MKNet-family architectures for auto-segmentation of the residual pancreas after pancreatic resection: a deep learning comparative study.

Journal: Abdominal radiology (New York)
Published Date: Nov 27, 2025

Abstract

PURPOSE: Accurate interpretation of CT scans after pancreatic resection is crucial for detecting abnormalities, including postoperative complications and cancer recurrence. This study investigates the feasibility and clinical utility of a novel MKNet-family deep learning architecture for auto-segmentation of the residual pancreas on postoperative CT imaging, in comparison to previous approaches. METHOD: Novel MKNet, MSKNet and MAKNet architectures were developed. Two datasets were used: the National Institutes of Health (NIH) dataset, comprising 82 annotated normal preoperative CT scans, and the IMPACT Consortium dataset (NCT06055010; https://github.com/IMPACTconsortium/IMPACT ), comprising 81 annotated postoperative CT scans obtained < 4 weeks after pancreatectomy. Performance was assessed by Hausdorff Distance (HD), 95th-percentile-HD (HD95) and Normalized Surface Distance (NSD), and secondarily by Dice Similarity Coefficient (DSC), and compared with self-implemented existing models for preoperative pancreas auto-segmentation. Qualitative evaluation was conducted by ten abdominal radiologists. RESULTS: In the postoperative setting, the MAKNet architecture showed the best performance, with an HD and HD95 of 17.3 ± 11.2 mm and 11.5 ± 10.2 mm, respectively. DSC (64.9 ± 14.8%) and NSD (27.2 ± 8.2%) were comparable to the Attention-U-Net (DSC 66.0 ± 13.8%; NSD 27.8 ± 8.4%). Clinical evaluation indicated that the MKNet-family accurately defined the postoperative pancreas (i.e., requiring minimal or no modifications) in 64 of 81 segmentations (79%). CONCLUSION: This study demonstrates the effectiveness of novel MKNet-family architectures to accurately segment the residual pancreas on postoperative CT imaging over previous approaches. This advances the state-of-the-art in pancreas auto-segmentation and may be beneficial for medical application and education, acceleration of data annotation, and future research.

Authors

  • Dennis Böhm
    Datacation B.V., Eindhoven, The Netherlands.
  • Paul C M Andel
    Regional Academic Cancer Center Utrecht, UMC Utrecht Cancer Center & St. Antonius Hospital Nieuwegein, Department of Surgery, Utrecht, The Netherlands.
  • Paul A Akkermans
    Medical Spectrum Twente, Department of Radiology, Enschede, The Netherlands.
  • Bas Boekestijn
    Leiden University Medical Center, Department of Radiology, Leiden, The Netherlands.
  • Willem van der Geest
    Datacation B.V., Eindhoven, The Netherlands.
  • Robbert J de Haas
    Department of Radiology, Medical Imaging Center Groningen, University of Groningen, University Medical Center Groningen, PO Box 30001, 9700 RB, Groningen, The Netherlands. [email protected].
  • Jakob W Kist
    Amsterdam UMC, location University of Amsterdam, Department of Radiology, Amsterdam, The Netherlands.
  • I Quintus Molenaar
    Department of Surgery, Regional Academic Cancer Center Utrecht, UMC Utrecht Cancer Center and St Antonius Hospital Nieuwegein, Utrecht University, Utrecht, the Netherlands.
  • Joost Nederend
    From the Department of Medical Imaging, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA Nijmegen, the Netherlands (K.G.v.L., S.S., M.J.C.M.R., M.H., C.M.S.P., M.d.R., B.v.G., B.H.J.G., J.M.); Department of Radiology (M.J.C.M.R.) and Department of MICT and Imaging Techniques (T.S.), Jeroen Bosch Hospital, 's-Hertogenbosch, the Netherlands; Department of Radiology, Meander Medical Centre, Amersfoort, the Netherlands (C.M.S.P., M.V.); Department of Radiology, Hospital Gelderse Vallei, Ede, the Netherlands (B.M., M.M.V.); Department of Radiology, Noordwest Ziekenhuisgroep, Alkmaar, the Netherlands (C.F.v.D., P.A.); Department of Radiology & Nuclear Medicine, Máxima Medical Center, Eindhoven, the Netherlands (E.L.K., F.v.d.W.); Department of Radiology, Ziekenhuisgroep Twente, Almelo, the Netherlands (E.V.H., F.M.t.B., M.M., O.V., Y.H.G.v.B.F.); Center for Radiology and Nuclear Medicine, Deventer Hospital, Deventer, the Netherlands (E.L.V., J.M.L., M.N.); Department of Radiology, Catharina Hospital, Eindhoven, the Netherlands (E.M.J.M., J.N., K.M.E.M.); Department of Radiology, University Medical Center Utrecht, Utrecht, the Netherlands (F.A.A.M.H.); Department of Radiology, Zaans Medisch Centrum, Zaandam, the Netherlands (F.v.H.); Department of Radiology and Nuclear Medicine, Amsterdam UMC-Location University of Amsterdam, Amsterdam, the Netherlands (I.A.H.v.d.B.); Department of Radiology & Nuclear Medicine, Haaglanden Medical Center, The Hague, the Netherlands (J.H.); Department of Radiology, Amsterdam University Medical Center, Amsterdam, the Netherlands (J.I.M.L.V.); Department of Radiology and Nuclear Medicine, Rijnstate, Arnhem, the Netherlands (L.N.D.); Department of Radiology, St Antonius Hospital, Nieuwegein, the Netherlands (L.C.M.L., S.A.); Department of Radiology, Isala Hospital, Zwolle, the Netherlands (M.F.B.); and Department of Radiology, Groene Hart Hospital, Gouda, the Netherlands (S.M.B.).
  • C Yung Nio
    Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
  • Bobby K Pranger
    UMC Utrecht Cancer Center, Department of Radiology, Utrecht, The Netherlands.
  • Hjalmar C van Santvoort
    Department of Surgery, Regional Academic Cancer Center Utrecht, UMC Utrecht Cancer Center and St Antonius Hospital Nieuwegein, Utrecht University, Utrecht, the Netherlands.
  • Femke Struik
    Cancer Center Amsterdam, Amsterdam, The Netherlands.
  • Inez M Verpalen
    Department of Radiology, Isala Hospital, Zwolle, The Netherlands.
  • Frank J Wessels
    UMC Utrecht Cancer Center, Department of Radiology, Utrecht, The Netherlands.
  • Wouter B Veldhuis
    Department of Radiology, University Medical Center Utrecht, Utrecht University, Utrecht, 3584 CX, the Netherlands.
  • Helena M Verkooijen
    Division of Imaging and Oncology, University Medical Centre Utrecht Heidelberglaan 100, 3584CXUtrecht the Netherlands.
  • François E J A Willemssen
    Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands.
  • Ralf I Zoetekouw
    Datacation B.V., Eindhoven, The Netherlands.
  • Jouke Dijkstra
    Department of Radiology, Division of Image Processing, Leiden University Medical Center, Leiden, The Netherlands.
  • Martijn P W Intven
  • Michael Weinmann
    Delft University of Technology, TU Delft, The Netherlands.
  • Lois A Daamen
    Regional Academic Cancer Center Utrecht, UMC Utrecht Cancer Center & St. Antonius Hospital Nieuwegein, Department of Surgery, Utrecht, The Netherlands. [email protected].

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