Nannini Guido, Suk Julian, Rygiel Patryk, Saitta Simone, Mariani Luca, Maranga Riccardo, Baggiano Andrea, Pontone Gianluca, Wolterink Jelmer M, Redaelli Alberto
Department of Electronics Information and Bioengineering, Politecnico di Milano, Milan, Italy.
Department of Applied Mathematics and Technical Medical Center, University of Twente, Enschede, The Netherlands.
Comput Biol Med. 2025 Jun 17;195:110477. doi: 10.1016/j.compbiomed.2025.110477.
Coronary artery disease involves the narrowing of coronary vessels due to atherosclerosis and is currently the leading cause of death worldwide. The gold standard for its diagnosis is the fractional flow reserve (FFR) examination, which measures the trans-stenotic pressure ratio during maximal vasodilation. However, the invasiveness and cost of this procedure have prompted the development of computer-based virtual FFR (vFFR) computation, which simulates coronary flow using computational fluid dynamics (CFD) techniques. Geometric deep learning algorithms have recently shown the capability to learn features on meshes, including applications in cardiovascular research. In this work, we aim to conduct a comprehensive empirical analysis of different backends for predicting vFFR fields in coronary arteries, serving as surrogates for CFD simulations. We evaluate six different backends and compare their performance in learning hemodynamics on meshes using CFD solutions as ground truth. This study is divided into two main parts: i) First, we use a dataset of 1,500 synthetic bifurcations of the left coronary artery. Each model is trained to predict various pressure-related fields, from which the vFFR field is reconstructed. We compare the models' performance when different learning variables are used during training. ii) Second, we use a dataset of 427 patient-specific CFD simulations from a previous study by our group. Here, we repeat the experiments conducted on the synthetic dataset, focusing on the learning variable that yielded the best performance in the synthetic dataset. Most backends achieved very good performance on the synthetic dataset, particularly when learning the pressure drop over the manifold. For other network output variables (e.g., pressure and the vFFR field), transformer-based backends outperformed all other architectures. When trained on patient-specific data, transformer-based architectures were the only ones to achieve strong performance, both in terms of average per-point error and in accurately predicting vFFR in stenotic lesions. Our findings indicate that various geometric deep learning backends can serve as effective CFD surrogates for problems involving simple geometries. However, for tasks involving datasets with complex and heterogeneous topologies, transformer-based networks are the optimal choice. Additionally, pressure drop emerged as the optimal network output for learning pressure-related fields.
冠状动脉疾病是由于动脉粥样硬化导致冠状动脉血管狭窄,目前是全球主要的死亡原因。其诊断的金标准是血流储备分数(FFR)检查,该检查测量最大血管扩张时的跨狭窄压力比。然而,该检查的侵入性和成本促使了基于计算机的虚拟FFR(vFFR)计算的发展,它使用计算流体动力学(CFD)技术模拟冠状动脉血流。几何深度学习算法最近显示出在网格上学习特征的能力,包括在心血管研究中的应用。在这项工作中,我们旨在对用于预测冠状动脉vFFR场的不同后端进行全面的实证分析,作为CFD模拟的替代方法。我们评估了六种不同的后端,并以CFD解决方案作为基准,比较它们在学习网格上的血流动力学方面的性能。本研究分为两个主要部分:i)首先,我们使用了1500个左冠状动脉合成分叉的数据集。每个模型都经过训练以预测各种与压力相关的场,从中重建vFFR场。我们比较了训练期间使用不同学习变量时模型的性能。ii)其次,我们使用了我们小组之前一项研究中的427个患者特异性CFD模拟数据集。在这里,我们重复了在合成数据集上进行的实验,重点关注在合成数据集中产生最佳性能的学习变量。大多数后端在合成数据集上取得了非常好的性能,特别是在学习歧管上的压力降时。对于其他网络输出变量(例如压力和vFFR场),基于变压器的后端优于所有其他架构。在患者特异性数据上进行训练时,基于变压器的架构是唯一在平均逐点误差和准确预测狭窄病变中的vFFR方面都取得强大性能的架构。我们的研究结果表明,各种几何深度学习后端可以作为涉及简单几何形状问题的有效CFD替代方法。然而,对于涉及具有复杂和异构拓扑的数据集的任务,基于变压器的网络是最佳选择。此外,压力降成为学习与压力相关场的最佳网络输出。