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Abstract #0054

Predicting Adverse Outcomes for BAV Aortopathy Patients by Fluid Physics-Informed Velocity Estimation from Contrast-Enhanced MR Angiography

Ethan Johnson1, Haben Berhane1, Aniket Dehadrai1, Anthony Maroun1, David Dushfunian1, Bradley D Allen1, and Michael Markl1
1Northwestern University, Chicago, IL, United States

Synopsis

Keywords: Vascular/Vessel Wall, Blood vessels, angiography, CEMRA, MRA, aortopathy, BAV, machine learning, hemodynamics

Motivation: Aortic hemodynamics have involvement in bicuspid aortic valve (BAV) aortopathy progression, but measuring velocities with 4D flow MRI is time-consuming and not routine clinically.

Goal(s): We aimed to evaluate a prognostic value of hemodynamics derived from velocities estimated by a machine-learning network from common standard-of-care CEMRA images.

Approach: A cycleGAN was trained to estimate velocity from paired 4D flow/CEMRA training data. Adverse outcomes (surgery/aneurysm/dissection) were tallied for a separate BAV cohort with CEMRA acquired, and the cycleGAN was applied to estimate velocities. Performance predicting outcomes from hemodynamic estimates was evaluated.

Results: Good predictive performance (AUC>0.7) using CEMRA-derived hemodynamic estimates was observed.

Impact: Strong performance predicting adverse outcomes with estimates of hemodynamics derived from easy-to-acquire CEMRA images suggests high potential clinical utility in management of BAV aortopathy, and this may offer new and powerful ways to stratify risk in patients with BAV aortopathy.

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Keywords