Cinematic Rendering of 3D Early and Late Gadolinium Enhancement Cardiac MRI: A Feasibility Demonstration

Summary

This article demonstrates the feasibility of applying cinematic rendering, a photorealistic Monte Carlo path-traced visualization technique previously developed for cardiovascular computed tomography, to three-dimensional early and late gadolinium enhancement cardiac magnetic resonance datasets while outlining a reproducible post-processing workflow.

Abstract

Cinematic rendering (CR) is a physically based three-dimensional visualization technique that uses Monte Carlo path tracing with global illumination to generate photorealistic images from volumetric medical imaging data. Although CR has been extensively applied to cardiovascular computed tomography, its application to cardiac magnetic resonance imaging (CMR), particularly to gadolinium-enhanced datasets, has been only rarely described. This report demonstrates the feasibility of applying CR to three-dimensional early and late gadolinium enhancement (EGE/LGE) CMR acquired in a single adult patient at 1.5T. Using a Monte Carlo path-tracing platform with vendor-integrated artificial intelligence (AI) denoising (syngo.via Cinematic Anatomy, Siemens Healthineers), matched CR reconstructions were generated in four-chamber, two-chamber, and short-axis orientations, as well as additional oblique perspectives. The protocol details acquisition parameters, segmentation methodology, rendering workflow, and parameter documentation to support reproducibility. CR is presented as a complementary visualization adjunct suitable for multidisciplinary communication, procedural planning, and trainee education, and is not intended as a primary diagnostic tool for myocardial enhancement. The photorealistic surface texture characteristic of path tracing should not be interpreted as diffuse enhancement. Future studies in scar-positive cohorts are required to evaluate comparative reader performance against conventional grayscale reconstructions and to validate any potential clinical role.

Introduction

Late gadolinium enhancement (LGE) imaging using cardiac magnetic resonance (CMR) is the reference standard for detecting myocardial fibrosis and scar formation and for distinguishing ischemic from nonischemic cardiomyopathies^1,2. Conventional LGE images are interpreted using two-dimensional grayscale reconstructions or, increasingly, three-dimensional acquisitions reformatted in standard cardiac planes. Although these displays are diagnostically robust, they provide limited depth perception and do not natively convey the three-dimensional spatial relationships among the myocardium, blood pool, pericardium, and....

Protocol

Written informed consent for publication of de-identified images was obtained from the patient. The study was conducted in accordance with the Declaration of Helsinki (2013 revision) and HIPAA privacy regulations. The protocol was reviewed by the Columbia University Irving Medical Center Institutional Review Board and determined to be exempt as a retrospective single-patient case report. The software, equipment, and reagents used in this protocol are listed in the Table of Materials.​

1. Patient preparation and CMR acquisition

1. The patient was positioned supine with appropriate cardiac coil....

Results

Feasibility of CR applied to three-dimensional EGE/LGE CMR
Cinematic rendering (CR) reconstructions were successfully generated from both the three-dimensional early gadolinium enhancement (EGE) and three-dimensional late gadolinium enhancement (LGE) datasets in all attempted views, demonstrating the technical feasibility of the workflow. The complete pipeline, from Digital Imaging and Communications in Medicine (DICOM) import to converged figure export, was completed in a single post-processing sess.......

Discussion

This report demonstrated the technical feasibility of applying cinematic rendering (CR), a Monte Carlo path-tracing visualization technique with global illumination, to three-dimensional early- and late-gadolinium-enhancement cardiac magnetic resonance (CMR) datasets from a single patient. The workflow from Digital Imaging and Communications in Medicine (DICOM) import to converged figure export was reproducible; the resulting outputs differed qualitatively from conventional volume rendering, and the protocol provides a f.......

Materials

List of materials used in this article

Name	Company	Catalog Number	Comments
AI source-image reconstruction (optional)	Siemens Healthineers, Erlangen, Germany	Deep Resolve	Deep-learning source-image reconstruction to improve baseline signal-to-noise of the 3D LGE source dataset.
Cardiac MRI Scanner	Siemens Healthineers, Erlangen, Germany	MAGNETOM Sola	1.5T whole-body scanner used for acquisition of 3D EGE/LGE CMR datasets. System software: syngo MR XA60.
Cinematic rendering software	Siemens Healthineers, Erlangen, Germany	syngo.via Cinematic Anatomy (VB80)	Monte Carlo path-tracing renderer with global illumination, high-dynamic-range environment lighting, and vendor-integrated AI denoiser.
Dedicated cardiac phased-array coil	Siemens Healthineers, Erlangen, Germany	Body 18 coil	18-channel body matrix coil used for cardiac signal reception.
Gadolinium-based contrast agent	Bayer HealthCare, Berlin, Germany	Gadavist (gadobutrol)	Macrocyclic gadolinium-based contrast agent administered intravenously at 0.1 mmol/kg body weight.
Post-processing workstation	Siemens Healthineers, Erlangen, Germany	syngo.via VB80	Multimodality post-processing workstation used for volumetric reconstruction, multiplanar reformation, and DICOM export. GPU: NVIDIA RTX A6000.