Patient-Specific Coronary Hemodynamics by 3D Printing

通过 3D 打印进行患者特定的冠状动脉血流动力学

• 批准号: 9926910
• 负责人: Simon Dunham
• 金额: $ 66.44万
• 依托单位: WEILL MEDICAL COLL OF CORNELL UNIV
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-01 至 2023-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9926910
• 关键词: 3-Dimensional; 3D Print; Accounting; Adult; Anatomy; Arterial Fatty Streak; Arteries; Blood Circulation; Blood Pressure; Cessation of life; Characteristics; Clinical; Clinical Data; Clinical Trials; Complex; Computer software; Coronary; Coronary Arteriosclerosis; Coronary artery; Couples; Data; Diagnosis; Diagnostic; Dose; Elastomers; Electrocardiogram; Equipment; Evaluation; Exercise; Functional disorder; Goals; Gold; Grant; Heart Rate; Hospitalization; Human; Image; In Vitro; Individual; Intervention; Ischemia; Label; Life; Measurement; Measures; Mechanics; Methods; Modeling; Multicenter Studies; Multicenter Trials; Myocardial; Myocardial Ischemia; Myocardial perfusion; Myocardium; Outcome; Oxygen Consumption; Patients; Performance; Perfusion; Physical activity; Physiological; Positron-Emission Tomography; Property; Pulsatile Flow; Reporting; Resistance; Severities; Stenosis; Stress; Stress Tests; Symptoms; System; Techniques; Testing; Tissues; United States National Institutes of Health; Velocimetries; X-Ray Computed Tomography; accurate diagnosis; base; burden of illness; clinical imaging; exercise capacity; experimental study; hemodynamics; imaging modality; improved; in vitro testing; in vivo; individual variation; innovation; non-invasive system; novel; particle; performance tests; personalized diagnostics; pre-clinical; predictive modeling; pressure; sensor; targeted treatment; three-dimensional modeling

ABSTRACT. Despite improvements in therapies targeted at reducing disease burden, CAD continues to afflict >16 million US adults, accounting for more than 1/3 of all deaths and responsible for ~1.2 million hospitalizations annually. Coronary revascularization remains a mainstay of treatment for CAD, with >1.2 million percutaneous interventions performed annually in the US. Prior multicenter trials have demonstrated propitious outcomes for individuals with who undergo ischemia-guided revascularization by fractional flow reserve (FFR)—an invasive “gold” standard that determines the physiologic significance of coronary stenoses. More recently we have studied the accuracy of a non-invasive CT-based alternative to FFR, termed FFRCT. While this new method is moderately accurate, it possesses several limitations such as assuming the walls of the coronaries are rigid and flow is non-pulsatile. Therefore, we have determined an alternative approach to assessing coronary hemodynamics via 3D printing, which allows physical measurements of coronary flow using realistic tissue mechanics and pulsatile flow. In this application, we will optimize the hardware, software, workflows, and analysis to build and evaluate coronary hemodynamics based on patient CT images. Extensive clinical imaging data, including 15O-H2O labeled PET imaging will be used to validate the accuracy of these models for predicting coronary hemodynamics. Finally, these 3D printed models will be used to develop clinically useful reports that can provide diagnostic determination of a patient's level of ischemia using only non-invasive CT imaging.

摘要：尽管针对减轻疾病负担的治疗方法有所改进，但 CAD 仍然困扰着患者。 >1600 万美国成年人，占所有死亡人数的 1/3 以上，约 120 万 每年住院治疗的人数>1.2，冠状动脉血运重建仍然是 CAD 的主要治疗方法。 此前的多中心试验表明，美国每年进行数百万次经皮介入治疗。 通过分次血流进行缺血引导血运重建的个体可获得良好的结果 储备（FFR）——确定冠状动脉狭窄生理意义的侵入性“金”标准。 最近，我们研究了基于 CT 的非侵入性 FFR 替代方案（称为 FFRCT）的准确性。 虽然这种新方法具有一定的准确性，但它具有一些局限性，例如假设墙壁为 冠状动脉是刚性的，血流是非脉动的，因此，我们确定了另一种方法。 通过 3D 打印评估冠状动脉血流动力学，从而可以物理测量冠状动脉流量 使用真实的组织力学和脉动流在这个应用程序中，我们将优化硬件、软件、 工作流程以及基于患者 CT 图像构建和评估冠状动脉血流动力学的分析。 广泛的临床影像数据，包括 15O-H2O 标记的 PET 成像，将用于验证 这些模型用于预测冠状动脉血流动力学，最后，这些 3D 打印模型将用于开发。 临床上有用的报告，仅使用即可提供患者缺血水平的诊断确定 非侵入性 CT 成像。