ArticleTomography (Ann Arbor, Mich.)2026
Hepatocellular Carcinoma Segmentation on MRI: Five-Fold ATLAS Benchmarking, Phase-Wise External Stress Testing, and Multiphasic OpenSwissHCC Ablation.
Article in Tomography (Ann Arbor, Mich.), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
BACKGROUND/
objectivesTo establish an auditable nnU-Net v2 HCC MRI segmentation benchmark, quantify phase- and cohort-dependent transportability without external fine-tuning, evaluate false-positive safety on HCC-negative examinations, and test whether complementary arterial-plus-venous input improves performance in OpenSwissHCC.
methodsA 3D full-resolution nnU-Net was trained by five-fold cross-validation on 60 public ATLAS cases. The unchanged five-fold ensemble was applied separately to arterial, portal/venous, delayed and native T1-weighted images in LiverHccSeg and OpenSwissHCC. All 132 OpenSwissHCC subjects (63 HCC-positive and 69 HCC-negative) underwent inference in every phase; positive-case overlap and detection were reported separately from negative-examination specificity. A patient-paired five-fold ablation compared venous-only with arterial-plus-venous OpenSwissHCC training. MRI-to-CT application to 97 valid-reference HCC-TACE-Seg cases was exploratory.
resultsThe ATLAS out-of-fold mean Dice was 0.5315 (95% CI 0.4478-0.6126). The OpenSwissHCC positive mean Dice was 0.3388 arterial, 0.1267 venous, 0.1810 delayed and 0.0814 native; the corresponding detection was 55.6%, 28.1%, 27.6% and 23.8%, while the negative-examination specificity ranged from 50.7% to 81.2%. The detection was lower when all of the documented HCCs were <20 mm. Arterial-plus-venous training increased the mean Dice from 0.2269 to 0.3705 (paired difference +0.1435, 95% CI +0.0520 to +0.2343;
conclusionsThe HCC segmentation performance was strongly domain-sensitive. Multiphasic input improved segmentation quality within the cohort, but reliable clinical use requires substantially broader development and prospective validation.
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