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Comparing the reliability of three software programmes for manual and (semi-)automatic volumetry in healthy livers
Ariadne L van der Velden, Robrecht R M M Knapen, Hossein Rahmani, Joachim E Wildberger, Christiaan van der Leij, Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+, Maastricht 6229 HX, Limburg, Netherlands
Ariadne L van der Velden, Robrecht R M M Knapen, Sinéad James, Hossein Rahmani, Ronald M van Dam, Christiaan van der Leij, GROW Research Institute for Oncology and Reproduction, Maastricht University, Maastricht 6229 ER, Limburg, Netherlands
Sinéad James, Ralph Brecheisen, Ronald M van Dam, Department of Surgery, Maastricht University Medical Center+, Maastricht 6229 HX, Limburg, Netherlands
Sander M J van Kuijk, Department of Clinical Epidemiology and Medical Technology Assess
Joachim E Wildberger, CARIM, Institute for Cardiovascular Diseases, Maastricht University, Maastricht 6229 ER, Limburg, Netherlands
Ronald M van Dam, Department of General, Visceral and Transplant Surgery, University Hospital Essen, Essen 45147, Germany
Co-first authors: Ariadne L van der Velden and Robrecht R M M Knapen.
Author contributions: Van der Velden AL and Knapen RRMM performed the data selection, extraction and statistical analysis, drafted the manuscript as co-first authors; van der Velden AL, Knapen RRMM and van der Leij C designed the research study; James S contributed to the academic English writing and editing as a native English speaker, retrieved ethical approval of the medical ethical board; Rahmani H, Brecheisen R, van Kuijk SMJ, Wildberger JE, van Dam RM, and Van der Leij C critically revised and edited the manuscript; van Kuijk SMJ contributed to the methodology design and performed the statistical review; all authors reviewed and approved the final manuscript.
AI contribution statement: No AI tools were used for development of the manuscript. The authors take full responsibility for the scientific content of the manuscript.
Institutional review board statement: The local medical ethics committee approved the study protocol and waived the need for obtaining informed consent (No. 2023-0185).
Informed consent statement: The need for patient consent was waived.
Conflict-of-interest statement: Wildberger JE reports institutional conflicts of interests at Clinical Trial Center Maastricht and Department of Radiology and Nuclear Medicine for Abbott, Anaconda Biomed, Asklepios, Bayer, Becton & Dickinson Medical, Bentley, Boston, Brainlab, GE Healthcare, Gleamer, Hologic, Inari Medical, Johnson & Johnson, LCRB, Medtronic, Merit Medical Systems, Microvention, Nico-Lab, Nova Techs, Oldelft Benelux, Ontario Association of Radiologists, Penumbra, Philips, Screenpoint Medical, Siemens, Stryker, Tajpan Sro, and speakers bureau for Bayer, Siemens (paid to institution). van Dam RM reports the following conflicts of interests for research grants and study materials from Abbott Laboratories, Guerbet. All are outside the submitted work. van der Leij C reports the following conflict of interest for research grant received from Innovative Health Initiative, European Union. Outside the submitted work. The other authors declare no conflict of interest.
Data sharing statement: No additional data are available.
Corresponding author: Christiaan van der Leij, Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+, P. Debyelaan 25, Maastricht 6229 HX, Limburg, Netherlands. christiaan.vander.leij@mumc.nl
Received: May 27, 2026
Revised: July 24, 2026
Accepted: August 25, 2026
Published online: September 28, 2026
Processing time: 124 Days and 16.4 Hours
Revised: July 24, 2026
Accepted: August 25, 2026
Published online: September 28, 2026
Processing time: 124 Days and 16.4 Hours
Core Tip
Core Tip: This study compared three software programs (semi-automatic and manual) for computed tomography-based liver volumetry in 200 patients. Total liver volume and segment II/III volume – used as a surrogate for the future liver remnant – showed excellent interobserver agreement and strong agreement between all three software programs. Although Synapse 3D, Syngo.via, and OsiriX® produced small systematic differences in absolute volume estimates, the standardized future liver remnant remained comparable. These findings indicate that all three programs can provide reliable liver volumetry, while highlighting that absolute measurements should be interpreted in relation to the software used.