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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(由申请人提供)：这项建议将调查以下假设：与最大动脉瘤直径的临床标准相比，几何替代物的量化将预测随后的峰值壁破裂风险指数(PWRRI)，从而提供更好的动脉瘤破裂风险估计。因此，我们建议高度创新地使用放射和非放射临床成像来开发一种计算工具，该工具可以比目前的临床标准更准确地评估AAA破裂的风险。这种工具将允许对单个AAA几何图形进行准确量化实现研究的主要目标，即确定患者特定的AAA几何特征，以替代患者特定的PWRRI。在提出的方法中，我们将首先基于一种称为基于图像的血管机械表征技术(IV-MECH)的创新方法来计算真正个性化的PWRRI。与PWRRI高度相关的几何特征将被认为是这一基于生物力学的指标的替代品。研究的第二阶段将是用实际的临床结果验证替代品，这将产生准确的破裂预测因素。这种方法不需要复杂的有限元建模，基于一种快速的、近乎自动化的几何量化计算工具，将为手术干预的必要性提供特殊的理论基础，并具有重要的临床意义。因此，为了解决上述假设，项目期间将完成以下具体目标：(1)验证IV-MECH用于估计特定患者的AAA时空壁应力；(2)使用IV-MECH计算单个PWRRI以预测AAA破裂的高风险和低风险；(3)识别可替代PWRRI的个体几何特征；以及(4)评估几何替代物对预测AAA破裂风险的临床意义。这项研究的主要结果将是能够消除AAA破裂风险的歧义或揭开神秘面纱，对于AAA，护理标准(最大直径)不是评估其风险状况的准确指标。与传统的推荐选择性修复的最大直径截断法相比，PWRRI的几何替代物被假设为减少假阳性和假阴性。此外，PWRRI是通过一种新的、新的技术(IV-MECH)来预测的，该技术通过非放射临床成像而不使用本构软组织力学来估计动脉瘤的壁应力。

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.