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At least 19 records

Propagating uncertainties in large-scale hemodynamics models via network uncertainty quantification and reduced-order modeling

Numerical simulations of the cardiovascular system are affected by uncertainties arising from a substantial lack of data related to the boundary conditions and the physical parameters of the mathematical models. Quantifying the impact of this uncertainty on the numerical results along the circulatory network is challenged by the complexity of both the morphology of the domain and the local dynamics. Here, we propose to integrate (i) the Transverse Enriched Pipe Element Methods (TEPEM) as a reduced-order model for effectively computing the 3D local hemodynamics; and (ii) a combination of uncertainty quantification via Polynomial Chaos Expansion and classical relaxation methods – called network uncertainty quantification (NetUQ) – for effectively propagating random variables that encode uncertainties throughout the networks. The findings demonstrate the computational effectiveness of computing the propagation of uncertainties in networks with nontrivial topology, including portions of the cerebral and the coronary systems.

97 MATHEMATICS AND COMPUTING↗

A Poisson equation method for prescribing fully developed non-Newtonian inlet conditions for computational fluid dynamics simulations in models of arbitrary cross-section

Prescribing inlet boundary conditions for computational fluid dynamics (CFD) simulations of internal flow in complex geometries such as anatomical vascular models is challenging. In the absence of patient-specific inlet velocity data, a common approach for long blood vessels is to assume that the inlet flow is fully developed. In vessels of irregular cross section, however, prescribing fully developed conditions is complicated due to the lack of a general closed-form analytical solution. In this study, we develop a simple Poisson equation method for prescribing fully developed inlet conditions for the flow of either Newtonian or non-Newtonian fluids in CFD models of arbitrary cross-section. We first derive the generalized Poisson equation for fully developed flow of a non-Newtonian fluid and we then develop and verify a methodology for numerically computing the solution on any planar boundary domain. In addition, we develop a simple extension of the method for prescribing a non-orthogonal inlet velocity that represents fully developed flow from an upstream tube that is connected to the CFD inlet at a non-orthogonal angle. This may be used to investigate a common source of uncertainty in CFD simulations of internal flow that is due to a lack of information concerning the exact streamwise flow direction at the inlets. Comparison to several Newtonian and non-Newtonian benchmark verification solutions shows the method to be extremely accurate. As a practical demonstration case, we use the method to prescribe fully developed conditions on multiple non-circular inlets for the non-Newtonian flow of blood in a patient-specific model of the inferior vena cava (IVC). Finally, we further demonstrate the utility of the method by performing a sensitivity study using the patient-specific IVC model, wherein we investigate the influence of inlet velocity flow direction on the non-Newtonian IVC hemodynamics. Given its simplicity and computational efficiency, the method is shown to be far superior to alternative approaches for prescribing fully developed inlet conditions in such complicated geometries. In conclusion, to facilitate the adoption of our Poisson equation method, we have distributed our OpenFOAM source code and the associated test cases from this study as open-source software.

97 MATHEMATICS AND COMPUTING↗

Feasibility of Vascular Parameter Estimation for Assessing Hypertensive Pregnancy Disorders

Abstract Hypertensive pregnancy disorders (HPDs), such as pre-eclampsia, are leading sources of both maternal and fetal morbidity in pregnancy. Noninvasive imaging, such as ultrasound (US) and magnetic resonance imaging (MRI), is an important tool for predicting and monitoring these high risk pregnancies. While imaging can measure hemodynamic parameters, such as uterine artery pulsatility and resistivity indices (PI and RI), the interpretation of such metrics for disease assessment relies on ad hoc standards, which provide limited insight to the physical mechanisms underlying the emergence of hypertensive pregnancy disorders. To provide meaningful interpretation of measured hemodynamic data in patients, advances in computational fluid dynamics can be brought to bear. In this work, we develop a patient-specific computational framework that combines Bayesian inference with a reduced-order fluid dynamics model to infer parameters, such as vascular resistance, compliance, and vessel cross-sectional area, known to be related to the development of hypertension. The proposed framework enables the prediction of hemodynamic quantities of interest, such as pressure and velocity, directly from sparse and noisy MRI measurements. We illustrate the effectiveness of this approach in two systemic arterial network geometries: an aorta with branching carotid artery and a maternal pelvic arterial network. For both cases, the model can reconstruct the provided measurements and infer parameters of interest. In the case of the maternal pelvic arteries, the model can make a distinction between the pregnancies destined to develop hypertension and those that remain normotensive, expressed through the value range of the predicted absolute pressure.

