BoneMesh: An Open-source 3D Slicer Framework for Automated Mesh Generation and Material Mapping from CT to Finite Elements

• BoneMesh automatically meshes CT-segmented bones and maps materials • Produces high-quality meshes at user-specified edge length • Integrated into open-source platform 3D Slicer, intuitive user interface • Optimized tetrahedral meshes match or exceed quality of commercial tools • Element-wise BMD mapping closely agrees with the established Bonemat workflow Finite Element Analysis (FEA) is a powerful computational technique used to assess bone strength and fracture risk based on patient-specific anatomical data. However, the widespread clinical and research adoption of this technique is often hindered by the complex and labor-intensive preprocessing steps required to convert clinical imaging data into analysis-ready finite element models, including segmentation, mesh generation, material property mapping, and solver-specific file formatting. To address this bottleneck, we developed BoneMesh , an automated meshing and material-mapping software module integrated into the open-source 3D Slicer platform. BoneMesh streamlines the generation of high-quality, patient-specific tetrahedral meshes directly from CT-based bone segmentations and efficiently assigns bone mineral density values derived from the imaging data. We verified the performance of BoneMesh against established commercial and freeware software (Abaqus, Simpleware and Bonemat) using CT-scans and segmentations from frequently analyzed human bones (Femur, Tibia, Lumbar vertebra, and Thoracic vertebra), demonstrating similar or superior performance in achieving targeted mesh quality parameters, including mesh edge length accuracy, element shape factors, and aspect ratios. BoneMesh significantly reduces manual intervention, preprocessing time, and the potential for human errors, thus offering an open-source, accessible, reliable, and efficient pipeline for advancing patient-specific finite element simulations in clinical research and potentially in routine clinical assessments.