Cardiac image analysis remains fragmented across tasks: anatomical segmentation, disease classification, and grounded clinical report generation are typically handled by separate networks trained under different data regimes. No existing framework unifies these objectives within a single architecture while retaining generalization across imaging modalities and datasets. We introduce PULSE, a multi-task vision-language framework built on self-supervised representations and optimized through a composite supervision strategy that balances region overlap learning, pixel wise classification fidelity, and boundary aware IoU refinement. A multi-scale token reconstruction decoder enables anatomical segmentation, while shared global representations support disease classification and clinically grounded text output allowing the model to transition from pixels to structures and finally clinical reasoning within one architecture. Unlike prior task-specific pipelines, PULSE learns task-invariant cardiac priors, generalizes robustly across datasets, and can be adapted to new imaging modalities with minimal supervision. This moves the field closer to a scalable, foundation style cardiac analysis framework.

Cardiac diseases are among the leading causes of morbidity and mortality worldwide, which requires accurate and timely diagnostic strategies. In this study, we introduce an innovative approach that combines deep learning image registration with physics-informed regularization to predict the biomechanical properties of moving cardiac tissues and extract features for disease classification. We utilize the energy strain formulation of Neo-Hookean material to model cardiac tissue deformations, optimizing the deformation field while ensuring its physical and biomechanical coherence. This explainable approach not only improves image registration accuracy, but also provides insights into the underlying biomechanical processes of the cardiac tissues. Evaluation on the Automated Cardiac Diagnosis Challenge (ACDC) dataset achieved Dice scores of 0.945 for the left ventricular cavity, 0.908 for the right ventricular cavity, and 0.905 for the myocardium. Subsequently, we estimate the local strains within the moving heart and extract a detailed set of features used for cardiovascular disease classification. We evaluated five classification algorithms, Logistic Regression, Multi-Layer Perceptron, Support Vector Classifier, Random Forest, and Nearest Neighbour, and identified the most relevant features using a feature selection algorithm. The best performing classifier obtained a classification accuracy of 98% in the training set and 100% in the test set of the ACDC dataset. By integrating explainable artificial intelligence, this method empowers clinicians with a transparent understanding of the model's predictions based on cardiac mechanics, while also significantly improving the accuracy and reliability of cardiac disease diagnosis, paving the way for more personalized and effective patient care.

Objectives Parametric tissue mapping enables quantitative cardiac tissue characterization but is limited by inter-observer variability during manual delineation. Traditional approaches relying on average relaxation values and single cutoffs may oversimplify myocardial complexity. This study evaluates whether deep learning (DL) can achieve segmentation accuracy comparable to inter-observer variability, explores the utility of statistical features beyond mean T1/T2 values, and assesses whether machine learning (ML) combining multiple features enhances disease detection. Materials & Methods T1 and T2 maps were manually segmented. The test subset was independently annotated by two observers, and inter-observer variability was assessed. A DL model was trained to segment left ventricle blood pool and myocardium. Average (A), lower quartile (LQ), median (M), and upper quartile (UQ) were computed for the myocardial pixels and employed in classification by applying cutoffs or in ML. Dice similarity coefficient (DICE) and mean absolute percentage error evaluated segmentation performance. Bland-Altman plots assessed inter-user and model-observer agreement. Receiver operating characteristic analysis determined optimal cutoffs. Pearson correlation compared features from model and manual segmentations. F1-score, precision, and recall evaluated classification performance. Wilcoxon test assessed differences between classification methods, with p < 0.05 considered statistically significant. Results 144 subjects were split into training (100), validation (15) and evaluation (29) subsets. Segmentation model achieved a DICE of 85.4%, surpassing inter-observer agreement. Random forest applied to all features increased F1-score (92.7%, p < 0.001). Conclusion DL facilitates segmentation of T1/ T2 maps. Combining multiple features with ML improves disease detection.

Deep learning-based myocardial scar segmentation from late gadolinium enhancement (LGE) cardiac MRI has shown great potential for accurate and timely diagnosis and treatment planning for structural cardiac diseases. However, the limited availability and variability of LGE images with high-quality scar labels restrict the development of robust segmentation models. To address this, we introduce CLAIM: \textbf{C}linically-Guided \textbf{L}GE \textbf{A}ugmentation for Real\textbf{i}stic and Diverse \textbf{M}yocardial Scar Synthesis and Segmentation framework, a framework for anatomically grounded scar generation and segmentation. At its core is the SMILE module (Scar Mask generation guided by cLinical knowledgE), which conditions a diffusion-based generator on the clinically adopted AHA 17-segment model to synthesize images with anatomically consistent and spatially diverse scar patterns. In addition, CLAIM employs a joint training strategy in which the scar segmentation network is optimized alongside the generator, aiming to enhance both the realism of synthesized scars and the accuracy of the scar segmentation performance. Experimental results show that CLAIM produces anatomically coherent scar patterns and achieves higher Dice similarity with real scar distributions compared to baseline models. Our approach enables controllable and realistic myocardial scar synthesis and has demonstrated utility for downstream medical imaging task. Code is available at https://github.com/farheenjabeen/CLAIM-Scar-Synthesis.

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.

