Method and system for prediction of post-stenting hemodynamic metrics for treatment planning of arterial stenosis

Patent metadata

Field	Value
Publication number	US-10130266-B2
Application number	US-201514704233-A
Country	US
Kind code	B2
Filing date	May 5, 2015
Priority date	Jun 30, 2014
Publication date	Nov 20, 2018
Grant date	Nov 20, 2018

Abstract

A method and system for prediction of post-stenting hemodynamic metrics for treatment planning of arterial stenosis is disclosed. A pre-stenting patient-specific anatomical model of the coronary arteries is extracted from medical image data of a patient Blood flow is simulated in the pre-stenting patient-specific anatomical model of the coronary arteries with a modified pressure-drop model that simulates an effect of stenting on a target stenosis region used to compute a pressure drop over the target stenosis region. Parameter values for the modified pressure-drop model are set without modifying the pre-stenting patient-specific anatomical model of the coronary arteries. A predicted post-stenting hemodynamic metric for the target stenosis region, such as fractional flow reserve (FFR), is calculated based on the pressure-drop over the target stenosis region computed using the modified pressure-drop model.

First claim

The invention claimed is:

1. A method for predicting a post-stenting hemodynamic metric for a coronary artery stenosis from pre-stenting medical image data, comprising:
extracting a pre-stenting patient-specific anatomical model of the coronary arteries from medical image data of a patient;
directly modifying one or more parameters of a pressure-drop model that computes a pressure-drop over a target stenosis region in the pre-stenting anatomical model of the coronary arteries without modifying the pre-stenting patient-specific anatomical model of the coronary arteries, resulting in a modified pressure-drop model that simulates an effect of stenting on the target stenosis region;
simulating blood flow in the pre-stenting patient-specific anatomical model of the coronary arteries with the modified pressure-drop model used for computing the pressure-drop over the target stenosis region in the pre-stenting patient-specific anatomical model of the coronary arteries, wherein the modified pressure-drop model simulates the effect of stenting on the target stenosis region; and
calculating a predicted post-stenting hemodynamic metric for the target stenosis region based on the pressure-drop over the target stenosis region computed using the modified pressure-drop model.

2. The method of claim 1 , wherein simulating blood flow in the pre-stenting patient-specific anatomical model of the coronary arteries with the modified pressure-drop model used for computing the pressure-drop over the target stenosis region in the pre-stenting patient-specific anatomical model of the coronary arteries comprises:
simulating blood flow in the pre-stenting patient-specific anatomical model of the coronary arteries using a computational model of coronary circulation that represents stenosis regions in the pre-stenting patient-specific anatomical model of the coronary arteries with pressure-drop models, wherein the modified pressure-drop model that simulates the effect of stenting on the target stenosis region is used as the pressure-drop representing the target stenosis region to compute the pressure-drop over the target stenosis region in the pre-stenting patient-specific anatomical model of the coronary arteries.

3. The method of claim 1 , wherein the modified pressure-drop model is one of a fully successful post-stenting pressure-drop model that simulates the effect of a fully successful stenting treatment on the target stenosis region or a partially successful post-stenting pressure drop model that simulates the effect of a partially successful stenting procedure on the target stenosis region.

4. The method of claim 3 , wherein the modified pressure-drop model is the fully successful post-stenting pressure-drop model, and simulating blood flow in the pre-stenting patient-specific anatomical model of the coronary arteries with a modified pressure-drop model for computing a pressure drop over a target stenosis region in the pre-stenting patient-specific anatomical model of the coronary arteries comprises:
determining an assumed value for a parameter of the modified pressure-drop model to simulate complete enlargement of the target stenosis region without modifying the pre-stenting patient-specific anatomical model of the coronary arteries; and
computing a predicted post-stenting pressure drop over the target stenosis region based on the simulated blood flow in the pre-stenting patient-specific anatomical model of the coronary arteries using the modified pressure-drop model with the assumed value for the parameter.

