MKNet-family architectures for auto-segmentation of the residual pancreas after pancreatic resection

a deep learning comparative study

Journal Article (2026)
Author(s)

Dennis Böhm (Datacation B.V., Student TU Delft)

Paul C.M. Andel (St. Antonius Hospital, University Medical Centre Utrecht)

Paul A. Akkermans (Medisch Spectrum Twente)

Bas Boekestijn (Leiden University Medical Center)

Willem van der Geest (Datacation B.V.)

Robbert J. de Haas (University Medical Center Groningen)

Jakob W. Kist (Datacation B.V.)

Michael Weinmann (TU Delft - Electrical Engineering, Mathematics and Computer Science)

Lois A. Daamen (St. Antonius Hospital, University Medical Centre Utrecht)

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Research Group
Computer Graphics and Visualisation
DOI related publication
https://doi.org/10.1007/s00261-025-05211-4 Final published version
More Info
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Publication Year
2026
Language
English
Research Group
Computer Graphics and Visualisation
Journal title
Abdominal Radiology
Issue number
7
Volume number
51
Pages (from-to)
3492-3503
Downloads counter
2
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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.