Xie, C.; Hu, B.; Alakeel, A. M.; Fleischer, C. C.; Fedorov, A. G.

The development of digital twins in medicine, i.e., virtual replicas of human organs, offers a promising path toward precision medicine by enabling interpretable, mechanistic, and actionable insights. In the brain, cerebrovascular twins support individualized modeling of hemodynamics and bio-transport, with broad applications. A major bottleneck, however, is the lack of robust methods to transform in vivo cerebrovascular images into simulation-ready cerebrovascular meshes or graphs. Here, we present CerebroVascular Imaging to Graph reconstruction (CVIG), a robust and multiscale framework for reconstructing whole brain cerebrovascular graphs from in vivo cerebrovascular images. CVIG integrates vessel vectorization, with tolerance to discontinuity in vessel structures, using a topology-guided assembly of vessel trees to generate cerebrovascular graphs from medical images. We demonstrate the ability of CVIG to generate vascular graphs with improved vascular coverage and topological correctness, the capability essential for high fidelity brain biophysical simulations. This work establishes a vascular graph framework for individualized modeling and analysis, providing a key foundation for digital twins of the human brain.