Uncertainty Quantification in Cardiac Model Personalisation from Ultrafast Ultrasound
Abstract: Cardiac model personalisation requires inferring mechanical parameters that are not directly measurable in vivo. Ultrafast ultrasound shear wave elastography (SWE) enables non-invasive tracking of myocardial stiffness dynamics over the cardiac cycle, providing a target for personalisation. However, mapping these observations to subject specific model parameters remains ill-posed, as multiple parameter sets can reproduce the same stiffness dynamics. We formulate SWE-informed personalisation as a statistical inference problem using simulation-based inference (SBI). Using a subject-adapted 0D cardiovascular model and neural posterior estimation, we estimate model-conditional posterior distributions over active stiffness scale k0, contraction rate kATP, and relaxation rate kSR, conditioned on SWE-derived curve features and subject specific context. Among six healthy volunteers, four passed objective prior-support diagnostics and were retained for quantitative posterior analysis. Curve-level RMSE against the observed SWE target decreased from 12.61 $\pm$ 5.55 kPa for the prior predictive median to 1.14 $\pm$ 0.38 kPa for the posterior predictive median, an 89.7 $\pm$ 4.2% reduction. Posterior analysis revealed parameter-specific uncertainty, k0-kATP compensation, weaker constraint of kSR, and the importance of prior-predictive diagnostics for assessing whether each subject is represented within the modelled SWE feature space. These results support SBI for uncertainty aware SWE-based personalisation, while identifying prior support and forward-model adequacy as key diagnostics.