Biophysics↗

Collagen Turnover in Relation to Risk Factors and Hemodynamics in Human Intracranial Aneurysms

Determinants for molecular and structural instability, that is, impending growth or rupture, of intracranial aneurysms (IAs) remain uncertain. To elucidate this, we endeavored to estimate the actual turnover rates of the main molecular constituent in human IA (collagen) on the basis of radiocarbon ( 14 C) birth dating in relation to IA hemodynamics. Collagen turnover rates in excised human IA samples were calculated using mathematical modeling of 14 C birth dating data of collagen in relation to risk factors and histological markers for collagen maturity/turnover in selected IA. Hemodynamics were simulated using image-based computational fluid dynamics. Correlation, logistic regression, and receiver operating characteristic analyses were performed. Collagen turnover rates were estimated in 46 IA (43 patients); computational fluid dynamics could be performed in 20 IA (20 patients). The mean collagen turnover rate (γ) constituted 126% (±1% error) per year. For patients with arterial hypertension, γ was greater than 2600% annually, whereas γ was distinctly lower with 32% (±1% error) per year for patients without risk factors, such as smoking and hypertension. There was a distinct association between histological presence of rather immature collagen in human IA and the presence of modifiable risk factors. Spatial-temporal averaged wall shear stress predicted rapid collagen turnover (odds ratio, 1.6 [95% CI, 1.0–2.7]). Receiver operating characteristic analysis demonstrated a good test accuracy (area under the curve, 0.798 [95% CI, 0.598–0.998]) for average wall shear stress with a threshold ≥4.9 Pa for rapid collagen turnover. Our data indicate that turnover rates and stability of collagen in human IA are strongly associated with the presence of modifiable risk factors and aneurysmal hemodynamics. Finally, these findings underline the importance of strict risk factor modification in patients with unruptured IA. Future should include more detailed risk factor data to establish a more causal understanding of hemodynamics and the rupture risk of individual IA.

60 APPLIED LIFE SCIENCES↗

Multi-GPU immersed boundary method hemodynamics simulations

Large-scale simulations of blood flow that resolve the 3D deformation of each comprising cell are increasingly popular owing to algorithmic developments in conjunction with advances in compute capability. Among different approaches for modeling cell-resolved hemodynamics, fluid structure interaction (FSI) algorithms based on the immersed boundary method are frequently employed for coupling separate solvers for the background fluid and the cells within one framework. GPUs can accelerate these simulations; however, both current pre-exascale and future exascale CPU-GPU heterogeneous systems face communication challenges critical to performance and scalability. In this paper, we describe, to our knowledge, the largest distributed GPU-accelerated FSI simulations of high hematocrit cell-resolved flows with over 17 million red blood cells. We compare scaling on a fat node system with six GPUs per node and on a system with a single GPU per node. Through comparison between the CPU- and GPU-based implementations, we identify the costs of data movement in multiscale multi-grid FSI simulations on heterogeneous systems and show it to be the greatest performance bottleneck on the GPU.

97 MATHEMATICS AND COMPUTING↗

Multilevel and multifidelity uncertainty quantification for cardiovascular hemodynamics

Standard approaches for uncertainty quantification in cardiovascular modeling pose challenges due to the large number of uncertain inputs and the significant computational cost of realistic three-dimensional simulations. Here, we propose an efficient uncertainty quantification framework utilizing a multilevel multifidelity Monte Carlo (MLMF) estimator to improve the accuracy of hemodynamic quantities of interest while maintaining reasonable computational cost. This is achieved by leveraging three cardiovascular model fidelities, each with varying spatial resolution to rigorously quantify the variability in hemodynamic outputs. We employ two low-fidelity models (zero- and one-dimensional) to construct several different estimators. Our goal is to investigate and compare the efficiency of estimators built from combinations of these two low-fidelity model alternatives and our high-fidelity three-dimensional models. We demonstrate this framework on healthy and diseased models of aortic and coronary anatomy, including uncertainties in material property and boundary condition parameters. Our goal is to demonstrate that for this application it is possible to accelerate the convergence of the estimators by utilizing a MLMF paradigm. Therefore, we compare our approach to single fidelity Monte Carlo estimators and to a multilevel Monte Carlo approach based only on three-dimensional simulations, but leveraging multiple spatial resolutions. We demonstrate significant, on the order of 10 to 100 times, reduction in total computational cost with the MLMF estimators. We also examine the differing properties of the MLMF estimators in healthy versus diseased models, as well as global versus local quantities of interest. As expected, global quantities such as outlet pressure and flow show larger reductions than local quantities, such as those relating to wall shear stress, as the latter rely more heavily on the highest fidelity model evaluations. Similarly, healthy models show larger reductions than diseased models. In all cases, our workflow coupling Dakota’s MLMF estimators with the SimVascular cardiovascular modeling framework makes uncertainty quantification feasible for constrained computational budgets.

