Table of Contents
Fetching ...

Med-Real2Sim: Non-Invasive Medical Digital Twins using Physics-Informed Self-Supervised Learning

Keying Kuang, Frances Dean, Jack B. Jedlicki, David Ouyang, Anthony Philippakis, David Sontag, Ahmed M. Alaa

TL;DR

This paper introduces a physics-informed SSL algorithm that initially pretrains a neural network on the pretext task of learning a differentiable simulator of a physiological process, and trains the model to reconstruct physiological measurements from noninvasive modalities while being constrained by the physical equations learned in pretraining.

Abstract

A digital twin is a virtual replica of a real-world physical phenomena that uses mathematical modeling to characterize and simulate its defining features. By constructing digital twins for disease processes, we can perform in-silico simulations that mimic patients' health conditions and counterfactual outcomes under hypothetical interventions in a virtual setting. This eliminates the need for invasive procedures or uncertain treatment decisions. In this paper, we propose a method to identify digital twin model parameters using only noninvasive patient health data. We approach the digital twin modeling as a composite inverse problem, and observe that its structure resembles pretraining and finetuning in self-supervised learning (SSL). Leveraging this, we introduce a physics-informed SSL algorithm that initially pretrains a neural network on the pretext task of learning a differentiable simulator of a physiological process. Subsequently, the model is trained to reconstruct physiological measurements from noninvasive modalities while being constrained by the physical equations learned in pretraining. We apply our method to identify digital twins of cardiac hemodynamics using noninvasive echocardiogram videos, and demonstrate its utility in unsupervised disease detection and in-silico clinical trials.

Med-Real2Sim: Non-Invasive Medical Digital Twins using Physics-Informed Self-Supervised Learning

TL;DR

This paper introduces a physics-informed SSL algorithm that initially pretrains a neural network on the pretext task of learning a differentiable simulator of a physiological process, and trains the model to reconstruct physiological measurements from noninvasive modalities while being constrained by the physical equations learned in pretraining.

Abstract

A digital twin is a virtual replica of a real-world physical phenomena that uses mathematical modeling to characterize and simulate its defining features. By constructing digital twins for disease processes, we can perform in-silico simulations that mimic patients' health conditions and counterfactual outcomes under hypothetical interventions in a virtual setting. This eliminates the need for invasive procedures or uncertain treatment decisions. In this paper, we propose a method to identify digital twin model parameters using only noninvasive patient health data. We approach the digital twin modeling as a composite inverse problem, and observe that its structure resembles pretraining and finetuning in self-supervised learning (SSL). Leveraging this, we introduce a physics-informed SSL algorithm that initially pretrains a neural network on the pretext task of learning a differentiable simulator of a physiological process. Subsequently, the model is trained to reconstruct physiological measurements from noninvasive modalities while being constrained by the physical equations learned in pretraining. We apply our method to identify digital twins of cardiac hemodynamics using noninvasive echocardiogram videos, and demonstrate its utility in unsupervised disease detection and in-silico clinical trials.
Paper Structure (27 sections, 1 theorem, 40 equations, 12 figures, 5 tables)

This paper contains 27 sections, 1 theorem, 40 equations, 12 figures, 5 tables.

Key Result

Theorem D.1

Every linear circuit is equivalent to one with a single current source and single resistor in parallel with a load of interest.

Figures (12)

  • Figure 1: Digital twins for cardiac hemodynamics. Left: Illustration of the cardiovascular system. Right: Digital twin models of cardiac hemodynamics based on hydraulic or electric representations.
  • Figure 2: Illustration of Med-Real2Sim digital twins for cardiovascular hemodynamics. (a) Pictorial depiction of the two-step physics-informed SSL algorithm proposed in Section \ref{['Sec22']}. (b) Five state lumped-parameter electric circuit model of cardiac hemodynamics from simaan2008dynamical. Here $\mathbf{x}(t)= [x_1(t), x_2(t), x_3(t), x_4(t), x_5(t)] =$$[P_{LV}(t), P_{LA}(t), P_{A}(t), P_{Ao}(t), Q(t)]$ describes the voltages $x_1,x_2,x_3,x_4$ or pressures in the left-ventricle, left atrium, arteries, and aorta, respectively, and total flow $x_5$. The LVAD is modeled through an electric circuit connected to the digital twin via a switch. An LVAD intervention is applied if the switch is closed.
  • Figure 3: (a) Learned parameters of the digital twin in high- and low-EF patient groups within the EchoNet an CAMUS datasets. (b) Comparison of average (simulated) PV loops in digital twins of non-Mitral Stenosis (MS) patients and MS patients. The plot illustrates differences in simulated hemodynamics in the two groups and agrees with theoretical PV loops for MS patients pv_loops2. Depicting of the theoretical PV loop for MS is courtesy of https://cvphysiology.com/heart-disease/hd009a.
  • Figure 4: Counterfactual simulations of the LVAD intervention (left): (a),(b),(c). PV loops for patients with normal, high, and low EF (right).
  • Figure 5: Nodes for deriving circuit equations. The fifth row is derived using total flow and inductance.
  • ...and 7 more figures

Theorems & Definitions (1)

  • Theorem D.1: Norton