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Uncertainty Quantification for Non-invasive Assessment of Pressure Drop Across a Coarctation of the Aorta Using CFD

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Abstract

Purpose

Numerical assessment of the pressure drop across an aortic coarctation using CFD is a promising approach to replace invasive catheter-based measurements. The aim of this study was to investigate and quantify the uncertainty of numerical calculation of the pressure drop introduced during two essential steps of medical image processing: segmentation of the patient-specific geometry and measurement of patient-specific flow rates from 4D-flow-MRI.

Methods

Based on the baseline segmentation, geometries with different stenosis diameters were generated for a sample of ten patients. The pressure drop generated by these geometries was calculated for different volume flow rates using computational fluid dynamics. Based on these simulations, a second order polynomial fit was calculated. Based on these polynomial fits an uncertainty of pressure drop calculation was quantified.

Results

The calculated pressure drop values varied strongly between the patients. In four patients, pressure drops above and below the clinical threshold of 20 mmHg were found. The median standard deviation of the pressure drop was 2.3 mmHg. The sensitivity of the pressure drop toward changes in the volume flow rate or the stenosis geometry varied between patients.

Conclusion

The uncertainty of numerical pressure drop calculation introduced by uncertainties during image segmentation and measurement of volume flow rates was comparable to the uncertainty of pressure drop measurements using invasive catheterization. However, in some patients this uncertainty would have led to different treatment decision. Therefore, patient-specific uncertainty assessment might help to better understand the reliability of a numerically calculated biomarker as the pressure drop across an aortic coarctation.

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Notes

  1. https://doi.org/10.6084/m9.figshare.6993581.

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Conflict of interest

The authors declare that they has no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants and/or their guardians included in the study.

Funding

This work was funded by the German Research Foundation (IDs GO1967/6-1 and KU1329/10-1) and the European Commission (ID 611232).

Author information

Authors and Affiliations

  1. Institute for Imaging Science and Computational Modelling in Cardiovascular Medicine, Charité – Universitätsmedizin Berlin, Augustenburger Platz 1, Forum 4 – 0.0561, 13353, Berlin, Germany

    Jan Brüning, Florian Hellmeier, Pavlo Yevtushenko, Titus Kühne & Leonid Goubergrits

  2. Department of Congenital Heart Disease - Unit of Cardiovascular Imaging, German Heart Center Berlin, Berlin, Germany

    Titus Kühne

  3. DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany

    Titus Kühne

Authors
  1. Jan Brüning
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  2. Florian Hellmeier
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  3. Pavlo Yevtushenko
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Correspondence to Jan Brüning.

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Associate Editors David A. Steinman, Francesco Migliavacca, and Ajit P. Yoganathan oversaw the review of this article.

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Brüning, J., Hellmeier, F., Yevtushenko, P. et al. Uncertainty Quantification for Non-invasive Assessment of Pressure Drop Across a Coarctation of the Aorta Using CFD. Cardiovasc Eng Tech 9, 582–596 (2018). https://doi.org/10.1007/s13239-018-00381-3

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