Comparing the reliability of three software programmes for manual and (semi-)automatic volumetry in healthy livers

Multiple software programs are available for manual or (semi-)automated liver segmentation. Although manual segmentation has traditionally been the standard, it is time-intensive and susceptible to inter-observer variability. Conversely, (semi-)automated approaches have been shown to reduce segmentation time, but the availability and use of different software tools can introduce variability in liver volumetry outcomes.

To evaluate the reliability of three segmentation software programs (Synapse 3D (Fujifilm), OsiriX^® (Pixmea), and Syngo.via (Siemens Healthineers)) for liver volumetry.

Patients (≥ 18 years) with abdominal computed tomography images without liver pathology were included. Total liver volume (TLV) and segment II/III volume - a surrogate for the future liver remnant (FLR) - were measured. Two blinded independent researchers performed volumetric assessments. The intraclass correlation coefficient (ICC) was calculated for interobserver variability for the first 30 scans between both researchers. This was also performed for intra-observer variability between the software programs in 200 randomly selected patients (52.5% male; mean age: 63.5 years).

Mean TLV's reported by Synapse 3D, Syngo.via and OsiriX^® were 1705 ± 462 mL, 1672 ± 463 mL, and 1627 ± 449 mL, respectively. Mean segment II/III volumes reported were 304 ± 115 mL, 282 ± 109 mL, and 277 ± 108 mL, respectively. The highest interobserver agreement (n = 30) was for TLV with Synapse 3D (ICC: 0.999; 95%CI: 0.998-0.999), and highest intraobserver ICC was between Synapse 3D and Syngo.via for TLV (ICC: 0.997; 95%CI: 0.985-0.999). Mean standardized FLR for Synapse 3D, Syngo.via and OsiriX^® were 18.6%, 17.2%, and 16.9%, respectively.

Although absolute volumes varied slightly, the standardized FLR remained comparable across the software programs, indicating that all three are suitable for reliable computed tomography liver volumetry.