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

Table 7 Artificial intelligence-supported decision algorithm

Predicted parameter	Threshold	Suggested clinical action
Predicted PHLF risk	> 20%-25%	Avoid major hepatectomy; consider LVD or two-stage strategies
	10%-20%	Prefer LVD over PVE; optimize FLR function, nutrition
	< 10%	PVE adequate; proceed with resection after hypertrophy
Predicted hypertrophy insufficient after PVE (model forecast)	< 25% expected growth	Prefer primary LVD
Tumor progression risk during waiting period	High	Consider ALPPS or accelerated LVD
Functional FLR prediction (radiomics/MRI)	Below functional cutoffs	Avoid ALPPS; prefer staged or non-surgical options

LVD: Liver venous deprivation; ALPPS: Associating liver partition and portal vein ligation for staged hepatectomy; MRI: Magnetic resonance imaging; FLR: Future liver remnant; PVE: Portal vein embolization.