• Neural Implicit Heart Coordinates (NIHCs) proposed as a standardized anatomical reference system. • Dual-network model predicts NIHCs from sparse segmentations without requiring 3D meshes. • Method accurately reconstructs biventricular heart anatomy, including the four valve annuli. • Extensive evaluation on over 10,000 cases spanning both healthy and diseased populations. 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 ± 0.33 mm in a diseased cohort (n=4549) and 2.31 ± 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.

Accurate segmentation of cardiac MRI is essential for assessment of cardiac function through biomarkers such as the left and right ventricular ejection fraction (LVEF, RVEF). Although AI methods have achieved high average segmentation accuracy, the precision of biomarkers for individual patients-quantified by estimation variance, remains critical for reliable diagnosis. Calibrated biomarkers, whose uncertainty accurately reflects the true variability, are highly desirable. However, existing evaluations predominantly focus on population-level segmentation accuracy, leaving biomarker-level uncertainty and calibration largely underexplored. Intrinsic anatomical ambiguity and annotation variability are major sources of biomarker variability and cannot be fully eliminated, even when training on a single annotation set. To address this, we propose a probabilistic segmentation framework that explicitly models aleatoric uncertainty with the goal of improving calibration in the biomarker space. The framework disentangles two key sources of uncertainty: 1) detection uncertainty, arising from ambiguous inclusion of basal or apical slices in 2D cardiac MRI, modeled via objectness probabilities; and 2) contour uncertainty, reflecting variability in ventricular boundary delineation, modeled through mean-variance regression of elliptic Fourier descriptors, a compact representation of closed contours. By propagating these uncertainties to derived biomarkers, the proposed method produces more informative and better-calibrated confidence estimates for ejection fraction. Compared to conventional pixel-wise approaches, our framework improves biomarker reliability, particularly in realistic settings dominated by annotation ambiguity and limited domain shift.

Statistical shape modeling is a powerful tool for visualizing and quantifying geometric and functional patterns of the heart. After myocardial infarction (MI), the left ventricle typically remodels in response to physiological challenges. Several methods have been proposed in the literature to describe statistical shape changes. Which method best characterizes left ventricular remodeling after MI is an open research question. A better descriptor of remodeling is expected to provide a more accurate evaluation of disease status in MI patients. We therefore designed a challenge to test shape characterization in MI given a set of three-dimensional left ventricular surface points. The training set comprised 100 MI patients, and 100 asymptomatic volunteers (AV). The challenge was initiated in 2015 at the Statistical Atlases and Computational Models of the Heart workshop, in conjunction with the MICCAI conference. The training set with labels was provided to participants, who were asked to submit the likelihood of MI from a different (validation) set of 200 cases (100 AV and 100 MI). Sensitivity, specificity, accuracy and area under the receiver operating characteristic curve were used as the outcome measures. The goals of this challenge were to (1) establish a common dataset for evaluating statistical shape modeling algorithms in MI, and (2) test whether statistical shape modeling provides additional information characterizing MI patients over standard clinical measures. Eleven groups with a wide variety of classification and feature extraction approaches participated in this challenge. All methods achieved excellent classification results with accuracy ranges from 0.83 to 0.98. The areas under the receiver operating characteristic curves were all above 0.90. Four methods showed significantly higher performance than standard clinical measures. The dataset and software for evaluation are available from the Cardiac Atlas Project website1.

Cardiac magnetic resonance perfusion examinations enable noninvasive quantification of myocardial blood flow. However, motion between frames due to breathing must be corrected for quantitative analysis. Although several methods have been proposed, there is a lack of widely available benchmarks to compare different algorithms. We sought to compare many algorithms from several groups in an open benchmark challenge. Nine clinical studies from two different centers comprising normal and diseased myocardium at both rest and stress were made available for this study. The primary validation measure was regional myocardial blood flow based on the transfer coefficient (K-trans), which was computed using a compartment model and the myocardial perfusion reserve (MPR) index. The ground truth was calculated using contours drawn manually on all frames by a single observer, and visually inspected by a second observer. Six groups participated and 19 different motion correction algorithms were compared. Each method used one of three different motion models: rigid, global affine, or local deformation. The similarity metric also varied with methods employing either sum-of-squared differences, mutual information, or cross correlation. There were no significant differences in K-trans or MPR compared across different motion models or similarity metrics. Compared with the ground truth, only Ktrans for the sum-of-squared differences metric, and for local deformation motion models, had significant bias. In conclusion, the open benchmark enabled evaluation of clinical perfusion indices over a wide range of methods. In particular, there was no benefit of nonrigid registration techniques over the other methods evaluated in this study. The benchmark data and results are available from the Cardiac Atlas Project (www.cardiacatlas.org).

