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

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.