Prediction of myocardial blood flow under stress conditions by means of a computational model

Keywords

Computational Medicine for the Cardiocirculatory System
Living Systems and Precision Medicine
Code:
95/2021
Title:
Prediction of myocardial blood flow under stress conditions by means of a computational model
Date:
Tuesday 28th December 2021
Author(s):
Di Gregorio, S.; Vergara, C.; Montino Pelagi, G.; Baggiano, A.; Zunino, P.; Guglielmo, M.; Fusini, L.; Muscogiuri, G.; Rossi, A.; Rabbat, M.G.; Quarteroni, A.; Pontone, G.
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Abstract:
Purpose. Quantification of myocardial blood flow (MBF) and functional assessment of coronary artery disease (CAD) can be achieved through stress myocardial computed tomography perfusion (stress-CTP). This requires an additional scan after the resting coronary computed tomography angiography (cCTA) and administration of an intravenous stressor. This complex protocol has limited reproducibility and non-negligible side effects for the patient. We aim to mitigate these drawbacks by proposing a computational model able to reproduce MBF maps. Methods. A computational perfusion model was used to reproduce MBF maps. The model parameters were estimated by using information from cCTA and MBF measured from stress-CTP (MBFCTP) maps. The relative error between the computational MBF under stress conditions (MBFCOMP) and MBFCTP was evaluated to assess the accuracy of the proposed computational model. Results. Applying our method to 9 patients (4 control subjects without ischemica vs 5 patients with myocardial ischemia), we found an excellent agreement between the values of MBFCOMP and MBFCTP. In all patients, the relative error was below 8% over all the myocardium, with an average-in-space value below 4%. Conclusion. The results of this pilot work demonstrate the accuracy and reliability of the proposed computational model in reproducing MBF under stress conditions. This consistency test is a preliminary step in the framework of a more ambitious project which is currently under investigation, i.e. the construction of a computational tool able to predict MBF avoiding the stress protocol and potential side effects while reducing radiation exposure.
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Pubblicato su European Journal of Nuclear Medicine and Molecular Imaging