biv-me: Open-source software for generating time-varying biventricular meshes from cine cardiovascular magnetic...

The generation of geometric representations of the heart is essential for personalised approaches to cardiac assessment. Structured biventricular meshes customised to imaging data have demonstrated utility in a number of model-based applications that can provide more sensitive insights into patient health than routine cardiac indices alone. Cardiovascular magnetic resonance (CMR) imaging is a common starting point for the creation of digital twin geometries, with numerous published methods for mesh reconstruction. However, the majority of these methods are not open-source, are typically developed and validated using data from a single-centre, and lack deployability across heterogeneous scanning protocols and patient groups. We present an open-source, end-to-end pipeline (biv-me), to automatically generate time-varying biventricular meshes from cine CMR DICOM images, and perform external validation against a clinical reference software tool on 1313 CMR imaging studies across five publicly available datasets. We report excellent agreement in left and right ventricular indices and high scan-rescan reproducibility. Mesh generation was rapid, with a mean processing time of 2.5 min, and highly feasible, with 99% of meshes successfully generated to a high standard with median error of <1.5 mm. The biv-me pipeline - including code, models, and documentation - is available at https://github.com/UOA-Heart-Mechanics-Research/biv-me.