Ivana Išgum

Soufiane Ben Haddou, Laura Alvarez-Florez, Erik J. Bekkers et al.

Late gadolinium enhancement (LGE) imaging is the clinical standard for myocardial scar assessment, but limited annotated datasets hinder the development of automated segmentation methods. We propose a novel framework that synthesises both LGE images and their corresponding segmentation masks using implicit neural representations (INRs) combined with denoising diffusion models. Our approach first trains INRs to capture continuous spatial representations of LGE data and associated myocardium and fibrosis masks. These INRs are then compressed into compact latent embeddings, preserving essential anatomical information. A diffusion model operates on this latent space to generate new representations, which are decoded into synthetic LGE images with anatomically consistent segmentation masks. Experiments on 133 cardiac MRI scans suggest that augmenting training data with 200 synthetic volumes contributes to improved fibrosis segmentation performance, with the Dice score showing an increase from 0.509 to 0.524. Our approach provides an annotation-free method to help mitigate data scarcity.The code for this research is publicly available.

Laura Alvarez-Florez, Angel Bujalance-Gomez, Femke Raijmakers et al.

Cardiac magnetic resonance imaging (CMR) offers detailed evaluation of cardiac structure and function, but its limited accessibility restricts use to selected patient populations. In contrast, the electrocardiogram (ECG) is ubiquitous and inexpensive, and provides rich information on cardiac electrical activity and rhythm, yet offers limited insight into underlying cardiac structure and mechanical function. To address this, we introduce a contrastive learning framework that improves the extraction of clinically relevant cardiac phenotypes from ECG by learning from paired ECG-CMR data. Our approach aligns ECG representations with 3D CMR volumes at end-diastole (ED) and end-systole (ES), with a dual-phase contrastive loss to anchor each ECG jointly with both cardiac phases in a shared latent space. Unlike prior methods limited to 2D CMR representations with or without a temporal component, our framework models 3D anatomy at both ED and ES phases as distinct latent representations, enabling flexible disentanglement of structural and functional cardiac properties. Using over 34,000 ECG-CMR pairs from the UK Biobank, we demonstrate improved extraction of image-derived phenotypes from ECG, particularly for functional parameters ($\uparrow$ 9.2\%), while improvements in clinical outcome prediction remained modest ($\uparrow$ 0.7\%). This strategy could enable scalable and cost-effective extraction of image-derived traits from ECG. The code for this research is publicly available.

Gino E. Jansen, Carolina Brás, R. Nils Planken et al.

Accurate 3D representations of cardiac structures allow quantitative analysis of anatomy and function. In this work, we propose a method for reconstructing complete 3D cardiac shapes from segmentations of sparse planes in CT angiography (CTA) for application in 2D transthoracic echocardiography (TTE). Our method uses a neural implicit function to reconstruct the 3D shape of the cardiac chambers and left-ventricle myocardium from sparse CTA planes. To investigate the feasibility of achieving 3D reconstruction from 2D TTE, we select planes that mimic the standard apical 2D TTE views. During training, a multi-layer perceptron learns shape priors from 3D segmentations of the target structures in CTA. At test time, the network reconstructs 3D cardiac shapes from segmentations of TTE-mimicking CTA planes by jointly optimizing the latent code and the rigid transforms that map the observed planes into 3D space. For each heart, we simulate four realistic apical views, and we compare reconstructed multi-class volumes with the reference CTA volumes. On a held-out set of CTA segmentations, our approach achieves an average Dice coefficient of 0.86 $\pm$ 0.04 across all structures. Our method also achieves markedly lower volume errors than the clinical standard, Simpson's biplane rule: 4.88 $\pm$ 4.26 mL vs. 8.14 $\pm$ 6.04 mL, respectively, for the left ventricle; and 6.40 $\pm$ 7.37 mL vs. 37.76 $\pm$ 22.96 mL, respectively, for the left atrium. This suggests that our approach offers a viable route to more accurate 3D chamber quantification in 2D transthoracic echocardiography.

Carolina Brás, Soufiane Ben Haddou, Thijs P. Kuipers et al.

The anisotropic nature of short-axis (SAX) cardiovascular magnetic resonance imaging (CMRI) limits cardiac shape analysis. To address this, we propose to leverage near-isotropic, higher resolution computed tomography angiography (CTA) data of the heart. We use this data to train a single neural implicit function to jointly represent cardiac shapes from CMRI at any resolution. We evaluate the method for the reconstruction of right ventricle (RV) and myocardium (MYO), where MYO simultaneously models endocardial and epicardial left-ventricle surfaces. Since high-resolution SAX reference segmentations are unavailable, we evaluate performance by extracting a 4-chamber (4CH) slice of RV and MYO from their reconstructed shapes. When compared with the reference 4CH segmentation masks from CMRI, our method achieved a Dice similarity coefficient of 0.91 $\pm$ 0.07 and 0.75 $\pm$ 0.13, and a Hausdorff distance of 6.21 $\pm$ 3.97 mm and 7.53 $\pm$ 5.13 mm for RV and MYO, respectively. Quantitative and qualitative assessment demonstrate the model's ability to reconstruct accurate, smooth and anatomically plausible shapes, supporting improvements in cardiac shape analysis.