# Seeing Beyond the Image: ECG and Anatomical Knowledge-Guided Myocardial Scar Segmentation from Late Gadolinium-Enhanced Images

arXiv: https://arxiv.org/abs/2511.14702 · HTML: https://mlsanity.com/paper/2511.14702/

## Key facts

- Cited by 1 papers in the map (data through 14 Oct 2026).
- Builds on 7 of its 21 references that are in the map.
- First posted on arXiv 18 Nov 2025.

## Builds on (most cited first, 7 of 7)

- [U-Net: Convolutional Networks for Biomedical Image Segmentation](https://mlsanity.com/paper/1505.04597/) (2015)
- [FiLM: Visual Reasoning with a General Conditioning Layer](https://mlsanity.com/paper/1709.07871/) (2017)
- [MyoPS: A Benchmark of Myocardial Pathology Segmentation Combining Three-Sequence Cardiac Magnetic Resonance Images](https://mlsanity.com/paper/2201.03186/) (2022)
- [MyoPS-Net: Myocardial Pathology Segmentation with Flexible Combination of Multi-Sequence CMR Images](https://mlsanity.com/paper/2211.03062/) (2022)
- [Towards Enabling Cardiac Digital Twins of Myocardial Infarction Using Deep Computational Models for Inverse Inference](https://mlsanity.com/paper/2307.04421/) (2023)
- [Large Language Model-informed ECG Dual Attention Network for Heart Failure Risk Prediction](https://mlsanity.com/paper/2403.10581/) (2024)
- [Robust Multimodal Learning via Entropy-Gated Contrastive Fusion](https://mlsanity.com/paper/2505.15417/) (2025)

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

- [Progressive Learning with Anatomical Priors for Reliable Left Atrial Scar Segmentation from Late Gadolinium Enhancement MRI](https://mlsanity.com/paper/2603.26186/) (2026)

## Abstract (arXiv)

Accurate segmentation of myocardial scar from late gadolinium enhanced (LGE) cardiac MRI is essential for evaluating tissue viability, yet remains challenging due to variable contrast and imaging artifacts. Electrocardiogram (ECG) signals provide complementary physiological information, as conduction abnormalities can help localize or suggest scarred myocardial regions. In this work, we propose a novel multimodal framework that integrates ECG-derived electrophysiological information with anatomical priors from the AHA-17 atlas for physiologically consistent LGE-based scar segmentation. As ECGs and LGE-MRIs are not acquired simultaneously, we introduce a Temporal Aware Feature Fusion (TAFF) mechanism that dynamically weights and fuses features based on their acquisition time difference. Our method was evaluated on a clinical dataset and achieved substantial gains over the state-of-the-art image-only baseline (nnU-Net), increasing the average Dice score for scars from 0.6149 to 0.8463 and achieving high performance in both precision (0.9115) and sensitivity (0.9043). These results show that integrating physiological and anatomical knowledge allows the model to "see beyond the image", setting a new direction for robust and physiologically grounded cardiac scar segmentation.