Patient-specific functional liver segments based on centerline classification of the hepatic and portal veins
Bibliographic record
Abstract
PURPOSE: Couinaud's liver segment classification has been widely adopted for liver surgery planning, yet its rigid anatomical boundaries often fail to align precisely with individual patient anatomy. This study proposes a novel patient-specific liver segmentation method based on detailed classification of hepatic and portal veins to improve anatomical adherence and clinical relevance. METHODS: Our proposed method involves two key stages: (1) surgeons annotate vascular endpoints on 3D models of hepatic and portal veins, from which vessel centerlines are computed; and (2) liver segments are calculated by assigning voxel labels based on proximity to these vascular centerlines. The accuracy and clinical applicability of our Hepatic and Portal Vein-based Classification (HPVC) were compared with conventional Plane-Based Classification (PBC), Portal Vein-Based Classification (PVC), and an automated deep learning method (nnU-Net) using volumetric measurements, Dice similarity scores, and expert evaluations. RESULTS: HPVC demonstrated superior anatomical conformity compared to traditional methods, especially in complex segments like 5 and 8, providing segmentations more reflective of actual vascular territories. Volumetric analysis revealed significant discrepancies among the methods, particularly with nnU-Net generally producing larger segment volumes. HPVC consistently achieved higher surgeon-rated scores in patient-specific anatomical adherence, perfusion region assessment, and accuracy in surgical planning compared to PBC, PVC, and nnU-Net. CONCLUSION: the open-source platform 3D Slicer significantly enhances its accessibility and usability.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".