5. The method of claim 4 , wherein determining an assumed value for a parameter of the modified pressure-drop model to simulate complete enlargement of the target stenosis region without modifying the pre-stenting patient-specific anatomical model of the coronary arteries comprises:
determining an assumed value for a post-stenting cross-sectional area of a distal portion of the target stenosis region without modifying the pre-stenting patient-specific anatomical model of the coronary arteries.

6. The method of claim 5 , wherein the modified pressure-drop model is a fully analytical pressure drop model, and computing a predicted post-stenting pressure drop over the target stenosis region based on the simulated blood flow in the pre-stenting patient-specific anatomical model of the coronary arteries using the modified pressure-drop model with the assumed value for the parameter comprises:
computing a convection pressure-drop term based on the assumed value for the post-stenting cross-sectional area of the distal portion of the target stenosis region, and computing a viscous pressure drop term based on an average of the assumed value for the post-stenting cross-sectional area of the distal portion of the target stenosis region and a cross-sectional area of a proximal portion of the target stenosis region in the pre-stenting patient-specific anatomical model of the coronary arteries.

7. The method of claim 5 , wherein the modified pressure-drop model is a fully analytical pressure drop model, and computing a predicted post-stenting pressure drop over the target stenosis region based on the simulated blood flow in the pre-stenting patient-specific anatomical model of the coronary arteries using the modified pressure-drop model with the assumed value for the parameter comprises:
computing a convection pressure-drop term based on the assumed value for the post-stenting cross-sectional area of the distal portion of the target stenosis region, and computing a viscous pressure drop term based on an interpolation between a cross-sectional area of a proximal portion of the target stenosis region in the pre-stenting patient-specific anatomical model of the coronary arteries and the assumed value for the post-stenting cross-sectional area of the distal portion of the target stenosis region.

8. The method of claim 5 , wherein the modified pressure-drop model is a semi-empirical pressure drop model and computing a predicted post-stenting pressure drop over the target stenosis region based on the simulated blood flow in the pre-stenting patient-specific anatomical model of the coronary arteries using the modified pressure-drop model with the assumed value for the parameter comprises:
computing a convection pressure-drop term based on the assumed value for the post-stenting cross-sectional area of the distal portion of the target stenosis region, and computing a viscous pressure drop term based on a viscous coefficient that is adapted to correspond to the assumed value for the post-stenting cross-sectional area of the distal portion of the target stenosis region.

9. The method of claim 3 , wherein the modified pressure-drop model is the partially successful post-stenting pressure drop model;
wherein directly modifying one or more parameters of a pressure-drop model that computes a pressure-drop over a target stenosis region in the pre-stenting anatomical model of the coronary arteries without modifying the pre-stenting patient-specific anatomical model of the coronary arteries, resulting in a modified pressure-drop model that simulates an effect of stenting on the target stenosis region, comprises: determining assumed values for one or more parameters of the modified pressure-drop model to simulate partial enlargement of the target stenosis region without modifying the pre-stenting patient-specific anatomical model of the coronary arteries; and
wherein simulating blood flow in the pre-stenting patient-specific anatomical model of the coronary arteries with the modified pressure-drop model used for computing the pressure-drop over the target stenosis region in the pre-stenting patient-specific anatomical model of the coronary arteries comprises: computing a predicted post-st

Assignees

• Siemens Healthcare Gmbh

Inventors

• Itu Lucian Mihai
• Sharma Puneet
• Sauer Frank

Classifications

• A61B5/02028

  Determining haemodynamic parameters not otherwise provided for, e.g. cardiac contractility or left ventricular ejection fraction · CPC title

• A61F2/82

  Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents (stent-grafts for tubular structures of the body other than blood vessels A61F2/04; stent-grafts for blood vessels A61F2/07) · CPC title

• A61B5/7275

  Determining trends in physiological measurement data; Predicting development of a medical condition based on physiological measurements, e.g. determining a risk factor · CPC title

• A61B6/03

  Computed tomography [CT] · CPC title

• A61B5/055

  involving electronic [EMR] or nuclear [NMR] magnetic resonance, e.g. magnetic resonance imaging · CPC title