The diagnosis of aortic diseases could be significantly enhanced with modern advances in model-based vessel visualization, objective parameter quantification, as well as information gained through numerical blood flow simulation. Most state-of-the-art methods, however, require heavy processing and are often split across various frameworks that require setting up complex workflows, making many clinical applications unrealistic and hindering research on large datasets. We present the AortaAnalyzer, a unified, end-to-end pipeline for processing computed-tomography angiography (CTA) of the aorta, integrating a state-of-the-art 3D segmentation network (Dice 0 . 95 ± 0 . 01 , HD95 5 . 25 ± 5 . 73 mm), interactive correction tools, automated surface extraction, robust centerline computation, inlet/outlet capping for numerical hemodynamics, and clinical metric quantification. All modules share a single GUI, use standard formats (nrrd, STL, OBJ, CSV), and propagate changes automatically, eliminating complex multi-tool workflows. We developed the framework in an iterative process based on evaluations with seven independent experts—two numerical hemodynamics researchers, two vessel visualization researchers, two cardiac surgeons, and one radiologist. The framework received high usefulness ratings and feature requests drove the addition of surface capping and extended metric measurements. To assess efficiency, we compared processing time against 3D Slicer and SimVascular. The AortaAnalyzer demonstrated increased robustness and required substantially less manual interaction and overall processing time. AortaAnalyzer supports both clinical assessment and research purposes by providing rapid visualization of the vessel morphology, reproducible diameter, volume, and landmark analysis, and accelerated pre-processing for blood-flow simulation. It is open access and serves as an extendable platform.

The morphology of saccular intracranial aneurysms is widely assumed to encode biomechanical information critical for rupture risk, yet existing predictors rely almost exclusively on handcrafted shape descriptors that are subjective and capture only limited aspects of the geometry. We introduce a data-driven framework for uniform parametric mapping and statistical shape analysis of aneurysm surfaces, applied to a multi-institutional set of 958 patient-extracted intracranial aneurysms. We develop a uniform parametric mapping based on an angular- and radial-field parameterization, yielding a surface map into a registered canonical space. The mapping is fully automatic, requires no manual annotations, and is independent of the cut configuration, meshing regularity, and sampling density. Using the mapping, we create uniform point correspondences across all aneurysms. From these correspondences, high-dimensional shape vectors are constructed, and principal component analysis (PCA) yields the mean aneurysm shape and dominant modes of variation. We investigate how strongly each mode contributes to the rupture association using logistic regression of the PCA coefficients. We identified three modes significantly associated with rupture status ( ) and provide interpretable deformation patterns for their morphological characteristics. The shape-based regression model classifying rupture status achieves an average accuracy of and an AUC of after 5-fold cross-validation. Based on a diverse range of aneurysm models, our framework demonstrates robust parameter mapping and statistical measures, offering a generalized, reproducible approach for shape-based risk stratification that may inform evidence-based management of unruptured aneurysms.

Abstract The emergence of computational fluid dynamics (CFD) enabled the simulation of intricate transport processes, including flow in physiological structures, such as blood vessels. While these so‐called hemodynamic simulations offer groundbreaking opportunities to solve problems at the clinical forefront, a successful translation of CFD to clinical decision‐making is challenging. Hemodynamic simulations are intrinsically complex, time‐consuming, and resource‐intensive, which conflicts with the time‐sensitive nature of clinical workflows and the fact that hospitals usually do not have the necessary resources or infrastructure to support CFD simulations. To address these transfer challenges, we propose a novel visualization system which enables instant flow exploration without performing on‐site simulation. To gain insights into the viability of the approach, we focus on hemodynamic simulations of the carotid bifurcation, which is a highly relevant arterial subtree in stroke diagnostics and prevention. We created an initial database of 120 high‐resolution carotid bifurcation flow models and developed a set of similarity metrics used to place a new carotid surface model into a neighborhood of simulated cases with the highest geometric similarity. The neighborhood can be immediately explored and the flow fields analyzed. We found that if the artery models are similar enough in the regions of interest, a new simulation leads to coinciding results, allowing the user to circumvent individual flow simulations. We conclude that similarity‐based visual analysis is a promising approach toward the usability of CFD in medical practice.

