Section: Application Domains

Development of a heart ventricle vessel generation model for perfusion analysis

Participant: Hugues Talbot (collaboration with L. Najman ESIEE Paris, I. Vignon-Clementel, REO Team, Inria, Leo Grady, Heartflow Inc.)

Cardio-vascular diseases are the leading cause of mortality in the world. Understanding these diseases is still a current, challenging and essential research project. The leading cause of heart malfunction are stenoses causing ischemia in the coronary vessels. Current CT and MRI technology allow to assess coronary diseases but are typically invasive, requiring catheterization and relatively toxic contrast agents injection. With Heartflow, a US based company, we have in the past worked to use image-based exams only, limiting the use of contrast agents and in many cases eliminating catheterisation. Heartflow is current the market leader in non-invasive coronary exams.

Unfortunately, current imaging technology is unable to assess the full length of coronary vessels. CT is limited to a resolution of about 1mm, whereas coronary vessels can be much smaller. Blood perfusion throughout the heart muscle can provide insight regarding coronary health in areas that CT or MRI cannot assess. Perfusion imaging with PET or a Gamma camera, the current gold standard, is an invasive technology requiring the use of radioactive tracers.

With heartflow and with the REO team of Inria, we have investigated patient-specific vessel generation models together with porous model simulations in order to propose a forward model of perfusion imaging, based on the known patient data, computer flow dynamic simulations as well as experimental data consistent with known vessel and heart muscle physiology. The objective of this work is to solve the inverse problem of locating and assessing coronary diseases even though the affected vessels are too small to be imaged directly.