59 BASIC BIOLOGICAL SCIENCES↗

Accelerating massively parallel hemodynamic models of coarctation of the aorta using neural networks

Comorbidities such as anemia or hypertension and physiological factors related to exertion can influence a patient’s hemodynamics and increase the severity of many cardiovascular diseases. Observing and quantifying associations between these factors and hemodynamics can be difficult due to the multitude of co-existing conditions and blood flow parameters in real patient data. Machine learning-driven, physics-based simulations provide a means to understand how potentially correlated conditions may affect a particular patient. Here, we use a combination of machine learning and massively parallel computing to predict the effects of physiological factors on hemodynamics in patients with coarctation of the aorta. We first validated blood flow simulations against in vitro measurements in 3D-printed phantoms representing the patient’s vasculature. We then investigated the effects of varying the degree of stenosis, blood flow rate, and viscosity on two diagnostic metrics – pressure gradient across the stenosis (ΔP) and wall shear stress (WSS) - by performing the largest simulation study to date of coarctation of the aorta (over 70 million compute hours). Using machine learning models trained on data from the simulations and validated on two independent datasets, we developed a framework to identify the minimal training set required to build a predictive model on a per-patient basis. We then used this model to accurately predict ΔP (mean absolute error within 1.18 mmHg) and WSS (mean absolute error within 0.99 Pa) for patients with this disease.

59 BASIC BIOLOGICAL SCIENCES↗

Determining the impacts of venoarterial extracorporeal membrane oxygenation on cerebral oxygenation using a one-dimensional blood flow simulator

Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is a mechanical system that provides rapid and short-term support for patients with cardiac failure. In many patients, pulmonary function is also impaired, resulting in poorly-oxygenated cardiac outflow competing against well-oxygenated VA-ECMO outflow, a condition known as North-South syndrome. North-South syndrome is a primary concern because of its potential to cause cerebral hypoxia, which has a critical influence on neurological complications often seen in this patient population. In order to reduce ischemic neurological complications, it is important to understand how clinical decisions regarding VA-ECMO parameters influence blood oxygenation. In our work, we studied the impacts of flow rate and cannulation site on oxygenation using a one-dimensional (1D) model to simulate blood flow. Our model was initially tested by comparing blood flow results to those observed from experimental work in VA-ECMO patients. The 1D model was combined with a two-phase flow model to simulate oxygenation. Additionally, the influence of various other clinician-tunable parameters on oxygenation in the common carotid arteries (CCAs) were tested, including, blood viscosity, cannula position within the insertion artery, heart rate, and systemic vascular resistance (SVR), as well as geometrical changes such as arterial radius and length. Our results indicated that blood oxygenation to the brain strongly depended on the cannula insertion site and the VA-ECMO flow rate with a weaker but potentially significant dependence on arterial radius. During femoral cannulation, VA-ECMO flow rates greater than ~4.9 L/min were needed to perfuse the CCAs. However, axillary and central cannulation began to perfuse the CCAs at significantly lower flow (~1 L/min). These results may help explain the incidence of cerebral hypoxia in this patient population and the common need to change cannulation strategies during treatment to address this clinical problem. While this work describes patient-averaged results, determining these relationships between VA-ECMO parameters and cerebral hypoxia is an important step towards future work to develop patient-specific models that clinicians can use to improve outcomes.

1D blood flow↗

Diagnosis and Prognosis of Coronary Artery Disease with SPECT and PET

Purpose of Review: Radionuclide myocardial perfusion imaging (MPI) continues to be the most reliable modality for diagnosis of hemodynamically significant coronary artery disease (CAD). The application of radionuclide MPI using single photon emission computed tomography (SEPCT) and positron emission tomography (PET) for CAD is reviewed, with emphasis on diagnosis and risk stratification. Recent Findings: Contemporary studies have reported the diagnostic and prognostic value of novel imaging protocols, employing stress-first or stress-only approach. In addition, the superior diagnostic value of PET has been established with a role of assessment of myocardial blood flow to improve risk stratification. The utility of MPI in special populations, such as the elderly, women, and diabetic patients has also been recently evaluated. Furthermore, multicenter studies have reported a similar diagnostic and prognostic value of radionuclide MPI compared with other functional and anatomical techniques for CAD. Summary: Radionuclide MPI with SPECT and PET are efficacious for diagnosis and prognosis of CAD. Its universal application in varied patient populations highlights its excellent clinical effectiveness.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Personalized and uncertainty-aware coronary hemodynamics simulations: From Bayesian estimation to improved multi-fidelity uncertainty quantification

