Artificial intelligence in expanding hepatic resection boundaries: Integrating portal flow modulation and regenerative strategies

Table 5 Ethical, regulatory, and implementation challenges

Challenge area	Description	Example/impact
Algorithmic bias	Incomplete data, non-generalizable models	Less accurate for underrepresented groups
Transparency/explainability	Black-box predictions frustrate trust	Difficult to validate medical rationale
Generalizability	Overfit to single-center/population data	Poor results in new settings
Data privacy/regulation	Compliance with HIPAA/GDPR	Re-identification risks in cloud-based AI
Clinical validation	Lack of RCTs/prospective evidence	Hinders regulatory approval, uptake

HIPAA: Health insurance portability and accountability act; GDPR: General data protection regulation; AI: Artificial intelligence; RCT: Randomized controlled trial.