Hi @Niels_Dekker, yes, from what I can tell your proposed implementation is the best way to accomplish this. I do not believe there is are mesh wrappings with double coordinates in the ITK Python wheels at the moment.
FYI I would find 64-bit floating point support for a Python itk.Mesh interesting, especially because in Python, the built-in floating point type also corresponds with 64-bit double: sys — System-specific parameters and functions — Python 3.10.6 documentation So supporting double as mesh coordinate type would allow Python users to pass their floating point data to an itk.Mesh in a lossless way.