A Framework for the generation of digital twins of cardiac electrophysiology from clinical 12-leads ECGs

Autor: Edward J. Vigmond, Matthias A. F. Gsell, Ursula Reiter, Darko Štern, Martin Urschler, Thomas Grandits, Aurel Neic, Christian Payer, Gernot Plank, Christoph M. Augustin, Jason D. Bayer, Thomas Pock, Gert Reiter, Karli Gillette, Anton J. Prassl, Elias Karabelas
Rok vydání: 2021
Předmět:
Parameter identification
Computer science
media_common.quotation_subject
Heart Ventricles
Inference
Fidelity
Health Informatics
computer.software_genre
030218 nuclear medicine & medical imaging
Ventricular activation and repolarization sequence
03 medical and health sciences
Electrocardiography
0302 clinical medicine
Sampling (signal processing)
Humans
Computer Simulation
Radiology
Nuclear Medicine and imaging
media_common
Modality (human–computer interaction)
Radiological and Ultrasound Technology
Cardiac electrophysiology
Heart
Gold standard (test)
Computer Graphics and Computer-Aided Design
Cardiac digital twins
Workflow
Multi-label image segmentation
Proof of concept
Satelli sampling
Data mining
Computer Vision and Pattern Recognition
Electrophysiologic Techniques
Cardiac
computer
030217 neurology & neurosurgery
Forward ECG modeling
Zdroj: Medical Image Analysis
ISSN: 1361-8415
DOI: 10.1016/j.media.2021.102080
Popis: Cardiac digital twins (Cardiac Digital Twin (CDT)s) of human electrophysiology (Electrophysiology (EP)) are digital replicas of patient hearts derived from clinical data that match like-for-like all available clinical observations. Due to their inherent predictive potential, CDTs show high promise as a complementary modality aiding in clinical decision making and also in the cost-effective, safe and ethical testing of novel EP device therapies. However, current workflows for both the anatomical and functional twinning phases within CDT generation, referring to the inference of model anatomy and parameters from clinical data, are not sufficiently efficient, robust and accurate for advanced clinical and industrial applications. Our study addresses three primary limitations impeding the routine generation of high-fidelity CDTs by introducing; a comprehensive parameter vector encapsulating all factors relating to the ventricular EP; an abstract reference frame within the model allowing the unattended manipulation of model parameter fields; a novel fast-forward electrocardiogram (Electrocardiogram (ECG)) model for efficient and bio-physically-detailed simulation required for parameter inference. A novel workflow for the generation of CDTs is then introduced as an initial proof of concept. Anatomical twinning was performed within a reasonable time compatible with clinical workflows ( 4h) for 12 subjects from clinically-attained magnetic resonance images. After assessment of the underlying fast forward ECG model against a gold standard bidomain ECG model, functional twinning of optimal parameters according to a clinically-attained 12 lead ECG was then performed using a forward Saltelli sampling approach for a single subject. The achieved results in terms of efficiency and fidelity demonstrate that our workflow is well-suited and viable for generating biophysically-detailed CDTs at scale.
Databáze: OpenAIRE
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