Non-invasive simulations of coronary hemodynamics have improved clinical risk stratification and treatment outcomes for coronary artery disease, compared to relying on anatomical imaging alone. However, simulations typically use empirical approaches to distribute total coronary flow amongst the arteries in the coronary tree, which ignores patient variability, the presence of disease, and other clinical factors. Further, uncertainty in the clinical data often remains unaccounted for in the modeling pipeline. We present an end-to-end uncertainty-aware pipeline to (1) personalize coronary flow simulations by incorporating vessel-specific coronary flows as well as cardiac function; and (2) predict clinical and biomechanical quantities of interest with improved precision, while accounting for uncertainty in the clinical data. We assimilate patient-specific measurements of myocardial blood flow from clinical CT myocardial perfusion imaging to estimate branch-specific coronary artery flows. Simulated noise in the clinical data is used to estimate the joint posterior distributions of the model parameters using adaptive Markov Chain Monte Carlo sampling. Additionally, the posterior predictive distribution for the relevant quantities of interest is determined using a new approach combining multi-fidelity Monte Carlo estimation with non-linear, data-driven dimensionality reduction. This leads to improved correlations between high- and low-fidelity model outputs. Our framework accurately recapitulates clinically measured cardiac function as well as branch-specific coronary flows under measurement noise uncertainty. We observe substantial reductions in confidence intervals for estimated quantities of interest compared to single-fidelity Monte Carlo estimation and state-of-the-art multi-fidelity Monte Carlo methods. This holds especially true for quantities of interest that showed limited correlation between the low- and high-fidelity model predictions. In addition, the proposed multi-fidelity Monte Carlo estimators are significantly cheaper to compute than traditional estimators, under a specified confidence level or variance. The proposed pipeline for personalized and uncertainty-aware predictions of coronary hemodynamics is based on routine clinical measurements and recently developed techniques for CT myocardial perfusion imaging. The proposed pipeline offers significant improvements in precision and reduction in computational cost.

Bayesian parameter estimation↗

Evaluation of intracoronary hemodynamics identifies perturbations in vorticity

Coronary artery disease (CAD) is highly prevalent and associated with adverse events. Challenges have emerged in the treatment of intermediate coronary artery stenoses. These lesions are often interrogated with fractional flow reserve (FFR) testing to determine if a stenosis is likely to be causative for ischemia in a cardiac territory. This invasive test requires insertion of a pressure wire into a coronary vessel. Recently computational fluid dynamics (CFD) has been used to noninvasively assess fractional flow reserve in vessels reconstructed from medical imaging data. However, many of these simulations are unable to provide additional information about intravascular hemodynamics, including velocity, endothelial shear stress (ESS), and vorticity. We hypothesized that vorticity, which has demonstrated utility in the assessment of ventricular and aortic diseases, would also be an important hemodynamic factor in CAD. Three-dimensional (3D), patient-specific coronary artery geometries that included all vessels >1 mm in diameter were created from angiography data obtained from 10 patients who underwent diagnostic angiography and FFR testing (n = 9). A massively parallel CFD solver (HARVEY) was used to calculate coronary hemodynamic parameters including pressure, velocity, ESS, and vorticity. These simulations were validated by comparing velocity flow fields from simulation to both velocities derived from in vitro particle image velocimetry and to invasively acquired pressure wire-based data from clinical testing. There was strong agreement between findings from CFD simulations and particle image velocimetry experimental testing (p < 0.01). CFD-FFR was also highly correlated with invasively measured FFR (ρ = 0.77, p = 0.01) with an average error of 5.9 ± 0.1%. CFD-FFR also had a strong inverse correlation with the vorticity (ρ = -0.86, p = 0.001). Simulations to determine the effect of the coronary stenosis on intravascular hemodynamics demonstrated significant differences in velocity and vorticity (both p < 0.05). Further evaluation of an angiographically normal appearing non-FFR coronary vessel in patients with CAD also demonstrated differences in vorticity when compared with FFR vessels (p < 0.05). The use of highly accurate 3D CFD-derived intravascular hemodynamics provides additional information beyond pressure measurements that can be used to calculate FFR. Vorticity is one parameter that is modified by a coronary stenosis and appears to be abnormal in angiographically normal vessels in patients with CAD, highlighting a possible use-case in preventative screening for early coronary disease.

