Model generation of the extended coronary vasculature for more realistic simulation of coronary artery disease

The four-dimensional extended cardiac-torso (XCAT) phantom is widely used in virtual imaging trials (VITs) due to its realistic computational model of human anatomy. However, the current XCAT phantom has limitations representing the beating heart, such as the absence of a detailed model of the extended coronary vasculature and restricted capabilities to simulate disease. This study aims to address these limitations by applying a modern tree generation algorithm to extend the coronary vasculature within XCAT heart models, and integrating this with models for motion, coronary plaque generation and insertion, and blood flow to create a framework to simulate diseased states of the heart. The utility of this framework was demonstrated through an example CT simulation comparing plaque visualization with standard and photon-counting CT. The results illustrate the significant potential of these tools to simulate both normal and abnormal cases to evaluate cardiac imaging techniques.