Physics-Based Growth and Remodeling Modeling for Virtual Abdominal Aortic Aneurysm Evolution and Growth Prediction

Abstract Computational growth and remodeling (G&R) models have been extentively used to investigate abdominal aortic aneurysm (AAA) progression and to support clinical decision-making. However, the development of robust predictive models is often limited by the scarcity of large-scale longitudinal imaging datasets. In this study, we propose a physics-based G&R framework to simulate AAA shape evolution and generate a virtual cohort of aneurysms, thereby addressing data limitations and enabling integration with data-driven machine learning approaches for growth prediction. The proposed arterial G&R model incorporates key mechanisms influencing aneurysm progression, including elastin degradation and stress-mediated collagen production. A modified elastin degradation formulation was introduced to generate realistic aneurysm geometries exhibiting clinically relevant features such as asymmetry and tortuosity. By systematically varying parameters governing elastin damage and collagen production, 200 distinct G&R simulations were performed to produce a diverse set of AAA geometries. The dataset was further expanded using kriging-based spatial interpolation to construct a large in silico cohort. The synthetic dataset, combined with longitudinal imaging data from 25 patients, was used to train and validate four machine learning models: Deep Belief Network (DBN), Recurrent Neural Network (RNN), Long Short-Term Memory (LSTM), and Gated Recurrent Unit (GRU). A two-step training strategy was adopted to predict maximum aneurysm diameter and growth rate based on prior geometric characteristics. The LSTM model achieved the highest performance for maximum diameter prediction (R² = 0.92), while the RNN demonstrated strong overall performance (R² = 0.90 for maximum diameter and 0.89 for growth rate). The DBN and GRU models also showed competitive predictive capability. Overall, this study demonstrates that integrating physics-based G&R simulations with machine learning enables accurate prediction of AAA growth and maximum diameter. The proposed framework provides a scalable strategy for augmenting limited clinical datasets and offers a promising tool to support personalized risk assessment and treatment planning.