Digital Twin for Medicine: The Remarkable Case of Aortic Aneurysm

A hemodynamic testbed, using 3D printing and ultrasound, replicates the physiological and pathological conditions of those with an aortic aneurysm: we explored the prospects of the digital twin with Marco Evangelos Biancolini, coordinator of the EU Meditate project.

Building physical and digital twins of the circulatory system is no longer science fiction: by combining 3D printing and ultrasound techniques, it is possible to replicate the complex hemodynamic conditions of people with cardiocirculatory diseases, allowing for detailed studies of blood flow and pressure. From this premise, specifically, the researchers at the BioCardioLab of the Monasterio Foundation have developed a high-tech system capable of replicating the conditions of a patient with an aortic aneurysm.

What makes this experimentation innovative is its ability to function as a physical twin that faithfully reproduces the patient's conditions. Thanks to a specific pump and pressurized chambers, the system can simulate various physiological and pathological scenarios, offering the possibility of customizing not only the working conditions but also the anatomy being investigated. This innovation, part of the recently concluded EU Meditate project (Medical Digital Twin for Aneurysm Prevention and Treatment), was created to improve the effectiveness of treatments by promoting personalized medicine. It opens up new prospects for optimizing medical devices and developing more precise diagnostic techniques. In particular, the technology has enabled the testing and validation of new ultrasound imaging approaches in a controlled environment, where researchers can accurately monitor every relevant parameter.

To understand the state of the art and future prospects, we spoke with Marco Evangelos Biancolini, mechanical engineer and professor of machine design at the University of Rome Tor Vergata , scientific lead of the Meditate project, and founder of cutting-edge companies in the field such as Rbf Morph and LivGemini .

Marco Evangelos Biancolini, in what ways can a digital twin in healthcare truly enable personalized patient treatment?

"The so-called medical digital twin, which the project focuses on, is a digital replica that accurately and faithfully mirrors the patient, creating a digital copy of the human body or specific anatomical parts. This approach, utilizing advanced simulation techniques and machine learning, allows us to study and simulate the behavior of the human body and its reactions to specific medical treatments. By leveraging supercomputing and big data management, the project aims to improve the effectiveness of medical treatments by personalizing them for each patient. This way, it becomes possible to obtain a detailed analysis of the patient’s condition and predict the progression of the disease or even estimate the effectiveness of a therapy before it is actually administered."

"The project, which started in 2020 and has recently concluded, involved a large number of researchers with the main goal of developing a platform that allows physicians to make more informed decisions by using high-fidelity digital simulations integrated with real clinical data. This not only optimizes treatments but also reduces surgical risks and improves the quality of care. In particular, the studies mainly focused on conditions such as aortic aneurysms and cerebrovascular diseases."

As you mentioned, the project is European. How does our continent position itself in the field of digital twins compared to global competition?

"Europe is trying to keep up with emerging technologies in the medical field, but it’s more about international collaboration than competition. For example, one of the main partners in the Meditate project is a U.S. company (Ansys ) specializing in simulation technologies. In general, there is strong collaboration between Europe and the United States through initiatives like the Virtual Physiological Human (VPH) Institute, which brings together partners from all over the world without regard to national boundaries."

"Of course, competition exists, but it is mainly driven by the push for innovation and the need to make these technologies usable in clinical settings. This requires a certification system that works both in Europe and the United States, so that medical innovations are recognized and adoptable in both markets. At the moment, the main focus is on making these technologies reliable and safe for patients, rather than worrying about geopolitical competition. Without public funding and close international collaboration, these research efforts would hardly progress as quickly."

Is the medical digital twin approach economically sustainable? And does it raise questions of equitable access?

"Economic sustainability is certainly one of the main challenges, but the outlook is positive. We are currently in an experimental phase, and the costs of processing patient data and images are quite high. Preparing a digital copy of the patient requires a lot of work and resources, but this process will streamline as digitization in the medical field progresses. High-performance computing (HPC) is also becoming increasingly accessible and democratic, with prices becoming more competitive. This reduction in costs for enabling technologies will promote the spread of the digital twin. The goal is to make this approach a part of everyday medical practice, with costs comparable to the most advanced imaging techniques, which are already widely used in hospitals today. In the long term, the use of the digital twin could prevent the need for surgical procedures costing tens of thousands of euros, as well as reduce the associated risk factors."

What synergies exist between the technologies you’ve described and other industries? Can we imagine an impact or influence on sectors like aerospace?

"The technologies developed are extremely versatile and can be applied in many other sectors. A clear example is the use of the digital twin in the aerospace industry, as well as in the automotive industry—sectors that have already adopted in silico simulation technologies for many years to reduce prototype costs and improve product performance. The same technology we use to replicate a patient can be used to create a digital copy of an airplane or a car, allowing engineers to test various scenarios and optimize designs in real time. Additionally, the use of augmented reality headsets allows for immersive interaction with these digital models, further enhancing the design process."

"The possibility of leveraging these innovations in other sectors not only improves the efficiency of the technologies themselves but also enables the development of synergies between different fields, creating new markets and opportunities. It is interesting to note how the medical industry and advanced engineering influence each other: on one hand, the healthcare sector benefits from technologies developed in the aerospace industry, while on the other hand, real-time technologies developed for medical digital twins are beginning to find applications in the automotive sector as well."

What are the challenges in collaboration between experts from different sectors? Specialist communication between engineers and doctors, for example, is by no means a simple matter...

"Collaboration between doctors and engineers is one of the most fascinating and complex challenges, both in general and for our project in particular. Each field has its own technical language and very specific approach to its work, so creating effective dialogue is not easy. For example, doctors are used to reasoning through images and clinical data, while engineers work with complex simulations and mathematical models. The real difficulty is integrating these two worlds so that simulation technologies are understandable and usable by doctors without them having to become engineers."

"Interdisciplinary collaboration requires a lot of effort, but it brings enormous advantages: surgeons, with their clinical experience, can provide crucial input on the practical and real-world aspects of using the digital twin, while engineers have the skills to develop increasingly precise and personalized models. Thanks to this dialogue, it becomes possible to achieve remarkable results, not only in pure research but also in the practical application of the technologies developed."