Neurovascular diseases, including stroke, aneurysms, and arteriovenous malformations, can cause
devastating and life-threatening injury to the brain. Each year these diseases affect nearly 1 million people
in the US. Stroke alone kills more than 130,000 Americans each year. Effective treatment of these diseases
requires understanding the cerebrovascular architecture, which is complex and patient specific. Existing
clinically available methods for imaging blood vessels in the brain are limited by several factors, including
spatial and temporal resolution, the need for ionizing radiation or contrast agents, and the lack of
availability of some types of imaging during surgical procedures.
We propose to generate patient-specific 4D models of cerebral vasculature with unprecedented spatial
and temporal resolution from a single pair of 2D Digital Subtraction Angiography (DSA) image sequences.
Two important advantages of using DSA are: 1) it has high spatial and temporal resolution; and 2) it is
readily available both pre-operatively, for planning surgery, and intra-operatively, for monitoring the
surgical procedure. To pursue this goal, we will investigate novel approaches for contouring vessels in DSA
images, extracting information about blood flow with high temporal resolution from DSA video
sequences, and annotating the contoured vessels with this temporal data. We will expand our recent work
on constrained 2D-to-3D reconstruction for generating patient-specific 4D cerebrovascular models that
will exploit these annotated vessel contours. The resultant models will support vessels as small as 0.1 mm3
and flow rates up to 15 frames per second, a 10-fold improvement in spatial and/or temporal resolution
over models generated from clinically available MRA, CTA and rotational DSA. Finally, we will develop new
software for visualizing and interacting with these 4D models and give surgeons the ability to virtually
inject a bolus of contrast at any point in the vascular network to observe downstream flow. This software
will give neurosurgeons a better understanding of their patient’s cerebral vasculature, allowing them to
plan and perform safer and more effective neurovascular surgery.