AUTHOR=Behland Jonas , Madai Vince I. , Aydin Orhun U. , Akay Ela M. , Kossen Tabea , Hilbert Adam , Sobesky Jan , Vajkoczy Peter , Frey Dietmar 

TITLE=Personalised simulation of hemodynamics in cerebrovascular disease: lessons learned from a study of diagnostic accuracy

JOURNAL=Frontiers in Neurology

VOLUME=Volume 14 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2023.1230402

DOI=10.3389/fneur.2023.1230402

ISSN=1664-2295

ABSTRACT=This is a provisional file, not the final typeset article transit time (relMTT) from dynamic susceptibility contrast MRI (DSC-MRI). In 68 subjects with unilateral stenosis >70% of the internal carotid artery (ICA) or middle cerebral artery (MCA), the sensitivity and specificity of the simulation were 0.65 and 0.67, respectively. The ROC AUC was 0.68. The low-to-moderate accuracy of the simulation may be attributed to assumptions of Newtonian blood flow, rigid vessel walls, and the use of time-of-flight MRI for geometric representation of subject vasculature. Future simulation approaches should focus on integrating additional patient data, increasing accessibility of precision medicine tools to clinicians, addressing disease burden disparities among different populations, and quantifying patient benefit. Our results underscore the need for further improvement of mechanistic simulations of brain hemodynamics to foster the translation of the technology to clinical practice.