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Related Experiment Video

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The Clinical Utility of Three-Dimensional Liver Modelling: A Multicenter Survey.

Keyur Radiya1,2, Eirik Kjus Aahlin3, Ashenafi Zebeneoldaregay4

  • 1Department of Gastroenterological Surgery at the University Hospital of North Norway (UNN), Tromsø, Norway. keyur.radiya@uit.no.

Journal of Imaging Informatics in Medicine
|February 26, 2026
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Summary
This summary is machine-generated.

Digital 3D liver models (3DL-RL) significantly shift pre-operative planning for complex liver surgery, often enabling parenchyma-sparing strategies. While 3DL-RL aids decision-making, inter-surgeon variability persists, highlighting the need for further outcome-linked studies.

Keywords:
3D liver modelHepatobiliaryImaging informaticsMachine learningPACSSurgical planning

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Area of Science:

  • Hepatobiliary Surgery
  • Medical Imaging
  • Surgical Planning

Background:

  • Pre-operative planning for complex liver surgery relies on 2D imaging (CT/MRI), which has limitations.
  • Digital 3D liver models (3DL-RL) show potential to enhance decision-making but lack multicenter evidence on their impact and surgeon variability.

Purpose of the Study:

  • To evaluate the effect of digital 3D liver models (3DL-RL) on pre-operative planning for complex liver surgery.
  • To assess inter-surgeon variability in planning decisions with and without 3DL-RL.

Main Methods:

  • A multicenter, case-based survey involving 10 HPB surgeons across five Norwegian centers.
  • Nine anonymized liver surgery cases were reviewed twice: first with CT/MRI only, then with CT/MRI plus 3DL-RL.
  • Statistical analysis included Krippendorff's α, Fleiss' κ, and paired t-tests to compare planning shifts and agreement.

Main Results:

  • 3DL-RL use led to a significant shift in surgical plans (Wilcoxon p=0.006).
  • Tumor counts changed in 75% of cases, and surgical plans were modified in 64% of these instances.
  • Frequent plan modifications included parenchyma-sparing strategies (20%), modality switches (10.9%), and extended resections (7.3%).
  • Overall inter-surgeon agreement on binary planning remained low, but anatomical agreement improved with 3DL-RL (α=0.664).

Conclusions:

  • Digital 3D liver models meaningfully influence pre-operative planning for complex liver surgery, facilitating targeted changes and parenchyma-sparing approaches.
  • Despite improved anatomical agreement, persistent inter-surgeon variability underscores the individualized nature of precision surgery.
  • Further prospective, outcome-linked studies and integration of ML-assisted workflows are recommended to confirm clinical and economic benefits.