Charlène Mauger

Marica Muffoletto, Uxio Hermida, Charlène Mauger et al.

Accurate reconstruction of cardiac anatomy from sparse clinical images remains a major challenge in patient-specific modeling. While neural implicit functions have previously been applied to this task, their application to mapping anatomical consistency across subjects has been limited. In this work, we introduce Neural Implicit Heart Coordinates (NIHCs), a standardized implicit coordinate system, based on universal ventricular coordinates, that provides a common anatomical reference frame for the human heart. Our method predicts NIHCs directly from a limited number of 2D segmentations (sparse acquisition) and subsequently decodes them into dense 3D segmentations and high-resolution meshes at arbitrary output resolution. Trained on a large dataset of 5,000 cardiac meshes, the model achieves high reconstruction accuracy on clinical contours, with mean Euclidean surface errors of 2.51$\pm$0.33 mm in a diseased cohort (n=4549) and 2.3$\pm$0.36 mm in a healthy cohort (n=5576). The NIHC representation enables anatomically coherent reconstruction even under severe slice sparsity and segmentation noise, faithfully recovering complex structures such as the valve planes. Compared with traditional pipelines, inference time is reduced from over 60 s to 5-15 s. These results demonstrate that NIHCs constitute a robust and efficient anatomical representation for patient-specific 3D cardiac reconstruction from minimal input data.

Devran Ugurlu, Shuang Qian, Elliot Fairweather et al.

A cardiac digital twin is a virtual replica of a patient's heart for screening, diagnosis, prognosis, risk assessment, and treatment planning of cardiovascular diseases. This requires an anatomically accurate patient-specific 3D structural representation of the heart, suitable for electro-mechanical simulations or study of disease mechanisms. However, generation of cardiac digital twins at scale is demanding and there are no public repositories of models across demographic groups. We describe an automatic open-source pipeline for creating patient-specific left and right ventricular meshes from cardiovascular magnetic resonance images, its application to a large cohort of ~55000 participants from UK Biobank, and the construction of the most comprehensive cohort of adult heart models to date, comprising 1423 representative meshes across sex (male, female), body mass index (range: 16 - 42 kg/m$^2$) and age (range: 49 - 80 years). Our code is available at https://github.com/cdttk/biv-volumetric-meshing/tree/plos2025 , and pre-trained networks, representative volumetric meshes with fibers and UVCs will be made available soon.

Yilin Lyu, Fan Yang, Xiaoyue Liu et al.

Accurate representation of myocardial infarct geometry is crucial for patient-specific cardiac modeling in MI patients. While Late gadolinium enhancement (LGE) MRI is the clinical gold standard for infarct detection, it requires contrast agents, introducing side effects and patient discomfort. Moreover, infarct reconstruction from LGE often relies on sparsely sampled 2D slices, limiting spatial resolution and accuracy. In this work, we propose a novel framework for automatically reconstructing high-fidelity 3D myocardial infarct geometry from 2D clinically standard cine MRI, eliminating the need for contrast agents. Specifically, we first reconstruct the 4D biventricular mesh from multi-view cine MRIs via an automatic deep shape fitting model, biv-me. Then, we design a infarction reconstruction model, CMotion2Infarct-Net, to explicitly utilize the motion patterns within this dynamic geometry to localize infarct regions. Evaluated on 205 cine MRI scans from 126 MI patients, our method shows reasonable agreement with manual delineation. This study demonstrates the feasibility of contrast-free, cardiac motion-driven 3D infarct reconstruction, paving the way for efficient digital twin of MI.

Yu Deng, Yiyang Xu, Linglong Qian et al.

Cardiac Magnetic Resonance (CMR) imaging is widely used for heart modelling and digital twin computational analysis due to its ability to visualize soft tissues and capture dynamic functions. However, the anisotropic nature of CMR images, characterized by large inter-slice distances and misalignments from cardiac motion, poses significant challenges to accurate model reconstruction. These limitations result in data loss and measurement inaccuracies, hindering the capture of detailed anatomical structures. This study introduces MorphiNet, a novel network that enhances heart model reconstruction by leveraging high-resolution Computer Tomography (CT) images, unpaired with CMR images, to learn heart anatomy. MorphiNet encodes anatomical structures as gradient fields, transforming template meshes into patient-specific geometries. A multi-layer graph subdivision network refines these geometries while maintaining dense point correspondence. The proposed method achieves high anatomy fidelity, demonstrating approximately 40% higher Dice scores, half the Hausdorff distance, and around 3 mm average surface error compared to state-of-the-art methods. MorphiNet delivers superior results with greater inference efficiency. This approach represents a significant advancement in addressing the challenges of CMR-based heart model reconstruction, potentially improving digital twin computational analyses of cardiac structure and functions.

Derek Long, Cameron McMurdo, Edward Ferdian et al.

Changes in cardiovascular hemodynamics are closely related to the development of aortic regurgitation, a type of valvular heart disease. Metrics derived from blood flows are used to indicate aortic regurgitation onset and evaluate its severity. These metrics can be non-invasively obtained using four-dimensional (4D) flow magnetic resonance imaging (MRI), where accuracy is primarily dependent on spatial resolution. However, insufficient resolution often results from limitations in 4D flow MRI and complex aortic regurgitation hemodynamics. To address this, computational fluid dynamics simulations were transformed into synthetic 4D flow MRI data and used to train a variety of neural networks. These networks generated super resolution, full-field phase images with an upsample factor of 4. Results showed decreased velocity error, high structural similarity scores, and improved learning capabilities from previous work. Further validation was performed on two sets of in-vivo 4D flow MRI data and demonstrated success in de-noising flow images. This approach presents an opportunity to comprehensively analyse aortic regurgitation hemodynamics in a non-invasive manner.

Avan Suinesiaputra, Charlene A Mauger, Bharath Ambale-Venkatesh et al.

The shape and motion of the heart provide essential clues to understanding the mechanisms of cardiovascular disease. With the advent of large-scale cardiac imaging data, statistical atlases become a powerful tool to provide automated and precise quantification of the status of patient-specific heart geometry with respect to reference populations. The Multi-Ethnic Study of Atherosclerosis (MESA), begun in 2000, was the first large cohort study to incorporate cardiovascular MRI in over 5000 participants, and there is now a wealth of follow-up data over 20 years. Building a machine learning based automated analysis is necessary to extract the additional imaging information necessary for expanding original manual analyses. However, machine learning tools trained on MRI datasets with different pulse sequences fail on such legacy datasets. Here, we describe an automated atlas construction pipeline using deep learning methods applied to the legacy cardiac MRI data in MESA. For detection of anatomical cardiac landmark points, a modified VGGNet convolutional neural network architecture was used in conjunction with a transfer learning sequence between two-chamber, four-chamber, and short-axis MRI views. A U-Net architecture was used for detection of the endocardial and epicardial boundaries in short axis images. Both network architectures resulted in good segmentation and landmark detection accuracies compared with inter-observer variations. Statistical relationships with common risk factors were similar between atlases derived from automated vs manual annotations. The automated atlas can be employed in future studies to examine the relationships between cardiac morphology and future events.