The burden of heart disease is rapidly worsening due to the increasing prevalence of obesity and diabetes. Data sharing and open database resources for heart health informatics are important for advancing our understanding of cardiovascular function, disease progression and therapeutics. Data sharing enables valuable information, often obtained at considerable expense and effort, to be reused beyond the specific objectives of the original study. Many government funding agencies and journal publishers are requiring data reuse, and are providing mechanisms for data curation and archival. Tools and infrastructure are available to archive anonymous data from a wide range of studies, from descriptive epidemiological data to gigabytes of imaging data. Meta-analyses can be performed to combine raw data from disparate studies to obtain unique comparisons or to enhance statistical power. Open benchmark datasets are invaluable for validating data analysis algorithms and objectively comparing results. This review provides a rationale for increased data sharing and surveys recent progress in the cardiovascular domain. We also highlight the potential of recent large cardiovascular epidemiological studies enabling collaborative efforts to facilitate data sharing, algorithms benchmarking, disease modeling and statistical atlases.

MOTIVATION: Integrative mathematical and statistical models of cardiac anatomy and physiology can play a vital role in understanding cardiac disease phenotype and planning therapeutic strategies. However, the accuracy and predictive power of such models is dependent upon the breadth and depth of noninvasive imaging datasets. The Cardiac Atlas Project (CAP) has established a large-scale database of cardiac imaging examinations and associated clinical data in order to develop a shareable, web-accessible, structural and functional atlas of the normal and pathological heart for clinical, research and educational purposes. A goal of CAP is to facilitate collaborative statistical analysis of regional heart shape and wall motion and characterize cardiac function among and within population groups. RESULTS: Three main open-source software components were developed: (i) a database with web-interface; (ii) a modeling client for 3D + time visualization and parametric description of shape and motion; and (iii) open data formats for semantic characterization of models and annotations. The database was implemented using a three-tier architecture utilizing MySQL, JBoss and Dcm4chee, in compliance with the DICOM standard to provide compatibility with existing clinical networks and devices. Parts of Dcm4chee were extended to access image specific attributes as search parameters. To date, approximately 3000 de-identified cardiac imaging examinations are available in the database. All software components developed by the CAP are open source and are freely available under the Mozilla Public License Version 1.1 (http://www.mozilla.org/MPL/MPL-1.1.txt). AVAILABILITY: http://www.cardiacatlas.org CONTACT: [email protected] SUPPLEMENTARY INFORMATION: Supplementary data are available at Bioinformatics online.

We study the effectiveness of stereoscopy and smooth motion as 3D cues for medical interpretation of vascular structures as obtained by 3D medical imaging techniques. We designed a user study where the user has to follow a path in a mazelike solid shaded 3D structure. The user controls rotation of the model. We measure user performance in terms of time taken and error rate. The experiment was executed with 32 (medical and non-medical) users. The results show that motion cue is more important than stereoscopy, and that stereoscopy has no added value when motion is already present, which is not consistent with previous experiments.

In this paper, a statistical shape analysis method for myocardial contraction is presented that was built to detect and locate regional wall motion abnormalities (RWMA). For each slice level (base, middle, and apex), 44 short-axis magnetic resonance images were selected from healthy volunteers to train a statistical model of normal myocardial contraction using independent component analysis (ICA). A classification algorithm was constructed from the ICA components to automatically detect and localize abnormally contracting regions of the myocardium. The algorithm was validated on 45 patients suffering from ischemic heart disease. Two validations were performed; one with visual wall motion scores (VWMS) and the other with wall thickening (WT) used as references. Accuracy of the ICA-based method on each slice level was 69.93% (base), 89.63% (middle), and 72.78% (apex) when WT was used as reference, and 63.70% (base), 67.41% (middle), and 66.67% (apex) when VWMS was used as reference. From this we conclude that the proposed method is a promising diagnostic support tool to assist clinicians in reducing the subjectivity in VWMS.

We propose an operational method to extract the left ventricle (LV) systole dynamics using harmonic phase (HARP) images extracted from tagged cardiac MR sequences. Established techniques to generate HARP sequences provide independent evidence for motion extraction, in the sense that the combined linear system for scalar brightness conservation, applied to the HARP images, can be uniquely solved for a dense field of motion parameters without the need for regularization. In contrast to some of the previously proposed popular methods, no segmentation or tracking of tags over time, nor interpolation of a sparse motion field explicitly coupled to the tag pattern is required, and the problem of tag fading is bypassed. An important novelty is the incorporation of automatic local scale selection so as to obtain a robust solution, which not only yields a stable, but also a smoothly varying motion field of the (healthy) LV myocardial wall. The scheme relies on an integer parameter representing order of approximation, and allows one to simultaneously obtain a dense field of differential tensors capturing the low order differential structure of the motion field, which is useful for the computation of relevant local quantities such as strain rates and material acceleration fields. The methodology is generic and straightforward to implement, and can be generalized to 3D and, in principle, to account for higher order differential structure.