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Report

Teaser, summary, work performed and final results

Periodic Reporting for period 1 - VPH-CaSE (VPH-Cardiovascular Simulation and Experimentation for Personalised Medical Devices)

Teaser

Summary

Cardiovascular disease accounts for 47% of all deaths in Europe with an estimated cost to the EU economy of ~ â‚¬196 billion a year. Use of simulation to optimise medical device design for patient-specific treatment offers attractive benefits, and is being championed in Europe through the Virtual Physiological Human (VPH) research initiative. Its ambitions are to improve healthcare outcomes and reduce the burden of disease, both important for cost-effective medicine given the ageing European population, with a multidisciplinary effort required to ensure interaction between the clinic, industry and academia. The focus of VPH-CaSE is to progress the state-of-the-art in personalised Medical Devices through a programme of multidisciplinary research integrating simulation and experimental techniques and building on the foundations of the VPH initiative. The network activity is directed by the needs of the industrial and clinical sectors, providing a truly multidisciplinary, multi-sectoral environment. This combines expertise of 5 academic and 4 industrial core Beneficiaries and 9 clinical, 1 academic and 4 industrial Partners to provide scientific support, secondments and training. The objectives of the network are:

1. To advance the state-of-the-art in personalised cardiovascular medical device design by addressing specific research questions that are also key issues highlighted by the Medical Devices Industry and Regulatory Agencies
2. To ensure the committed participation of industry in the ETN, working together to investigate cutting-edge issues for R&D in the Medical Devices Industry and equipping researchers with skill profiles based on a thorough understanding of the sectoral needs within academia and industry
3. To provide ESRs with an enviable skills mix, making them attractive to both academia and industry, preparing them for a competitive employment market and individually balancing technical and complementary skills training
4. To establish new, and strengthen existing, collaboration, both within the Network and between the Network and the wider community using simulation tools for personalised medical devices

Work performed

Effort has included recruitment of all 14 ESRs and establishment of monitoring processes through Steering Committee (SC) and Supervisory Board (SB) activity. Cohesion has been fostered through regular meetings of the SC including three network-wide Training Activities (Sheffield UK, Milan IT and Eindhoven NL) delivering complementary and technical skills in simulation and experimental techniques. These events have developed collaboration between researchers and have been used as a mechanism to review the ethical requirements for the Individual Research Projects. They also contribute to early-stage research training at the European level and to strengthening European innovation capacity.

Specific ESR research activity has been reported in deliverable D1.4, whilst wider network activity has been reported in 13 deliverables, with public documents available through the project website. This includes a summary of the first year of each project. Academic dissemination is evidenced by the seven conference and journal publications accepted within this reporting period, with a further 14 currently submitted and under review. The main scientific results achieved by the network so far are most clearly presented in the context of the three research clusters detailed below.

Final results

ESR effort has focussed on numerical and experimental techniques, applying them to address clinical and industrial needs not currently met by established or state-of-the-art systems. The initial testing and validation of these fundamental techniques is described below:

Cluster 1, Cardiac tissue function and cardiac support: Analysis of experimental ultrasound data to retrieve strain measures from dynamic cardiac images has been investigated, combined with in silico assessment of the same technique using a known strain field to characterise error propagation in strain measurement. Physiological processes in cardiac tissue have also been examined using the ex-vivo PhysioHeart platform of project Beneficiary LifeTec Group. Development of 3D models of cardiac function has included a structural model of the left ventricle with passive and active properties of cardiac tissue. A database of 200 synthetic pathological finite-element heart models from 5 real healthy left ventricle geometries informs the sensitivity of specific strain-based parameters in locating myocardial infarcts. Detailed modelling of cardiac electrophysiology has used a novel experimentally-calibrated population of models methodology to detect long term changes in the electrical activity of the heart. The experimental Physioheart platform allows recording of the electrical activity for hours as opposed to minutes, providing data for virtual populations of models.

Cluster 2, Cardiovascular haemodynamics - pathology and intervention: A computationally efficient moving-mesh method using ANSYS CFX software to account for wall motion in CFD simulations of aortic dissection has been developed. Future work will deploy modelling tools in combination with patient-specific data. Development of novel approaches to analyse the performance of blood oxygenators has used simulation with explicit meshing/porous media to represent the fibre bundles and simulation of single phase/multi-phase properties of blood. This has implications for future oxygenator design. Methods for improved segmentation to obtain aortic geometry from medical images have been extended to inform model boundary conditions. Novel Reduced Order Modelling techniques have been shown to give good agreement with full 3D CFD simulations for idealised flow conditions; this is to be extended to more complex cases.

Cluster 3 : Image-based diagnosis and imaging quality assurance: Experimental and theoretical work towards a ring vortex phantom has investigated stable and reproducible experimental vortex ring generation in both air and water. Implications for phantom design are being explored. A semi-automatic method for the reconstruction of 3D stented coronary artery models has exploited OCT and 3D printing, the high fidelity 3D geometry of the stented phantom was successfully used for CFD simulations with ANSYS Fluent software. Gabor filters have been developed to improve quantitative processing of TO-US images in both axial and lateral directions. This increases the robustness of the Phase Based Motion Estimator method. Further developments will follow.

VPH-CaSE aims to realise the full potential of the ESRs. This includes opportunities to experience academic, industrial and clinical environments through exchanges and provide new career perspectives, managed through a Personal Career Development Plan which documents collaborative meetings and longer term secondments. Wider issues are also recognised, acknowledging the values of integrity, transparency and ethics in research. VPH-CaSE has exposed research outcomes through formal scientific publication, a project website, newsletters and video content. Numerous public engagement events have also been delivered (reaching ~300 people). Exploitation of project results by Beneficiaries and Partners will continue to be an implicit feature of the network during the remaining period. VPH-CaSE has achieved all of its goals to date and continued, strong progress is anticipa