Observer- and sequence variability in personalized 4D flow MRI-based cardiovascular models

Subject-specific parameters in lumped hemodynamic models of the cardiovascular system can be estimated using data from experimental measurements, but the parameter estimation may be hampered by the variability in the input data. In this study, we investigate the influence of inter-sequence, intra-observer, and inter-observer variability in input parameters on estimation of subject-specific model parameters using a previously developed approach for model-based analysis of data from 4D Flow MRI acquisitions and cuff pressure measurements. The investigated parameters describe left ventricular time-varying elastance and aortic compliance. Parameter reproducibility with respect to variability in the MRI input measurements was assessed in a group of ten healthy subjects. The subject-specific parameters had coefficient of variations between 2.6 and 35% in the intra- and inter-observer analysis. In comparing parameters estimated using data from the two MRI sequences, the coefficients of variation ranged between 3.3 and 41%. The diastolic time constant of the left ventricle and the compliance of the ascending aorta were the parameters with the lowest and the highest variability, respectively. In conclusion, the modeling approach allows for estimating left ventricular elastance parameters and aortic compliance from non-invasive measurements with good to moderate reproducibility concerning intra-user, inter-user, and inter-sequence variability in healthy subjects.