Mark Y. Chan

Mengxiao Wang, Yilin Lyu, Julia Camps et al.

Accurate localization of myocardial infarction is essential for risk stratification. While LGE-MRI remains the gold standard, it is resource-intensive. Integrating cine MRI with ECG enables a more detailed representation of infarct properties. Existing inverse MI inference methods overlook realistic scar morphology and cardiac repolarization, reducing sensitivity to subtle ECG variations and interpretability of infarct-induced electrophysiological changes. In this paper, we propose a novel framework for noninvasive MI localization using cardiac digital twins. To bridge the domain gap between simulation and reality, we introduce an anatomy-aware stochastic infarct synthesis strategy to synthesize realistic, irregular scars with border zones, mimicking ischemic transmural progression. We then construct a virtual cohort to simulate QRS-T waveforms, capturing both depolarization and repolarization dynamics. Furthermore, we design a Physiology and Anatomy Aware Network (PAA-Net) that jointly encodes 3D myocardial geometry and multi-lead ECGs to infer infarct areas with varying localizations, sizes, spatial extents, and transmuralities. Experimental results demonstrate that our framework significantly outperforms existing methods in inverse inference, achieving Dice scores of 0.7391 and 0.5503 for scar and border zone segmentation, respectively, while further enhancing the interpretability of the ECG-infarct relationship. Our code will be released upon acceptance.

Xiaoyue Liu, Xiaohan Yuan, Mark Y Chan et al.

Accurate 3D+t whole-heart mesh reconstruction from cine MRI is a clinically crucial yet technically challenging task. The difficulty of this task arises from two coupled factors: inherently sparse sampling of 3D cardiac anatomy by 2D image slices and the tight coupling between cardiac shape and motion. Current cardiac image-to-mesh approaches typically reconstruct only a subset of cardiac chambers or a single phase of the cardiac cycle. In this work, we propose CineMesh4D, a novel end-to-end 4D (3D+t) pipeline that directly reconstructs patient-specific whole-heart mesh from multi-view 2D cine MRI via cross-domain mapping. Specifically, we introduce a differentiable rendering loss that enables supervision of 3D+t whole-heart mesh from multi-view sparse contours of cine MRI. Furthermore, we develop a dual-context temporal block that fuses global and local cardiac temporal information to capture high-dimensional sequential patterns. In quantitative and qualitative evaluations, CineMesh4D outperforms existing approaches in terms of reconstruction quality and motion consistency, providing a practical pathway for personalized real-time cardiac assessment. The code will be publicly released once the manuscript is accepted.

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.

Xiaoyue Liu, Xicheng Sheng, Xiahai Zhuang et al.

Cardiac digital twins (CDTs) provide personalized in-silico cardiac representations and hold great potential for precision medicine in cardiology. However, whole-heart CDT models that simulate the full organ-scale electromechanics of all four heart chambers remain limited. In this work, we propose a weakly supervised learning model to reconstruct 4D (3D+t) heart mesh directly from multi-view 2D cardiac cine MRIs. This is achieved by learning a self-supervised mapping between cine MRIs and 4D cardiac meshes, enabling the generation of personalized heart models that closely correspond to input cine MRIs. The resulting 4D heart meshes can facilitate the automatic extraction of key cardiac variables, including ejection fraction and dynamic chamber volume changes with high temporal resolution. It demonstrates the feasibility of inferring personalized 4D heart models from cardiac MRIs, paving the way for an efficient CDT platform for precision medicine. The code will be publicly released once the manuscript is accepted.