Abstract Analyzing stenoses of the internal carotids – local constrictions of the artery – is a critical clinical task in cardiovascular disease treatment and prevention. For this purpose, we propose a self‐contained pipeline for the visual analysis of carotid artery geometries. The only inputs are computed tomography angiography (CTA) scans, which are already recorded in clinical routine. We show how integrated model extraction and visualization can help to efficiently detect stenoses and we provide means for automatic, highly accurate stenosis degree computation. We directly connect multiple sophisticated processing stages, including a neural prediction network for lumen and plaque segmentation and automatic global diameter computation. We enable interactive and retrospective user control over the processing stages. Our aims are to increase user trust by making the underlying data validatable on the fly, to decrease adoption costs by minimizing external dependencies, and to optimize scalability by streamlining the data processing. We use interactive visualizations for data inspection and adaption to guide the user through the processing stages. The framework was developed and evaluated in close collaboration with radiologists and neurologists. It has been used to extract and analyze over 100 carotid bifurcation geometries and is built with a modular architecture, available as an extendable open‐source platform.

The Gaussian mixture model (GMM) describes the distribution of random variables from several different populations. GMMs have widespread applications in probability theory, statistics, machine learning for unsupervised cluster analysis and topic modeling, as well as in deep learning pipelines. So far, few efforts have been made to explore the underlying point distribution in combination with the GMMs, in particular when the data becomes high-dimensional and when the GMMs are composed of many Gaussians. We present an analysis tool comprising various GPU-based visualization techniques to explore such complex GMMs. To facilitate the exploration of high-dimensional data, we provide a novel navigation system to analyze the underlying data. Instead of projecting the data to 2D, we utilize interactive 3D views to better support users in understanding the spatial arrangements of the Gaussian distributions. The interactive system is composed of two parts: (1) raycasting-based views that visualize cluster memberships, spatial arrangements, and support the discovery of new modes. (2) overview visualizations that enable the comparison of Gaussians with each other, as well as small multiples of different choices of basis vectors. Users are supported in their exploration with customization tools and smooth camera navigations. Our tool was developed and assessed by five domain experts, and its usefulness was evaluated with 23 participants. To demonstrate the effectiveness, we identify interesting features in several data sets.

The helical axis is a common tool used in biomechanical modeling to parameterize the motion of rigid objects. It encodes an object’s rotation around and translation along a unique axis. Visualizations of helical axes have helped to make kinematic data tangible. However, the analysis process often remains tedious, especially if complex motions are examined. We identify multiple key challenges: the absence of interactive tools for the computation and handling of helical axes, visual clutter in axis representations, and a lack of contextualization. We solve these issues by providing the first generalized framework for kinematic analysis with helical axes. Axis sets can be computed on-demand, interactively filtered, and explored in multiple coordinated views. We iteratively developed and evaluated the HAExplorer with active biomechanics researchers. Our results show that the techniques we introduce open up the possibility to analyze non-planar, compound, and interdependent motion data.

Abstract Map‐like visualizations of patient‐specific cardiovascular structures have been applied in numerous medical application contexts. The term map‐like alludes to the characteristics these depictions share with cartographic maps: they show the spatial relations of data attributes from a single perspective, they abstract the underlying data to inCrease legibility, and they facilitate tasks centered around overview, navigation, and comparison. A vast landscape of techniques exists to derive such maps from heterogeneous data spaces. Yet, they all target similar purposes within disease diagnostics, treatment, or research and they face coinciding challenges in mapping the spatial component of a treelike structure to a legible layout. In this report, we present a framing to unify these approaches. On the one hand, we provide a classification of the existing literature according to the data spaces such maps can be derived from. On the other hand, we view the approaches in light of the manifold requirements medical practitioners and researchers have in their efforts to combat the ever‐growing burden of cardiovascular disease. Based on these two perspectives, we offer recommendations for the design of map‐like visualizations of the cardiovascular system.

