Artificial Intelligence-based Liver Volume Measurement Using Preoperative and Postoperative CT Images.

Abstract

Introduction: Accurate liver volumetry is crucial for hepatectomy. In this study, we developed and validated a deep learning system for automated liver volumetry in patients undergoing hepatectomy, both preoperatively and at 7 days and 3 months postoperatively.

Methods: A 3D U-Net model was trained on CT images from three time points using a five-fold cross-validation approach. Model performance was assessed with standard metrics and comparatively evaluated across the time points.

Results: The model achieved a mean Dice Similarity Coefficient (DSC) of 94.31% (preoperative: 94.91%; 7-day post-operative: 93.45%; 3-month postoperative: 94.57%) and a mean recall of 96.04%. The volumetric difference between predicted and actual volumes was 1.01 ± 0.06% preoperatively, compared to 1.04 ± 0.03% at other time points (p < 0.05).

Discussion: This study demonstrates a novel capability to automatically track post-hepatectomy regeneration using AI, offering significant potential to enhance surgical planning and patient monitoring. A key limitation, however, was that the direct correlation with clinical outcomes was not assessed due to constraints of the current dataset. Therefore, future studies using larger, multi-center datasets are essential to validate the model's clinical and prognostic utility.

Conclusion: The developed artificial intelligence model successfully and accurately measured liver volumes across three critical post-hepatectomy time points. These findings support the use of this automated technology as a precise and reliable tool to assist in surgical decision-making and postoperative assessment, providing a strong foundation for enhancing patient care.