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arXiv · 2603.18356

LGESynthNet: Controlled Scar Synthesis for Improved Scar Segmentation in Cardiac LGE-MRI Imaging

Athira J. Jacob·Puneet Sharma·Daniel Rueckert
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Abstract

Segmentation of enhancement in LGE cardiac MRI is critical for diagnosing various ischemic and non-ischemic cardiomyopathies. However, creating pixel-level annotations for these images is challenging and labor-intensive, leading to limited availability of annotated data. Generative models, particularly diffusion models, offer promise for synthetic data generation, yet many rely on large training datasets and often struggle with fine-grained conditioning control, especially for small or localized features. We introduce LGESynthNet, a latent diffusion-based framework for controllable enhancement synthesis, enabling explicit control over size, location, and transmural extent. Formulated as inpainting using a ControlNet-based architecture, the model integrates: (a) a reward model for conditioning-specific supervision, (b) a captioning module for anatomically descriptive text prompts, and (c) a biomedical text encoder. Trained on just 429 images (79 patients), it produces realistic, anatomically coherent samples. A quality control filter selects outputs with high conditioning-fidelity, which when used for training augmentation, improve downstream segmentation and detection performance, by up-to 6 and 20 points respectively.

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Athira J. Jacob, Puneet Sharma, Daniel Rueckert. 2026-03-18. LGESynthNet: Controlled Scar Synthesis for Improved Scar Segmentation in Cardiac LGE-MRI Imaging. https://arxiv.org/abs/2603.18356

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