Abstract In this work, we investigate how concepts from medical flow visualization can be applied to enhance stroke prevention diagnostics. Our focus lies on carotid stenoses, i.e., local narrowings of the major brain‐supplying arteries, which are a frequent cause of stroke. Carotid surgery can reduce the stroke risk associated with stenoses, however, the procedure entails risks itself. Therefore, a thorough assessment of each case is necessary. In routine diagnostics, the morphology and hemodynamics of an afflicted vessel are separately analyzed using angiography and sonography, respectively. Blood flow simulations based on computational fluid dynamics could enable the visual integration of hemodynamic and morphological information and provide a higher resolution on relevant parameters. We identify and abstract the tasks involved in the assessment of stenoses and investigate how clinicians could derive relevant insights from carotid blood flow simulations. We adapt and refine a combination of techniques to facilitate this purpose, integrating spatiotemporal navigation, dimensional reduction, and contextual embedding. We evaluated and discussed our approach with an interdisciplinary group of medical practitioners, fluid simulation and flow visualization researchers. Our initial findings indicate that visualization techniques could promote usage of carotid blood flow simulations in practice.

We propose a visualization application, designed for the exploration of human spine simulation data. Our goal is to support research in biomechanical spine simulation and advance efforts to implement simulation-backed analysis in surgical applications. Biomechanical simulation is a state-of-the-art technique for analyzing load distributions of spinal structures. Through the inclusion of patient-specific data, such simulations may facilitate personalized treatment and customized surgical interventions. Difficulties in spine modelling and simulation can be partly attributed to poor result representation, which may also be a hindrance when introducing such techniques into a clinical environment. Comparisons of measurements across multiple similar anatomical structures and the integration of temporal data make commonly available diagrams and charts insufficient for an intuitive and systematic display of results. Therefore, we facilitate methods such as multiple coordinated views, abstraction and focus and context to display simulation outcomes in a dedicated tool. By linking the result data with patient-specific anatomy, we make relevant parameters tangible for clinicians. Furthermore, we introduce new concepts to show the directions of impact force vectors, which were not accessible before. We integrated our toolset into a spine segmentation and simulation pipeline and evaluated our methods with both surgeons and biomechanical researchers. When comparing our methods against standard representations that are currently in use, we found increases in accuracy and speed in data exploration tasks. in a qualitative review, domain experts deemed the tool highly useful when dealing with simulation result data, which typically combines time-dependent patient movement and the resulting force distributions on spinal structures.

The mitral valve, one of the four valves in the human heart, controls the bloodflow between the left atrium and ventricle and may suffer from various pathologies. Malfunctioning valves can be treated by reconstructive surgeries, which have to be carefully planned and evaluated. While current research focuses on the modeling and segmentation of the valve, we base our work on existing segmentations of patient-specific mitral valves, that are also time-resolved ( 3D+t) over the cardiac cycle. The interpretation of the data can be ambiguous, due to the complex surface of the valve and multiple time steps. We therefore propose a software prototype to analyze such 3D+t data, by extracting pathophysiological parameters and presenting them via dimensionally reduced visualizations. For this, we rely on an existing algorithm to unroll the convoluted valve surface towards a flattened 2D representation. In this paper, we show that the 3D+t data can be transferred to 3D or 2D representations in a way that allows the domain expert to faithfully grasp important aspects of the cardiac cycle. In this course, we not only consider common pathophysiological parameters, but also introduce new observations that are derived from landmarks within the segmentation model. Our analysis techniques were developed in collaboration with domain experts and a survey showed that the insights have the potential to support mitral valve diagnosis and the comparison of the pre- and post-operative condition of a patient.