# LA-CaRe-CNN: Cascading Refinement CNN for Left Atrial Scar Segmentation

arXiv: https://arxiv.org/abs/2508.04553 · HTML: https://mlsanity.com/paper/2508.04553/

## Key facts

- Cited by 1 papers in the map (data through 14 Oct 2026).
- Builds on 18 of its 38 references that are in the map.
- First posted on arXiv 6 Aug 2025.

## Builds on (most cited first, 18 of 18)

- [Adam: A Method for Stochastic Optimization](https://mlsanity.com/paper/1412.6980/) (2014)
- [U-Net: Convolutional Networks for Biomedical Image Segmentation](https://mlsanity.com/paper/1505.04597/) (2015)
- [Delving Deep into Rectifiers: Surpassing Human-Level Performance on ImageNet Classification](https://mlsanity.com/paper/1502.01852/) (2015)
- [Temporal Ensembling for Semi-Supervised Learning](https://mlsanity.com/paper/1610.02242/) (2016)
- [Generalizing to Unseen Domains: A Survey on Domain Generalization](https://mlsanity.com/paper/2103.03097/) (2021)
- [Domain Generalization: A Survey](https://mlsanity.com/paper/2103.02503/) (2021)
- [Deep learning for cardiac image segmentation: A review](https://mlsanity.com/paper/1911.03723/) (2019)
- [Integrating Spatial Configuration into Heatmap Regression Based CNNs for Landmark Localization](https://mlsanity.com/paper/1908.00748/) (2019)
- [Can we trust deep learning models diagnosis? The impact of domain shift in chest radiograph classification](https://mlsanity.com/paper/1909.01940/) (2019)
- [Medical Image Analysis on Left Atrial LGE MRI for Atrial Fibrillation Studies: A Review](https://mlsanity.com/paper/2106.09862/) (2021)
- [AtrialJSQnet: A New Framework for Joint Segmentation and Quantification of Left Atrium and Scars Incorporating Spatial and Shape Information](https://mlsanity.com/paper/2008.04729/) (2020)
- [Atrial Scar Quantification via Multi-scale CNN in the Graph-cuts Framework](https://mlsanity.com/paper/1902.07877/) (2019)
- [Towards Enabling Cardiac Digital Twins of Myocardial Infarction Using Deep Computational Models for Inverse Inference](https://mlsanity.com/paper/2307.04421/) (2023)
- [Simultaneous Left Atrium Anatomy and Scar Segmentations via Deep Learning in Multiview Information with Attention](https://mlsanity.com/paper/2002.00440/) (2020)
- [AtrialGeneral: Domain Generalization for Left Atrial Segmentation of Multi-Center LGE MRIs](https://mlsanity.com/paper/2106.08727/) (2021)
- [Multiview Two-Task Recursive Attention Model for Left Atrium and Atrial Scars Segmentation](https://mlsanity.com/paper/1806.04597/) (2018)
- [CaRe-CNN: Cascading Refinement CNN for Myocardial Infarct Segmentation with Microvascular Obstructions](https://mlsanity.com/paper/2312.11315/) (2023)
- [Multi-Source and Multi-Sequence Myocardial Pathology Segmentation Using a Cascading Refinement CNN](https://mlsanity.com/paper/2409.12792/) (2024)

## Built on by (most cited first, 1 of 1)

- [Semantic-aware Random Convolution and Source Matching for Domain Generalization in Medical Image Segmentation](https://mlsanity.com/paper/2512.01510/) (2025)

## Abstract (arXiv)

Atrial fibrillation (AF) represents the most prevalent type of cardiac arrhythmia for which treatment may require patients to undergo ablation therapy. In this surgery cardiac tissues are locally scarred on purpose to prevent electrical signals from causing arrhythmia. Patient-specific cardiac digital twin models show great potential for personalized ablation therapy, however, they demand accurate semantic segmentation of healthy and scarred tissue typically obtained from late gadolinium enhanced (LGE) magnetic resonance (MR) scans. In this work we propose the Left Atrial Cascading Refinement CNN (LA-CaRe-CNN), which aims to accurately segment the left atrium as well as left atrial scar tissue from LGE MR scans. LA-CaRe-CNN is a 2-stage CNN cascade that is trained end-to-end in 3D, where Stage 1 generates a prediction for the left atrium, which is then refined in Stage 2 in conjunction with the original image information to obtain a prediction for the left atrial scar tissue. To account for domain shift towards domains unknown during training, we employ strong intensity and spatial augmentation to increase the diversity of the training dataset. Our proposed method based on a 5-fold ensemble achieves great segmentation results, namely, 89.21% DSC and 1.6969 mm ASSD for the left atrium, as well as 64.59% DSC and 91.80% G-DSC for the more challenging left atrial scar tissue. Thus, segmentations obtained through LA-CaRe-CNN show great potential for the generation of patient-specific cardiac digital twin models and downstream tasks like personalized targeted ablation therapy to treat AF.