--Precise and effective processing of cardiac imaging data is critical for the identification and management of the cardiovascular diseases. We introduce IntelliCardiac, a comprehensive, web-based medical image processing platform for the automatic segmentation of 4D cardiac images and disease classification, utilizing an AI model trained on the publicly accessible ACDC dataset. The system, intended for patients, cardiologists, and healthcare professionals, offers an intuitive interface and uses deep learning models to identify essential heart structures and categorize cardiac diseases. The system supports analysis of both the right and left ventricles as well as myocardium, and then classifies patient's cardiac images into five diagnostic categories: dilated cardiomyopathy, myocardial infarction, hypertrophic cardiomyopathy, right ventricular abnormality, and no disease. IntelliCardiac combines a deep learning-based segmentation model with a two-step classification pipeline. The classification module, trained on characteristics taken from segmented heart structures, achieves 98% accuracy in five categories. These results exceed the performance of the existing state-of-the-art methods that integrate both segmentation and classification models. IntelliCardiac, which supports real-time visualization, workflow integration, and AI-assisted diagnostics, has great potential as a scalable, accurate tool for clinical decision assistance in cardiac imaging and diagnosis.

Automated noninvasive cardiac diagnosis plays a critical role in the early detection of cardiac disorders and cost - effective clinical management. Automated diagnosis involves the automated segmentation and analysis of cardiac images. Precise delineation of cardiac substructures and extraction of their morphological attributes are essential for evaluating the cardiac function, and diagnosing cardiovascular disease such as cardiomyopathy, valvular diseases, abnormalities related to septum perforations, and blood - flow rate . Semantic segmentation labels the CMR image at the pixel - level, and localizes its subcomponents to facilitate the detection of abnormalities, including abnormalities in cardiac wall motion in an aging heart with muscle abnormalities, vascular abnormalities, and valvular abnormalities. In this paper, we describe a model to improve semantic segmentation of CMR images. The model extracts edge - attributes and context information during down - sampling of the U - Net and infuses this information during up - sampling to localize three major cardiac structures: left ventricle cavity (LV); right ventricle cavity (RV); and LV myocardium (LMyo) . We present an algorithm and performance results. A comparison of our model with previous leading models, using similarity - metrics between actual image and segmented image, shows that our approach improves Dice s imilarity c oefficient (DSC) by 2% - 11% and lowers Hausdorff distance (HD) by 1.6 - 5.7 mm .

Detection of hyperenhancement from cardiac LGE MRI images is a complex task requiring significant clinical expertise. Although deep learning-based models have shown promising results for the task, they require large amounts of data with fine-grained annotations. Clinical reports generated for cardiac MR studies contain rich, clinically relevant information, including the location, extent and etiology of any scars present. Although recently developed CLIP-based training enables pretraining models with image-text pairs, it requires large amounts of data and further finetuning strategies on downstream tasks. In this study, we use various strategies rooted in domain knowledge to train a model for LGE detection solely using text from clinical reports, on a relatively small clinical cohort of 965 patients. We improve performance through the use of synthetic data augmentation, by systematically creating scar images and associated text. In addition, we standardize the orientation of the images in an anatomy-informed way to enable better alignment of spatial and text features. We also use a captioning loss to enable fine-grained supervision and explore the effect of pretraining of the vision encoder on performance. Finally, ablation studies are carried out to elucidate the contributions of each design component to the overall performance of the model.

Accurate classification and anatomical localization are essential for effective medical diagnostics and research, which may be efficiently performed using deep learning techniques. However, availability of limited labeled data poses a significant challenge. To address this, we adapted Prototypical Networks and the Propagation-Reconstruction Network (PRNet) for few-shot classification and localization, respectively, in Single Photon Emission Computed Tomography (SPECT) images. For the proof of concept we used a 2D-sliced image cropped around heart. The Prototypical Network, with a pre-trained ResNet-18 backbone, classified ventricles, myocardium, and liver tissues with 96.67% training and 93.33% validation accuracy. PRNet, adapted for 2D imaging with an encoder-decoder architecture and skip connections, achieved a training loss of 1.395, accurately reconstructing patches and capturing spatial relationships. These results highlight the potential of Prototypical Networks for tissue classification with limited labeled data and PRNet for anatomical landmark localization, paving the way for improved performance in deep learning frameworks.

Background: Late Gadolinium Enhancement (LGE) imaging is the gold standard for assessing myocardial fibrosis and scarring, with left ventricular (LV) LGE extent predicting major adverse cardiac events (MACE). Despite its importance, routine LGE-based LV scar quantification is hindered by labor-intensive manual segmentation and inter-observer variability. Methods: We propose ScarNet, a hybrid model combining a transformer-based encoder from the Medical Segment Anything Model (MedSAM) with a convolution-based U-Net decoder, enhanced by tailored attention blocks. ScarNet was trained on 552 ischemic cardiomyopathy patients with expert segmentations of myocardial and scar boundaries and tested on 184 separate patients. Results: ScarNet achieved robust scar segmentation in 184 test patients, yielding a median Dice score of 0.912 (IQR: 0.863--0.944), significantly outperforming MedSAM (median Dice = 0.046, IQR: 0.043--0.047) and nnU-Net (median Dice = 0.638, IQR: 0.604--0.661). ScarNet demonstrated lower bias (-0.63%) and coefficient of variation (4.3%) compared to MedSAM (bias: -13.31%, CoV: 130.3%) and nnU-Net (bias: -2.46%, CoV: 20.3%). In Monte Carlo simulations with noise perturbations, ScarNet achieved significantly higher scar Dice (0.892 \pm 0.053, CoV = 5.9%) than MedSAM (0.048 \pm 0.112, CoV = 233.3%) and nnU-Net (0.615 \pm 0.537, CoV = 28.7%). Conclusion: ScarNet outperformed MedSAM and nnU-Net in accurately segmenting myocardial and scar boundaries in LGE images. The model exhibited robust performance across diverse image qualities and scar patterns.