59 BASIC BIOLOGICAL SCIENCES↗

Preparing the HARVEY Circulatory Modeling Code for Exascale

Atherosclerotic cardiovascular disease is the leading global cause of death, accounting for more than 17.3 million deaths per year, a number that is expected to grow to more than 23.6 million by 2030. Personalized computational models of the coronary arteries can be used to analyze the influence that a narrowing of the blood vessel can have on the associated hemodynamics. To achieve the necessary scale and precision in circulatory models with explicit fluid coupled to deformable cell models, our simulation code HARVEY must be designed to efficiently use current and next-generation HPC architectures. This Feasibility Study will involve a careful assessment and redesign of the code’s core data structure to prepare for GPU-accelerated systems like Sierra as well as next-generation architectures like the A21 exascale system.

59 BASIC BIOLOGICAL SCIENCES↗

Use of Cardiac Imaging to Evaluate Cardiac Function and Pulmonary Hemodynamics in Patients with Heart Failure

Purpose of Review: Noninvasive hemodynamic assessments in patients with heart failure (HF) are essential for appropriate diagnosis and establishment of the best treatment strategies. Recently, the impact of pulmonary circulation and right ventricular function on prognosis in HF patients has drawn increasing attention. In this article, we explore the usefulness of cardiac imaging for hemodynamic assessments, mainly focusing on echocardiographic evaluation. Recent Findings: The reliability of Doppler echocardiography as a noninvasive alternative to Swan-Ganz catheterization has been well investigated with higher than 80% accuracy for estimating pulmonary artery pressure. Strain measurement and three-dimensional echocardiography are useful for evaluating right ventricular function together with pulmonary circulation. The accuracy of analyzing left and right ventricular functions by cardiac computed tomography and cardiac magnetic resonate imaging has also been established. These modalities can provide myocardial tissue information and allow calculation of the extracellular volume fraction as well. Summary: According to the rapid improvement of technologies, cardiac imaging has become an essential tool for hemodynamic evaluation in HF management.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

Non-invasive characterization of complex coronary lesions

Conventional invasive diagnostic imaging techniques do not adequately resolve complex Type B and C coronary lesions, which present unique challenges, require personalized treatment and result in worsened patient outcomes. These lesions are often excluded from large-scale non-invasive clinical trials and there does not exist a validated approach to characterize hemodynamic quantities and guide percutaneous intervention for such lesions. This work identifies key biomarkers that differentiate complex Type B and C lesions from simple Type A lesions by introducing and validating a coronary angiography-based computational fluid dynamic (CFD-CA) framework for intracoronary assessment in complex lesions at ultrahigh resolution. Among 14 patients selected in this study, 7 patients with Type B and C lesions were included in the complex lesion group including ostial, bifurcation, serial lesions and lesion where flow was supplied by collateral bed. Simple lesion group included 7 patients with lesions that were discrete, <10mm long and readily accessible. Intracoronary assessment was performed using CFD-CA framework and validated by comparing to clinically measured pressure-based index, such as FFR. Local pressure, endothelial shear stress (ESS) and velocity profiles were derived for all patients. We validates the accuracy of our CFD-CA framework and report excellent agreement with invasive measurements (n=14,R 2 =0.6,p=0.0013). Ultra-high resolution achieved by the model enable physiological assessment in complex lesions and quantify hemodynamic metrics in all vessels up to 1mm in diameter. Importantly, we demonstrate that in contrast to traditional pressure-based metrics, there is a significant difference in the intracoronary hemodynamic forces, such as ESS, in complex lesions compared to simple lesions at both resting and hyperemic physiological states [n = 14, p=0.03]. Higher ESS was observed in the complex lesion group (7.0±4.7 Pa) than in simple lesion group (4.8±3.6 Pa). Complex coronary lesions have higher ESS compared to simple lesions, such differential hemodynamic evaluation can provide much the needed insight into the increase in adverse outcomes for such patients and has incremental prognostic value over traditional pressure-based indices, such as FFR.

