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  **Sequence-agnostic whole-liver segmentation on abdominal MRI.**
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- LiverSegMRI is a five-fold nnU-Net v2 ensemble (`3d_fullres`, `nnUNetTrainerNoMirroring`) that segments the whole liver on a single abdominal MRI sequence. It needs no sequence labels and handles:
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  - T1-weighted in- and opposed-phase
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- - pre-contrast and dynamic post-contrast (early and late arterial, portal venous, transitional or delayed)
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- - hepatobiliary phase
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  - T2-weighted
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- - diffusion-weighted and ADC
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  | Resource | Link |
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  Radar plots of patient-wise mean Dice for the three models, by MRI sequence type (**A**, internal test; **B**, external test) and by morphologic subgroup (**C**, internal; **D**, external). Each axis is one sequence type or subgroup; the values under each plot list the models in the same order as the axes. LiverSegMRI encloses both comparators on every axis.
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- The gap widens on the functional sequences. Relative to conventional T1-weighted phases, Dice falls by 0.011 on DWI and 0.016 on ADC for LiverSegMRI, against 0.071 and 0.085 for TotalSegmentator MRI and 0.181 and 0.145 for MRAnnotator. Subgroup performance (**C**, **D**) stays close to the whole-cohort level for LiverSegMRI in cirrhosis, irregular borders, prior resection, left lobe extension, exophytic lesions and ascites.
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  ADC = apparent diffusion coefficient, AP = arterial phase, DWI = diffusion-weighted imaging, EAP = early arterial phase, HBP = hepatobiliary phase, PVP = portal venous phase, T1W = T1-weighted, T2W = T2-weighted, TP/DP = transitional/delayed phase.
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  ![Liver contours from the manual reference and the three models on three MRI sequences, with Dice values](figures/figure4_qualitative_examples.jpg)
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- Three examinations, one per row, each shown with the manual reference (red) and the three models: LiverSegMRI (blue), TotalSegmentator MRI (orange) and MRAnnotator (teal). Dice for that case is printed in each panel.
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- - **A–D, portal venous phase T1-weighted imaging.** All three models find the liver and differ at the boundary: both comparators leak across the interlobar fissure into the stomach and spleen region, and TotalSegmentator MRI adds a spurious component outside the liver (0.93 vs 0.84 and 0.84).
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- - **E–H, T2-weighted imaging.** The liver is dark against a bright spleen; both comparators under-segment the dome and the left lobe (0.96 vs 0.74 and 0.75).
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- - **I–L, diffusion-weighted imaging.** The lowest-resolution sequence shown: TotalSegmentator MRI misses the posterior right lobe and MRAnnotator fragments inside the parenchyma, while LiverSegMRI reproduces the reference almost exactly (0.98 vs 0.68 and 0.79).
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- The pattern matches the quantitative result above: the models agree most on high-resolution contrast-enhanced T1-weighted imaging and diverge on T2-weighted and diffusion-weighted acquisitions.
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  See the paper for sequence-wise, subgroup, failure, and label-matched analyses.
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  **Sequence-agnostic whole-liver segmentation on abdominal MRI.**
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+ LiverSegMRI is a nnU-Net v2 (`3d_fullres`, `nnUNetTrainerNoMirroring`) based, sequence agnostic MRI segmentation model that segments the whole liver (3D) on a single abdominal MRI sequence. It handles:
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  - T1-weighted in- and opposed-phase
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+ - T1W pre-contrast and dynamic post-contrast (early and late arterial, portal venous, transitional or delayed)
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+ - T1W hepatobiliary phase
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  - T2-weighted
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+ - Diffusion-weighted (DWI) and ADC
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  | Resource | Link |
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  |---|---|
 
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  Radar plots of patient-wise mean Dice for the three models, by MRI sequence type (**A**, internal test; **B**, external test) and by morphologic subgroup (**C**, internal; **D**, external). Each axis is one sequence type or subgroup; the values under each plot list the models in the same order as the axes. LiverSegMRI encloses both comparators on every axis.
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+ Relative to conventional T1-weighted phases, Dice falls by 0.011 on DWI and 0.016 on ADC for LiverSegMRI, against 0.071 and 0.085 for TotalSegmentator MRI and 0.181 and 0.145 for MRAnnotator. Subgroup performance (**C**, **D**) stays close to the whole-cohort level for LiverSegMRI in cirrhosis, irregular borders, prior resection, left lobe extension, exophytic lesions and ascites.
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  ADC = apparent diffusion coefficient, AP = arterial phase, DWI = diffusion-weighted imaging, EAP = early arterial phase, HBP = hepatobiliary phase, PVP = portal venous phase, T1W = T1-weighted, T2W = T2-weighted, TP/DP = transitional/delayed phase.
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  ![Liver contours from the manual reference and the three models on three MRI sequences, with Dice values](figures/figure4_qualitative_examples.jpg)
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+ Representative qualitative comparison of liver segmentation across MRI sequences and challenging morphologic subgroups. Examples from external and internal test cohorts comparing reference annotations (red) with segmentations generated by LiverSegMRI (blue), TotalSegmentator MRI (orange), and MRAnnotator (green).
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+ - **A–D,** Portal venous phase T1-weighted imaging in a cirrhotic patient with left lobe elongation.
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+ - **E–H,** T2-weighted imaging in a cirrhotic patient with severe ascites.
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+ - **I–L,** Diffusion-weighted imaging in a patient with a large intrahepatic cholangiocarcinoma extending to the liver margins.
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+ LiverSegMRI demonstrates more consistent boundary delineation across heterogeneous sequences and complex liver morphologies.
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  See the paper for sequence-wise, subgroup, failure, and label-matched analyses.
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