# Transformer-Guided Graph Attention for Direct Cardiac Mesh Reconstruction: A Structural Digital Twin Framework

arXiv: https://arxiv.org/abs/2606.13188 · HTML: https://mlsanity.com/paper/2606.13188/

## Key facts

- Cited by 1 papers in the map (data through 14 Oct 2026).
- Builds on 8 of its 24 references that are in the map.
- First posted on arXiv 11 Jun 2026.

## Builds on (most cited first, 8 of 8)

- [U-Net: Convolutional Networks for Biomedical Image Segmentation](https://mlsanity.com/paper/1505.04597/) (2015)
- [Swin Transformer: Hierarchical Vision Transformer using Shifted Windows](https://mlsanity.com/paper/2103.14030/) (2021)
- [V-Net: Fully Convolutional Neural Networks for Volumetric Medical Image Segmentation](https://mlsanity.com/paper/1606.04797/) (2016)
- [3D U-Net: Learning Dense Volumetric Segmentation from Sparse Annotation](https://mlsanity.com/paper/1606.06650/) (2016)
- [Swin UNETR: Swin Transformers for Semantic Segmentation of Brain Tumors in MRI Images](https://mlsanity.com/paper/2201.01266/) (2022)
- [Deep learning for cardiac image segmentation: A review](https://mlsanity.com/paper/1911.03723/) (2019)
- [Evaluation of Algorithms for Multi-Modality Whole Heart Segmentation: An Open-Access Grand Challenge](https://mlsanity.com/paper/1902.07880/) (2019)
- [MeshCNN: A Network with an Edge](https://mlsanity.com/paper/1809.05910/) (2018)

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

- [MRI-Guided Reslice-Refined Cross-Slice SDF Reconstruction of the Left Ventricle from Cardiac MRI with Sparse Axial Supervision](https://mlsanity.com/paper/2609.08148/) (2026)

## Abstract (arXiv)

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.