Virtual Vascular Interventions

Clinical Challenge

In order to improve patient outcomes, treatment decisions must take into account all relevant factors, including patient anatomy and individual patient’s response to the treatment. In complex situations, due to the interplay between the vascular geometry and blood flow, the optimal treatment procedure is not immediately clear. Moreover, oftentimes, treatment decisions need to be made in multidisciplinary clinical environments where several entities from the radiology to intervention and surgery departments need to be involved. At Fraunhofer-MEVIS we develop platforms in order to investigate treatment options prior to an intervention or surgery and  provide it in such a way that is suitable for integration in the clinical workflow.

Solutions and Technologies

Interactive extraction and editing of image-based anatomical models

Based on different image modalities, including CT and MRI, Fraunhofer-MEVIS has developed tools and algorithms that enable a semi-automatic extraction of vascular anatomies. Moreover, the tools allow for interactive editing of the geometry in 2D and 3D views. The solution algorithms are already being applied in multitude of past and ongoing projects.

Virtual intervention

Based on the surface mesh model of the vascular geometry, we have developed tools that enable modeling of an intervention, such as a virtual stenting, through interactive geometry editing and parameter specification.

Patient-specific computational hemodynamics

At Fraunhofer-MEVIS we offer solutions for simulating the hemodynamics after a virtual intervention. The blood flow simulation is based on the lattice Boltzmann methods which offer a very fast preprocessing of the geometry due to its meshless structure. All the boundary conditions will be extracted from patient-specific anatomy and flow images.

Aorta Virtual Stenting
© Fraunhofer MEVIS

A geometric model of an aorta before (left) and after (right) virtual stenting.

Advanced hemodynamic analysis and visualization 

Measured and simulated hemodynamics can be analyzed and visualized through advanced quantitative and qualitative algorithmic tools. Particularly, 3D+time pressure maps and centerline pressure curves can be generated for a comparative before and after investigation. See also (heart function analysis, flow analysis).

Integration into the clinical infrastructure

Based on detailed workflow analysis, the stakeholders and various involved clinical disciplines are identified. Domain specific views, tools and interfaces are designed to allow for multidisciplinary applicability of the planning software. The solutions can span the complete data pipeline, from PACS integration up to distributed, web-based client applications (example) that support the individual steps of the decision making process.

 

Quantitative & qualitative comparision of pressure in the Extento web application.
© Fraunhofer MEVIS

Quantitative & qualitative comparison of pressure in the Extento web application.

Integration of the image-based virtual interventions in the therapy planning of coarctation of the aorta.
© Fraunhofer MEVIS

Integration of the image-based virtual interventions in the therapy planning of coarctation of the aorta.