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Computerized 3D Modeling and Simulations of Patient-Specific Cardiac Anatomy from Segmented MRI

Ringenberg, Jordan
http://rave.ohiolink.edu/etdc/view?acc_num=toledo1406129522

Abstract Details

2014, Doctor of Philosophy, University of Toledo, Engineering.
Diagnosis and treatment of structural heart disease is a substantial medical challenge in terms of morbidity, mortality, and financial burden to the health care system. Furthermore, lack of direct visualization of extent of fibrosis and scar tissue and insufficient prior knowledge about their functional consequences pose challenges in terms of diagnosis and accurate treatment. This dissertation presents novel computing approaches that allow MRI-based 3D reconstruction of ventricular anatomy tagged with precise areas of abnormal tissue (fibrosis). The resultant virtual models are used to reproduce patient-specific structural disorders. Realistic simulations conducted on these models are utilized to better understand the mechanisms responsible for unhealthy function (e.g. arrhythmias). Magnetic resonance imaging (MRI) has emerged as an excellent means to analyze cardiac function and is instrumental in providing viability assessment, surgical planning, and therapy strategies. However, manually interpreting MRI scans is a time-consuming and fallible process. This research presents two automated algorithms applied to cardiac MRI to segment the left and right ventricles from the entire MR image volume. These fast and robust computational tools for myocardial delineation and tissue classification are designed to ease clinical decision-making, greatly reduce the time required to calculate structural cardiac parameters, and reduce human errors in interpreting the scans. Accuracy results of the left ventricle segmentation algorithm have proven to rival expert manual delineation. Furthermore, the right ventricle segmentation algorithm has proven to be the most accurate method to-date, as demonstrated on a standard database of cardiac images. Segmented MRI scans are also imperative for reconstructing realistic 3D geometries for computerized clinical modeling. This research details a method for accurate patient-specific computational model generation from segmented MRI scans. That is, the discretely tagged 2D images resulting from the aforementioned automated tools are used to construct a 3D anatomical geometry. Once the 3D geometry of ventricles is obtained, it can be converted into a computational mesh for use in clinical visualization and computerized simulations using patient-specific electrophysiology. Leveraging high resolution DTMRI, the presented study validates the use of coarsely-sliced MRI, such as those acquired in vivo. The virtual models derived using this approach were utilized in computerized electrophysiological simulations to determine the effects of fibrosis extent and composition on the inducibility and fidelity of reentrant ventricular tachycardia (VT). Simulations demonstrated that 1) VT morphology was highly dependent on the extent of fibrosis which acts as a structural substrate, 2) reentry tended to be anchored to the fibrosis edges and showed transmural conduction of activations through narrow channels formed within fibrosis, and 3) increasing the extent of GZ within fibrosis tends to destabilize the structural reentry sites and aggravate the VT as compared to fibrotic regions of the same size and shape but with lower or no GZ. The approach and findings represent a significant step toward patient-specific cardiac modeling as a reliable tool for VT prediction and management of the patient.
Vijay Devabhaktuni (Committee Chair)
Makarand Deo (Committee Member)
Mansoor Alam (Committee Member)
Omer Berenfeld (Committee Member)
Brent Cameron (Committee Member)
Henry Ledgard (Committee Member)
182 p.
Computer Science; Engineering
Cardiac MRI, Image Segmentation, Medical Imaging, Object Classification, 3D Modeling, Cardiac Simulation, Ventricular Tachycardia, in vivo Magnetic Resonance

Recommended Citations

Citations

  • Ringenberg, J. (2014). Computerized 3D Modeling and Simulations of Patient-Specific Cardiac Anatomy from Segmented MRI [Doctoral dissertation, University of Toledo]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=toledo1406129522

    APA Style (7th edition)

  • Ringenberg, Jordan. Computerized 3D Modeling and Simulations of Patient-Specific Cardiac Anatomy from Segmented MRI . 2014. University of Toledo, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=toledo1406129522.

    MLA Style (8th edition)

  • Ringenberg, Jordan. "Computerized 3D Modeling and Simulations of Patient-Specific Cardiac Anatomy from Segmented MRI ." Doctoral dissertation, University of Toledo, 2014. http://rave.ohiolink.edu/etdc/view?acc_num=toledo1406129522

    Chicago Manual of Style (17th edition)

toledo1406129522
883
© 2014, some rights reserved.Creative Commons License Computerized 3D Modeling and Simulations of Patient-Specific Cardiac Anatomy from Segmented MRI by Jordan Ringenberg is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License. Based on a work at etd.ohiolink.edu.
This open access ETD is published by University of Toledo and OhioLINK.