GEMINI · Towards GEMINI: A Generation of Multi-scale Digital Twins of Ischaemic and Haemorrhagic Stroke Patients

GEMINI aims to deliver validated multi-organ and multi-scale computational models for treatment decision support and improved fundamental understanding of acute strokes, both ischaemic and haemorrhagic. We will demonstrate the added benefit of these computational models in personalised disease management. Specifically, GEMINI will deliver validated, integrated multi-scale, multi-organ Digital Twin in Healthcare (DTH) models for cerebral blood and cerebrospinal fluid flow, brain perfusion and metabolism, and blood flow and thrombosis along the heart-brain axis by integrating available and newly developed dynamic, interoperable, and modular computational models. Building on these models, GEMINI will deliver validated population-based DTHs of ischemic and haemorrhagic stroke aetiology and onset, treatment, and disease progression. Utilising these population-based DTHs, GEMINI will validate five personalised subject-specific DTHs, (1) stroke treatment, and (2) disease progression DTHs for acute ischaemic stroke and (3) aneurysm treatment, (4) subarachnoid haemorrhage progression, and (5) unruptured intracranial aneurysm risk assessment DTHs for haemorrhagic stroke to guide patient care and long-term management. We will bring proof of value of digital twins by the evaluation of the ischaemic stroke treatment selection DTH in a multi-centre clinical trial, in which treatment and patient outcomes are compared in situations with and without the availability of a DTH. GEMINI will implement a project-wide structured approach for data harmonisation, curation, model validation, verification, and model certification of the DTHs. Several outcomes of GEMINI have a high value for clinical practice, medical device industry, and in enhancing research in the fields of (bio)medical and computer sciences, warranting an extensive valorisation strategy with adequate IP protection and versatile exploitation actions to enhance a wide adaptation of the results of GEMINI.