Real-time cardiac cine MRI enables visualization of the beating heart during free breathing, but severe undersampling and motion make reconstruction highly challenging. A central challenge for reconstruction is incorporating powerful priors of cardiac anatomy while remaining computationally efficient. We propose Piecewise Dynamic Diffusion Regularization (PDDR), a reconstruction method that integrates a spatiotemporal diffusion model as a generative prior within a variational reconstruction framework for cine MRI. The model employs dedicated spatial layers to encode anatomical structure and temporal layers to capture cardiac motion learned from gated cine data. PDDR leverages the dynamic prior in a piecewise manner, enabling the efficient use of spatiotemporal diffusion models for processing of long real-time sequences. Experiments on retrospectively accelerated and prospective real-time cine MRI demonstrate that PDDR outperforms classical, unsupervised, and diffusion-based methods, delivering high-quality reconstructions with substantially reduced computation time compared to state-of-the-art baselines. These results highlight PDDR as a practical and scalable solution for free-breathing, real-time cardiac MRI. Code is available at https://github.com/MLI-lab/pddr.
Conventional cardiac cine MRI relies on breath-hold Cartesian acquisitions, which are vulnerable to motion artifacts and can be uncomfortable or infeasible, particularly for pediatric and other noncompliant patients who cannot reliably hold their breath. Free-breathing radial acquisitions can alleviate these limitations, but robust reconstruction at high acceleration remains challenging due to prominent streak artifacts. To address these limitations, we propose Cine-DL, a clinically oriented framework that couples targeted k-space preprocessing with fast, model-based deep reconstruction. In this pipeline, raw free-breathing radial data undergo retrospective cardiac binning and respiratory gating to resolve cardiac phases and discard motion-corrupted spokes. We then introduce Streak Optimized Coil Compression (SOC), which explicitly preserves cardiac signals while suppressing peripheral interference that typically drives the streak artifacts. The resulting 2D+t cine series is reconstructed with an unrolled network that alternates a ResNet proximal operator with physics-based data consistency updates solved via conjugate gradient. We further employ a memory-efficient training strategy that reduces peak memory usage. We evaluate Cine-DL on free-breathing volunteer data against established baselines (k-t SENSE and iGRASP) and demonstrate clinical translation via hospital deployment on newly acquired patient data. Our experiments show that Cine-DL consistently improves quantitative metrics and visual fidelity, supporting a practical route toward routine, time-sensitive clinical adoption of free-breathing cine MRI.
Accurate 4D whole-heart mesh reconstruction from sparse cine MRI is critical for creating cardiac digital twins, but remains challenging due to limited 2D slice coverage and the complex coupling between cardiac shape and motion. Existing methods often rely on intermediate contour fitting and typically reconstruct static, single-phase, or partial cardiac geometries, limiting their ability to capture full-chamber dynamics. We propose a novel end-to-end framework for reconstructing temporally resolved whole-heart meshes from multi-view 2D cine MRI sequences by learning an image-to-mesh mapping. The framework incorporates a differentiable contour renderer inspired by the Beer-Lambert attenuation principle, enabling anatomy-aware supervision of 3D+t mesh deformation through contour-based projection losses. To improve temporal consistency across the cardiac cycle, we further introduce a multi-scale temporal modeling module that integrates global cycle-level dynamics with local inter-frame coherence to generate smooth and physiologically plausible mesh trajectories. The proposed method achieved a whole-heart mean absolute error of 1.68 ± 0.31 mm and a motion jitter of 0.77 ± 0.17 mm/frame3, outperforming existing methods with lower reconstruction error and substantially improved motion smoothness. It also improved 2D contour alignment across multiple cine MRI views and supported downstream proof-of-concept electrophysiological simulation. The code will be released publicly upon acceptance of the manuscript for publication.
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.