The liver segmentation and volumetry unresolved issues and clinical significance

Modern methods of medical imaging have contributed to the emergence of new technologies and trends in liver medicine – liver segmentation, which is the process of dividing the organ into functionally independent segments with an individual system of blood supply, venous outflow and excretion of bile and its volumetry (volume-metry – measurements and assessment of the functional volumes of the organ). Given the significant variability of the shape, size, volume, features of the blood supply not only of the liver as a whole, but also of each of its segments, performing accurate segmentation of this organ remains a complex task. The objective of the review is to analyze classical and alternative systems of liver segmentation, which are anatomical and functional models of the organ. Their advantages and disadvantages are highlighted. Particular attention is paid to radiation methods of liver visualization with consideration of the range of their capabilities and limitations in segmentation and volumetry. The material for the study was foreign and domestic literature sources of recent years. The sources were selected using the following keywords: liver, anatomy, liver segments, liver volumetry, transplantation and some others. A total of 50 sources were selected. The descriptive method of analysis was used. Liver segmentation and volumetry already allow solving a wide range of clinical problems, including preoperative planning of resections and transplants, assessment of the dynamics and effectiveness of treatment, as well as building prognostic models and training. The review presents the results of studies of the volumetric assessment of the functional reserve of an organ when planning operations and ways to increase it, discusses manual, semi-automatic and automatic methods of segmentation with their advantages and disadvantages. Particular emphasis is placed on the role of the development of segmentation and volumetry technologies in transplantology. In conclusion, unresolved problems are noted, which require improvement of visualization algorithms, consideration of anatomical variants in segmentation and liver volumetry with the fastest integration of artificial intelligence to improve the accuracy and speed of the analysis. Timely solution of a wide range of designated tasks will continue to contribute to the transformation of approaches in surgical hepatology, providing priority to safe and personalized.