From Raw Segmentations to Simulation-Ready Cardiac Meshes: An Automated Framework for Anatomical Reconstruction and Virtual Cohort Generation
Authors: Francesco Fabbri, Martino Andrea Scarpolini, Paolo Ciancarella, Francesco Tudisco, Roberto Verzicco, Alessandro Ricci, Francesco Viola
Organizations: Gran Sasso Science Institute (GSSI), L’Aquila, Italy. · European Hospital, Rome, Italy. · University of Edinburgh, Edinburgh, Scotland. · Physics of Fluids Group, University of Twente, Enschede, Netherlands. · INFN–Laboratori Nazionali del Gran Sasso, Assergi, Italy.
Abstract
Computational models of the human heart are widely used to study electromechanical and fluid-dynamical cardiac function and to support applications such as in silico clinical trials. However, most studies remain limited to single or patient-specific anatomies, restricting the inclusion of population-level variability required for uncertainty quantification. A key challenge is translating medical-image segmentations, which may contain artifacts, mesh defects or disjoint domains, into topologically coherent geometries suitable for multiphysics simulations. In this work, we present a semi-automatic pipeline that converts CT-based segmentations into simulation-ready cardiac meshes within a few minutes while preserving anatomical and topological consistency. Building on modern deep learning segmentation methods, the framework incorporates a template-based registration stage to regularize artifacts and enforce mesh-quality constraints. A Chamfer-distance morphing strategy deforms a high-quality template toward each segmented heart, matching individual chambers while preserving topology. The resulting meshes are watertight, isotopological, and endowed with consistent point-to-point correspondence. The pipeline is validated on 58 healthy cardiac CT scans, including all cardiac chambers and proximal vessel segments. The resulting meshes can be represented in a unified shape space, enabling the construction of a statistical shape model of the heart and major vessels. Principal Component Analysis shows that a low-dimensional latent space efficiently captures population variability, while Gaussian Mixture Modeling enables synthetic anatomy generation. Overall, the proposed framework (released open-source) provides a pathway from raw segmentations to simulation-ready cardiac geometries, enabling anatomically consistent virtual cohorts for large-scale in silico studies.
Accurate patient-specific tetrahedral cardiac meshes are essential for in-silico trials, yet common segmentation-then-modelling pipelines can blur thin-wall anatomy and offer limited cross-case correspondence. We propose HeartVolMesh, which lifts each template vertex to an anisotropic Gaussian kernel and uses a 3D CNN-GNN to predict per-vertex displacements and Cholesky-parameterized covariances from volumetric images. Training is guided by a covariance-aware negative log-likelihood loss with lightweight mesh regularization. For volumetric meshing, we warp a fixed tetrahedral template to the reconstructed surface via staged alignment, non-rigid registration, and deformation propagation, preserving connectivity and correspondence by construction, with resolution controlled by template density. Experiments show consistent gains over deformation-based baselines in surface mesh accuracy and volumetric mesh fidelity.
Building patient-specific cardiac models sits at the heart of precision cardiology, yet getting those models into clinical use keeps running into the same wall: mesh generation is slow, messy, and frustrating. The standard workflow -- segmenting the image, running Marching Cubes, and then manually cleaning up the result -- is time-consuming, inconsistent across operators, and demands specialist knowledge most clinical teams do not have. We take a fundamentally different approach. Instead of treating segmentation and mesh generation as two separate problems, we train a single end-to-end network that goes directly from a raw 3D medical image to a smooth, simulation-ready cardiac surface mesh. The core is a 3D Swin Transformer encoder-decoder that extracts volumetric features from CT or MRI volumes, paired with a Graph Attention Network (GAT) head that iteratively deforms a template mesh to fit the patient's cardiac boundary. We tested on the MM-WHS 2017 benchmark using both CT and MRI. Segmentation scores were competitive (Dice of 0.84 on CT, 0.83 on MRI), but the primary focus is mesh quality: mean Chamfer distance of 1.8 mm, with 95th-percentile surface distance below 5 mm. Every mesh is produced in a single forward pass -- no Marching Cubes, no smoothing filters, no manual cleanup. We argue that for cardiac digital twin pipelines, geometric fidelity and topological correctness matter more than pixel-level Dice scores. By removing the post-processing bottleneck, this approach makes patient-specific cardiac simulation substantially more accessible for clinical use.
Abhishek H S, Akash Ganamukhi, Abhimanyu Suresh +3
Accurate cardiac anatomy modeling requires the model to be able to handle intricate interrelations among structures. In this paper, we propose VecHeart, a unified framework for holistic reconstruction and generation of four-chamber cardiac structures. To overcome the limitations of current feed-forward implicit methods, specifically their restriction to single-object modeling and their neglect of inter-part correlations, we introduce Hybrid Part Transformer, which leverages part-specific learnable queries and interleaved attention to capture complex inter-chamber dependencies. Furthermore, we propose Anatomical Completion Masking and Modality Alignment strategies, enabling the model to infer complete four-chamber structures from partial, sparse, or noisy observations, even when certain anatomical parts are entirely missing. VecHeart also seamlessly extends to 3D+t dynamic mesh sequence generation, demonstrating exceptional versatility. Experiments show that our method achieves state-of-the-art performance, maintaining high-fidelity reconstruction across diverse challenging scenarios. Code is available at https://github.com/Scalsol/VecHeart.