Automated Framework for the Augmentation of Missing Anatomical Structures and Generation of Personalized Atrial Models from Clinical Data

Luca Azzolin1, Claudia Nagel1, Deborah Nairn1, Jorge Sánchez2, Tianbao Zheng1, Eichenlaub Martin3, Jadidi Amir3, Olaf Doessel4, Axel Loewe5
1Karlsruhe Institute of Technology, 2Institue of Biomedical Engineering, Karlsruhe Institute of Technology (KIT), 3Universitäts-Herzzentrum Freiburg, 4Institute of Biomedical Engineering, Karlsruhe Institute of Technology, 5Karlsruhe Institute of Technology (KIT)


Clinical and computational studies highlighted the role of atrial anatomy for atrial fibrillation vulnerability. However, personalized computational models are often generated from electroanatomical maps, which might lack important anatomical structures like the appendages, or from imaging data which are potentially affected by segmentation uncertainty. A bi-atrial statistical shape model (SSM) covering relevant structures for electrophysiological simulations was shown to cover atrial shape variability. We hypothesized that it could, therefore, also be used to infer the shape of missing structures and deliver ready-to-use models to assess atrial fibrillation vulnerability in silico. We implemented a highly automatized pipeline to generate a personalized computational model by fitting the SSM to the clinically acquired geometries. We applied our framework to a geometry coming from an electroanatomical map and one derived from magnetic resonance images (MRI). Only landmarks belonging to the left atrium and no information from the right atrium were used in the fitting process. The left atrium surface-to-surface distance between electroanatomical map and a fitted instance of the SSM was 2.26+-1.95 mm. The distance between MRI segmentation and SSM was 2.07+-1.56 mm and 3.59+-2.84 mm in the left and right atrium, respectively. Our semi-automatic pipeline provides ready-to-use personalized computational models representing the original anatomy well by fitting a SSM. We were able to infer the shape of the right atrium even in the case of using information only from the left atrium.