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We report a general purpose mesh generator for creating finite-element surface or volumetric mesh from 3D binary or gray-scale medical images. This toolbox incorporates a number of existing free mesh processing utilities and enables researchers to perform a range of mesh processing tasks for image-based mesh generation, including raw image processing, surface mesh extraction, surface re-sampling, and multi-scale/adaptive tetrahedral mesh generation. We also implemented robust algorithms for meshing open-surfaces and sub-region labeling. Atomic meshing utilities for each processing step can be accessed with simple interfaces, which can be streamlined or executed independently. The toolbox is compatible with Matlab or GNU Octave. We demonstrate the applications of this toolbox for meshing a range of challenging geometries including complex vessel network, human brain and breast.