Geometric Surrogates for Clinical Management of Abdominal Aortic Aneurysms

腹主动脉瘤临床治疗的几何替代物

基本信息

批准号：
9463479
负责人：
ENDER A FINOL
金额：
$ 39.89万
依托单位：
UNIVERSITY OF TEXAS SAN ANTONIO
依托单位国家：
美国
项目类别：
财政年份：
2015
资助国家：
美国
起止时间：
2015-04-01 至 2021-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9463479
关键词：
Abdominal Aortic Aneurysm Address Aneurysm Award Biomechanics Blood Vessels Caliber Characteristics Classification Clinic Clinical Clinical Management Clinical Research Complex Consent Data Development Diagnosis Disease Electrocardiogram Elements Foundations Geometry Goals Growth Image Individual Intervention Knowledge Learning Machine Learning Magnetic Resonance Imaging Measures Mechanics Methods Modeling Motion Operative Surgical Procedures Outcome Outcomes Research Patients Phase Physiological Property Radiology Specialty Records Research Risk Rupture Ruptured Abdominal Aortic Aneurysm Ruptured Aneurysm Spatial Distribution Stress Surgeon Surveillance Program Survival Rate Techniques Technology Testing Time Validation X-Ray Computed Tomography base clinical imaging clinically significant computerized tools design high risk improved indexing individual patient innovation novel pressure primary outcome prospective public health relevance radiologist recruit repaired soft tissue spatiotemporal standard of care tool

项目摘要

DESCRIPTION (provided by applicant): This proposal will investigate the following hypothesis: that the quantification of geometric surrogates, which predict the ensuing peak wall rupture risk index (PWRRI), will provide an improved estimate of aneurysm rupture risk compared to the clinical standard of maximum aneurysm diameter. We thus propose the highly innovative use of both radiological and non-radiological clinical imaging to develop a computational tool that can assess AAA risk of rupture with greater accuracy than the current clinical standard. Such a tool will allow the accurate quantification of individual AAA geometry to achieve the main goal of the study, which is to identify the patient-specific AAA geometry characteristics that are surrogates for patient-specific PWRRI. In the proposed approach, we will first compute a truly individualized PWRRI based on an innovative method called image-based Vascular Mechanical Characterization technology (iV-MeCh). The geometry characteristics highly correlated with PWRRI will be considered the surrogates of this biomechanics-based index. A second phase of the study will be the validation of the surrogates with actual clinical outcomes, which will yield the accurate predictors of rupture. This approach, devoid of complex finite element modeling and based on a fast, nearly automated computational tool for geometry quantification, would provide an exceptional rationale for the need for surgical intervention and be of major clinical significance. Therefore, the following specific aims are to be completed during the project period to address the aforementioned hypothesis: (1) Validate iV-MeCh for estimating patient-specific spatio-temporal AAA wall stress; (2) Calculate individual PWRRI using iV-MeCh for high and low risk of rupture AAA; (3) Identify the individual geometry characteristics that are surrogates of PWRRI; and (4) Assess the clinical significance of geometric surrogates for the prediction of AAA rupture risk. The primary outcome of this research will be the ability to disambiguate or demystify rupture risk in AAA for which the standard of care (maximum diameter) is not an accurate metric for assessing their at-risk condition. The geometric surrogates of PWRRI are hypothesized to reduce false positives and false negatives compared to the conventional maximum diameter cut-off for recommending elective repair. In addition, PWRRI is predicted by means of a new, novel technique (iV-MeCh), which estimates wall stress in aneurysms by means of non-radiological clinical imaging and without the use of constitutive soft tissue mechanics.

描述（由适用提供）：该提案将研究以下假设：与最大动脉瘤临床标准相比，几何替代物的定量预测确保峰值壁破裂风险指数（PWRRI）将提供改进的动脉瘤破裂风险估计值。因此，我们提出了放射学和非放射学临床成像的高度创新使用，以开发一种计算工具，该工具可以比当前的临床标准更准确地评估AAA破裂风险。这样的工具将允许单个AAA几何形状的准确性数量实现研究的主要目标，即确定患者特异性的AAA几何特征是患者特异性PWRRI的替代物。在拟议的方法中，我们将基于一种创新的方法来计算真正个性化的PWRRI，称为基于图像的血管机械特性技术（IV-MECH）。与PWRRI高度相关的几何特性将被视为基于生物力学指数的替代物。该研究的第二阶段将是通过实际临床结果的替代物的验证，这将产生破裂的准确预测指标。这种方法没有复杂的有限元建模，并且基于用于几何定量的快速，几乎自动化的计算工具，将为需要进行手术干预而提供非凡的理由，并且具有重要的临床意义。因此，将在项目期间完成以下具体目标，以解决理由假设：（1）验证IV-MECH以估算患者特异性时空的AAA壁应力；（2）使用IV-Mech计算单个PWRRI，以使AAA破裂的高风险和低风险；（3）确定单个几何特征是Pwrri的替代物；（4）评估几何替代物对AAA破裂风险预测的临床意义。这项研究的主要结果将是能够在AAA中消除或揭示其破裂风险的能力，在该AAA中，护理标准（最大直径）不是评估其处于危险状况的准确指标。假设PWRRI的几何替代物可以减少假阳性和假否定性，而与常规的最大直径截止值相比，用于推荐选择性修复。此外，通过一种新型的新技术（IV-MEC）预测了PWRRI，该技术通过非放射学临床成像估计动脉瘤中的壁应力，而无需使用组成型软组织力学。

项目成果

期刊论文数量（15）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

The Effect of Pentagalloyl Glucose on the Wall Mechanics and Inflammatory Activity of Rat Abdominal Aortic Aneurysms.

五没食子酰葡萄糖对大鼠腹主动脉瘤壁力学和炎症活动的影响。

DOI：
10.1115/1.4040398
发表时间：
2018
期刊：
Journal of biomechanical engineering
影响因子：
0
作者：
Thirugnanasambandam,Mirunalini;Simionescu,DanT.;Escobar,PatriciaG.;Sprague,Eugene;Goins,Beth;Clarke,GeoffreyD.;Han,Hai-Chao;Amezcua,KrystaL.;Adeyinka,OluwaseunR.;Goergen,CraigJ.;Finol,Ender
通讯作者：
Finol,Ender

Wall Stress and Geometry Measures in Electively Repaired Abdominal Aortic Aneurysms.

选择性修复腹主动脉瘤的壁应力和几何测量。

DOI：
10.1007/s10439-019-02261-w
发表时间：
2019
期刊：
Annals of biomedical engineering
影响因子：
3.8
作者：
Wu,Wei;Rengarajan,Balaji;Thirugnanasambandam,Mirunalini;Parikh,Shalin;Gomez,Raymond;DeOliveira,Victor;Muluk,SatishC;Finol,EnderA
通讯作者：
Finol,EnderA

Design, Development, and Temporal Evaluation of a Magnetic Resonance Imaging-Compatible In Vitro Circulation Model Using a Compliant Abdominal Aortic Aneurysm Phantom.

使用顺应性腹主动脉瘤模型设计、开发和时间评估磁共振成像兼容的体外循环模型。

DOI：
10.1115/1.4049894
发表时间：
2021
期刊：
Journal of biomechanical engineering
影响因子：
0
作者：
Thirugnanasambandam,Mirunalini;Canchi,Tejas;Piskin,Senol;Karmonik,Christof;Kung,Ethan;Menon,PrahladG;Avril,Stephane;Finol,EnderA
通讯作者：
Finol,EnderA

Computational Fluid Dynamics Modeling of the Human Pulmonary Arteries with Experimental Validation.