Automatic Couinaud segmentation using AI and pictorial representation landmarking

ObjectivesDelineating the Couinaud segments is a critical component of liver surgery and monitoring that has traditionally relied on labor-intensive methods that are prone to variability. While fully or semi-automatic methods exist, they generally lack accuracy or require extensive post-processing or corrections to the outputs.MethodsWe present a framework that integrates deep learning-based segmentation with auxiliary landmark identification to create a personalized pictorial model on which to base precise Couinaud landmark localization. Data from 225 non-contrast T1-weighted MRIs from 4 different studies were used to evaluate the performance against benchmark techniques and human-defined ground truth.ResultsThe personalized model outperformed the benchmark method in every landmark placement and Couinaud segment volume estimation, being significantly better in 5/8 landmarks and 7/8 segments.ConclusionThe proposed system is explainable, agnostic to imaging modality and is able to incorporate new data without retraining, enhancing its robustness and scalability across diverse clinical contexts. These findings underscore the potential of our framework to substantially improve Couinaud accuracy and streamline clinical workflows, optimizing liver surgery planning and monitoring.

Citation

L.M. Núñez, P. Aljabar, S.M. Brady, "Automatic Couinaud segmentation using AI and pictorial representation landmarking," Abdominal Radiology, vol. 51, no. 3, pp. 1586-1594, 2025, https://doi.org/10.1007/s00261-025-05123-3.

Source

Abdominal Radiology

Keywords

32 Biomedical and Clinical Sciences, 3202 Clinical Sciences, Anatomic Landmarks, Deep Learning, Humans, Liver, Magnetic Resonance Imaging

Publisher

Springer Nature

DOI

10.1007/s00261-025-05123-3

Additional links

https://link.springer.com/article/10.1007/s00261-025-05123-3