46 INSTRUMENTATION RELATED TO NUCLEAR SCIENCE AND ↗

Artificial intelligence velocimetry and microaneurysm-on-a-chip for three-dimensional analysis of blood flow in physiology and disease

Significance Microfluidics is an important in vitro platform to gain insights into mechanics of blood flow and mechanisms of pathophysiology of human diseases. Extraction of 3D fields in microfluidics with dense cell suspensions remains a formidable challenge. We present artificial-intelligence velocimetry (AIV) as a general platform to determine 3D flow fields and a microaneurysm-on-a-chip to simulate blood flow in microaneurysms in patients with diabetic retinopathy. AIV is built on physics-informed neural networks that integrate seamlessly 2D images from microfluidic experiments or in vivo observations with physical laws to estimate full 3D velocity and stress fields. AIV could be integrated into imaging technologies to automatically infer key hemodynamic metrics from in vivo and in vitro biomedical images.

42 ENGINEERING↗

Investigating the Interaction Between Circulating Tumor Cells and Local Hydrodynamics via Experiment and Simulations

Introduction: The biological and mechanical properties of circulating tumor cells (CTCs) in combination with the hemodynamics affect the preference of metastatic sites in the vasculature. Despite the extensive literature on the effects of biological properties on cell adhesion, the effects of hydrodynamic forces on primary attachment remains an active area of research. Here, using simulations in conjunction with experimentation, we provide new insight into the interplay of CTCs dynamics and local hydrodynamics. Methods: A flow experiment of CTC attachment was performed within a bioprinted, double branching endothelialized vessel. Simulations of fluid flow and CTC transport in the reconstructed and idealized bifurcated vessel were respectively performed by HARVEY, our in-house massively parallel computational fluid dynamics solver. HARVEY is based on the lattice Boltzmann and finite element methods to model the fluid and cells dynamics. The immersed boundary method is employed for resolving the fluid–structure interaction. Results: CTC attachment was quantified experimentally at all regions of the complex vessel. The results demonstrate a clear preference for CTCs to attach at the branch points. To elucidate the effect of the vessel topology on the location of attachment, a fluid-only simulation was performed assessing the differences in the hydrodynamics along the vessel. CTC transport in idealized bifurcated vessels was subsequently studied to examine the effects of cell deformability on the local hydrodynamics patterns and, thus, the preference of attachment sites. Conclusions: The current work provides evidence on the correlation of the hydrodynamics forces arising from the vessel topology and CTC properties on the attachment regions.

60 APPLIED LIFE SCIENCES↗

Moment representation in the lattice Boltzmann method on massively parallel hardware

The widely-used lattice Boltzmann method (LBM) for computational fluid dynamics is highly scalable, but also significantly memory bandwidth-bound on current architectures. This paper presents a new regularized LBM implementation that reduces the memory footprint by only storing macroscopic, moment-based data. We show that the amount of data that must be stored in memory during a simulation is reduced by up to 47%. We also present a technique for cache-aware data re-utilization and show that optimizing cache utilization to limit data motion results in a similar improvement in time to solution. These new algorithms are implemented in the hemodynamics solver HARVEY and demonstrated using both idealized and realistic biological geometries. We develop a performance model for the moment representation algorithm and evaluate the performance on Summit.

Vardhan, Madhurima↗

Evaluating the Influence of Hemorheological Parameters on Circulating Tumor Cell Trajectory and Simulation Time

Extravasation of circulating tumor cells (CTCs) occurs primarily in the microvasculature, where flow and cell interactions significantly affect the blood rheology. Capturing cell trajectory at this scale requires the coupling of several interaction models, leading to increased computational cost that scales as more cells are added or the domain size is increased. In this work, we focus on micro-scale vessels and study the influence of certain hemorheological factors, including the presence of red blood cell aggregation, hematocrit level, microvessel size, and shear rate, on the trajectory of a circulating tumor cell. We determine which of the aforementioned factors significantly affect CTC motion and identify those which can potentially be disregarded, thus reducing simulation time. We measure the effect of these elements by studying the radial CTC movement and runtime at various combinations of these hemorheological parameters. To accurately capture blood flow dynamics and single cell movement, we perform high-fidelity hemodynamic simulations at a sub-micron resolution using our in-house fluid dynamics solver, HARVEY. We find that increasing hematocrit increases the likelihood of tumor cell margination, which is exacerbated by the presence of red blood cell aggregation. As microvessel diameter increases, there is no major CTC movement towards the wall; however, including aggregation causes the CTC to marginate quicker as the vessel size increases. Finally, as the shear rate is increased, the presence of aggregation has a diminished effect on tumor cell margination.

Roychowdhury, Sayan↗