Method for determining treatments using patient-specific lung models and computer methods
The disclosure relates to determining optimized parameters for mechanical ventilation comprising: obtaining data concerning a three-dimensional image of the subject's respiratory system; calculating a specific three-dimensional structural model of the subject's lung structure from the image data; calculating a specific three-dimensional structural model of the subject's airway structure from the image data; calculating a patient-specific three-dimensional structural model of the subject's lobar structure from the lung model; modeling the air flow through the airway, using the models of the airway and lobar structure of the subject at defined MV parameters; modeling the structural behavior of the airway and the interaction with the flow, using the models of the airway and lobar structure of the subject at defined MV parameters; determining the MV parameters which lead to a decrease in airway resistance and hence an increase in lobar mass flow for the same driving pressures according to the model.
1. A method for assessing an efficacy of a treatment for a respiratory condition in a subject comprising the steps of:
a) obtaining data concerning a pre-treatment three-dimensional image of a respiratory system of the subject, and a post-treatment three-dimensional image of the respiratory system of the subject,
b) calculating a specific three-dimensional structural model of a lung structure of the subject from each of the pre- and post-treatment image data obtained in step a),
c) calculating a specific three-dimensional structural model of an airway structure of the subject from each of the pre- and post-treatment image data obtained in step a),
d) calculating a patient-specific three-dimensional structural model of a lobar structure of the subject from each of the pre- and post-treatment lung structure models obtained in step b),
e) modeling by a computer, air flow through the airway structure at pre- and post-treatment states, using the respective pre- and post-treatment models of the airway structure and lobar structure of the subject obtained in steps c) and d);
f) modeling by a computer, structural behavior of the airway structure and the interaction with the air flow at pre- and post-treatment states, using the respective pre- and post-treatment models of the airway structure and lobar structure of the subject obtained in steps c) and d);
g) comparing the modeled air flow pre- and post-treatment and comparing the structural behaviour pre- and post-treatment to determine the efficacy of the treatment, wherein an efficacious treatment is one that decreases airway resistance, thereby increasing lobar mass for a same driving pressure, thereby determining the efficacy of the treatment for the respiratory condition.
2. Method according to claim 1 , wherein an increased efficacy is further defined by an increase in mass flow rate towards well-perfused areas.
3. Method according to claim 1 , wherein the image data of step a) is computed tomography (CT) or magnetic resonance imaging (MRI) scan data.
4. Method according to claim 1 , wherein the structural model of step c) is calculated using segmentation principles.
5. Method according to claim 1 , wherein the model of the lobar structure of step d) is calculated using lobar segmentation.
6. Method according to claim 1 , wherein the modeling of step e) comprises computational fluid dynamics incorporating solving Navier-Stokes equations numerically.
7. Method according to claim 6 , wherein the model of the lobar structure calculated in step d) is used to determine boundary conditions for computational fluid dynamics.
8. Method according to claim 7 , wherein
the data of step a) concerns three dimensional images of the respiratory system at total lung capacity (TLC) and at functional residual capacity (FRC),
the model of the lung structure in step b) and the model of the lobar structure in step d) are calculated both at TLC and FRC,
to determine mass flow rate towards each lobe and subsequently the boundary conditions for said computational fluid dynamics.
9. Method according to claim 1 , wherein the modeling of step f) comprises Finite Element Analysis.
10. A non-transitory computer-readable medium comprising a computer program comprising computer executable instructions that, when executed by a computing device, configure the computing device to perform operations comprising:
a) obtaining data concerning a pre-treatment three-dimensional image of a respiratory system of the subject, and a post-treatment three-dimensional image of the respiratory system of the subject;
b) calculating a specific three-dimensional structural model of a lung structure of the subject from each of the pre- and post-treatment image data obtained in step a);
c) calculating a specific three-dimensional structural model of an airway structure of the subject from each of the pre- and post-treatment image data obtained in step a);
d) calculating a patient-specific three-dimensional structural model of a lobar structure of the subject from each of the pre- and post-treatment lung structure models obtained in step b);
e) modeling by a computer, air flow through the airway structure at pre- and post-treatment states, using the respective pre- and post-treatment models of the airway structure and lobar structure of the subject obtained in steps c) and d);
f) modeling by a computer, structural behavior of the airway structure and the interaction with the air flow at pre- and post-treatment states, using the respective pre- and post-treatment models of the airway structure and lobar structure of the subject obtained in steps c) and d); and
g) comparing the modeled air flow pre- and post-treatment and comparing the structural behaviour pre- and post-treatment to determine an efficacy of a treatment, wherein an efficacious treatment is one that decreases airway resistance, thereby increasing lobar mass for a same driving pressure, thereby determining the efficacy of the treatment for the respiratory condition.