alvin for research by identifying unknown dependencies in published experimental data. Employing a detailed questionnaire, we showed the benefits of Alvin for education. We postulate that interactive, visual simulation of theoretical models, as we have implemented with Alvin on respiratory processes in the alveolus, can be of great help for communication between specialists and thereby advancing research.

On the Role and Effects of Uncertainties in Cardiovascular in silico Analyses

The assessment of cardiovascular hemodynamics with computational techniques is establishing its fundamental contribution within the world of modern clinics. Great research interest was focused on the aortic vessel. The study of aortic flow, pressure, and stresses is at the basis of the understanding of complex pathologies such as aneurysms. Nevertheless, the computational approaches are still affected by sources of errors and uncertainties. These phenomena occur at different levels of the computational analysis, and they also strongly depend on the type of approach adopted. With the current study, the effect of error sources was characterized for an aortic case. In particular, the geometry of a patient-specific aorta structure was segmented at different phases of a cardiac cycle to be adopted in a computational analysis. Different levels of surface smoothing were imposed to define their influence on the numerical results. After this, three different simulation methods were imposed on the same geometry: a rigid wall computational fluid dynamics (CFD), a moving-wall CFD based on radial basis functions (RBF) CFD, and a fluid-structure interaction (FSI) simulation. The differences of the implemented methods were defined in terms of wall shear stress (WSS) analysis. In particular, for all the cases reported, the systolic WSS and the time-averaged WSS (TAWSS) were defined.

MR and ultrasound cardiac image dynamic visualization and synchronization over Internet for distributed heart function diagnosis

Dual-modality 4D cardiac data visualization can convey a significant amount of complementary image information from various sources into a single and meaningful display. Even though there are existing publications on combining multiple medical images into a unique representation, there has been no work on rendering a series of cardiac image sequences, acquired from multiple sources, using web browsers and synchronizing the result over the Internet in real time. The ability to display multi-modality beating heart images using Web-based technology is hampered by the lack of efficient algorithms for fusing and visualizing constantly updated multi-source images and streaming the rendering results using internet protocols. To address this practical issue, in this paper we introduce a new Internet-based algorithm and a software platform running on a Node.js server, where a series of registered cardiac images from both magnetic resonance (MR) and ultrasound are employed to display dynamic fused cardiac structures in web browsers. Taking advantage of the bidirectional WebSocket protocol and WebGL-based graphics acceleration, internal cardiac structures are dynamically displayed, and the results of rendering and data exploration are synchronized among all the connected client computers. The presented research and software have the potential to provide clinicians with comprehensive information and intuitive feedback relating to cardiac behavior and anatomy and could impact areas such as distributed diagnosis of cardiac function and collaborative treatment planning for various heart diseases.

3D Hermite Transform Optical Flow Estimation inLeft Ventricle CT Sequences

Heart diseases are the most important causes of death in the world and over the years, thestudy of cardiac movement has been carried out mainly in two dimensions, however, it is important toconsider that the deformations due to the movement of the heart occur in a three-dimensional space.The 3D + t analysis allows to describe most of the motions of the heart, for example, the twistingmotion that takes place on every beat cycle that allows us identifying abnormalities of the heartwalls. Therefore, it is necessary to develop algorithms that help specialists understand the cardiacmovement. In this work, we developed a new approach to determine the cardiac movement inthree dimensions using a differential optical flow approach in which we use the steered Hermitetransform (SHT) which allows us to decompose cardiac volumes taking advantage of it as a model ofthe human vision system (HVS). Our proposal was tested in complete cardiac computed tomography(CT) volumes ( 3D + t), as well as its respective left ventricular segmentation. The robustness tonoise was tested with good results. The evaluation of the results was carried out through errors inforwarding reconstruction, from the volume at time t to time t + 1 using the optical flow obtained(interpolation errors). The parameters were tuned extensively. In the case of the 2D algorithm, theinterpolation errors and normalized interpolation errors are very close and below the values reportedin ground truth flows. In the case of the 3D algorithm, the results were compared with another similarmethod in 3D and the interpolation errors remained below 0.1. These results of interpolation errorsfor complete cardiac volumes and the left ventricle are shown graphically for clarity. Finally, a seriesof graphs are observed where the characteristic of contraction and dilation of the left ventricle isevident through the representation of the 3D optical flow.

Image-Based Computational Fluid Dynamic Analysis for Surgical Planning of Sequential Grafts in Coronary Artery Bypass Grafting

Coronary bypass grafting (CABG) is a surgical procedure for anastomosing small grafts to the coronary vessels. The bypass graft bridges the occluded or diseased coronary artery, allowing sufficient blood flow to deliver oxygen and nutrients to the heart muscles. Patient-specific (PS) anatomy obtained from coronary computed tomography angiography (CCTA) was used to generate a 3D aorto-coronary model (pre-surgery). Additionally, three more models with idealized grafts (individual and sequential grafts), were created using Boolean operations to represent post-surgery configuration. Fractional flow reserve (FFR) and wall shear stress (WSS) were estimated from the computational fluid dynamics (CFD). The pre-surgical FFR values for all the three left coronary arteries were significant (FFR<.80). The flow was restored (FFR>0.80) distal to stenosis in all the three post- surgical idealized graft models. Peak WSS values of 468, 336 and 295 dynes/cm² were observed at the toe of the individual end-to-side anastomosis for the three graft models. More importantly, low WSS (< 100 dynes/cm²) prevails at the heel and the walls opposite to the anastomosis in the sequential graft models. The prevailing low WSS at the heel and the wall bed opposite to anastomosis, in a sequential graft model, reduces restenosis rates and promotes a uniform hemodynamic environment for a better long-term patency of the graft. PS- CFD simulations based on CCTA can be helpful in assessing the hemodynamic parameters of graft models for optimal surgical planning.