ITU Workshop on “E-health services in low-resource settings: Requirements and ITU role” (Tokyo, Japan, 4-5 February 2013) New Heart Care System based on UT-Heart for Tailor-made Medicine Prof. Toshiaki Hisada, Ph.D. in Eng. Univ. of Tokyo Prof. Seiryou Sugiura, Ph.D. in MD. Univ. of Tokyo Yoshimasa Kadooka, Ph.D. in Sci. Fujitsu Ltd. •Collaborative research with Hisada Lab. of the University of Tokyo •Supported by Japan Science and Technology Agency Tokyo, Japan, 4-5 February 2013 Results of computational simulation by using UT-Heart Copyright 2013 FUJITSU LIMITED 1 What we are aiming at. P-V loop mechanics Tension Multi-physics X-bridge Glucose Biochemistr y glycolysi s ATP lactate Na+ Ca++ Channels Electrical activity K+ Molecular function/structure 10-9m Action potential ECG Cell 10-2m Orga n 100m Human body Multi-scale Integration Understanding of knowledge of human body Discovery Copyright 2013 FUJITSU LIMITED 2 Construction of numerical model based on CT-images CT-scan images Imbedding to the torso model Copyright 2013 FUJITSU LIMITED 3 Pumping Principle of the Heart as a Blood Pump Sinoatrial node Electrophysiology 100µm Pressure volume Excitation-Contraction Coupling Organ Myocardium Cell Copyright 2013 4 FUJITSU Fiber direction Fiber orientation Atrium Ventricles endo mid epi 5 2013 Copyright 5 FUJITSU Tetrahedral FEM model for mechanics Voxel model for EP analysis Torso structure Excitation propagation 664,334 elements 2,561,750 DOF 19,088,161 nodes Heart fluid Deformation 30,819,249 nodes (Total 49,425,860 nodes ) 435,227 elements 1,668,669 DOF (total ~4.2 million DOF) Copyright 2013 FUJITSU LIMITED 6 Measurement of Electrocardiogram(ECG) Comparison of ECG measurement between heart simulator and human heart Cardiac Pumping Potential Distribution on torso surface Cardiac Excitation Lead II ECG Copyright 2013 FUJITSU LIMITED 7 Planning of Surgery for Dilative Cardiomyopathy Surgery Planning of “Batista” by Heart Simulator Contractile force: 100% Plan A Aneurysm Necrotic myocardium Contractile force: 30% Before surgery Plan B ? Quantitative Prediction (QP) of Pressure - Volume QP of Stress – Strain Copyright 2013 FUJITSU LIMITED 8 New Medical System to realize Tailormade Medicine in the Cloud Heart Simulator Patient data Cardiac Excitation Propagation Micro Numerical Cell Ion channel model in Cell Fluid and Structure Interaction Surgery planning, Prediction of effect Blood pressure, electrocardiogram, and blood test Interactive Visualization System Echo Valves Relational model for Excitation and Contraction Diagnostic support Micro Model Coronary Circulation CT・MRI Peta-scale Computer Prediction of administering effect Medical information integration data base Electrical Care Card Taylor-made Medical Treatment by Heart Simulator Treatment for Intractable disease 9 Copyright 2013 FUJITSU LIMITED Standardization for patient data The data format for simulation results should be standardize. Unification of storage method for patient data Conservation of relational information between modality data and simulation result Example: Data specification Data Type Modality Data Simulation Results Format ・DICOM ・MFER ? ・Patient ID ・Simulation Date ・Organ name, bone, etc. ・Physical quantities: velocity, force, ..etc ・Type of Element ・No. of time steps ・Simulation scheme Tetra FEM, FDM, FVM, etc Hexa 10 Copyright 2013 FUJITSU LIMITED Conclusions and Recommedation We have developed a heart simulator “UT-Heart” which will contribute for a tailor-made medical treatment. Various kinds of computer simulations will be adopted for medical treatment in the near future. We recommend to develop a standardized format for simulation results (3D/4D image data) same as DICOM format for Modality data. 11