Annals of Surgery Open (Jun 2022)

nnU-Net Deep Learning Method for Segmenting Parenchyma and Determining Liver Volume From Computed Tomography Images

  • Rowland W. Pettit, BS,
  • Britton B. Marlatt, MS,
  • Stuart J. Corr, BE, MEE, MA, PhD,
  • Jim Havelka, MS, MBA,
  • Abbas Rana, MD

DOI
https://doi.org/10.1097/AS9.0000000000000155
Journal volume & issue
Vol. 3, no. 2
p. e155

Abstract

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Background:. Recipient donor matching in liver transplantation can require precise estimations of liver volume. Currently utilized demographic-based organ volume estimates are imprecise and nonspecific. Manual image organ annotation from medical imaging is effective; however, this process is cumbersome, often taking an undesirable length of time to complete. Additionally, manual organ segmentation and volume measurement incurs additional direct costs to payers for either a clinician or trained technician to complete. Deep learning-based image automatic segmentation tools are well positioned to address this clinical need. Objectives:. To build a deep learning model that could accurately estimate liver volumes and create 3D organ renderings from computed tomography (CT) medical images. Methods:. We trained a nnU-Net deep learning model to identify liver borders in images of the abdominal cavity. We used 151 publicly available CT scans. For each CT scan, a board-certified radiologist annotated the liver margins (ground truth annotations). We split our image dataset into training, validation, and test sets. We trained our nnU-Net model on these data to identify liver borders in 3D voxels and integrated these to reconstruct a total organ volume estimate. Results:. The nnU-Net model accurately identified the border of the liver with a mean overlap accuracy of 97.5% compared with ground truth annotations. Our calculated volume estimates achieved a mean percent error of 1.92% + 1.54% on the test set. Conclusions:. Precise volume estimation of livers from CT scans is accurate using a nnU-Net deep learning architecture. Appropriately deployed, a nnU-Net algorithm is accurate and quick, making it suitable for incorporation into the pretransplant clinical decision-making workflow.