{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T10:44:15Z","timestamp":1789469055836,"version":"build-2803163510"},"reference-count":18,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Tomography"],"abstract":"<jats:p>Background\/Objectives: To establish an auditable nnU-Net v2 HCC MRI segmentation benchmark, quantify phase- and cohort-dependent transportability without external fine-tuning, evaluate false-positive safety on HCC-negative examinations, and test whether complementary arterial-plus-venous input improves performance in OpenSwissHCC. Methods: A 3D full-resolution nnU-Net was trained by five-fold cross-validation on 60 public ATLAS cases. The unchanged five-fold ensemble was applied separately to arterial, portal\/venous, delayed and native T1-weighted images in LiverHccSeg and OpenSwissHCC. All 132 OpenSwissHCC subjects (63 HCC-positive and 69 HCC-negative) underwent inference in every phase; positive-case overlap and detection were reported separately from negative-examination specificity. A patient-paired five-fold ablation compared venous-only with arterial-plus-venous OpenSwissHCC training. MRI-to-CT application to 97 valid-reference HCC-TACE-Seg cases was exploratory. Results: The ATLAS out-of-fold mean Dice was 0.5315 (95% CI 0.4478\u20130.6126). The OpenSwissHCC positive mean Dice was 0.3388 arterial, 0.1267 venous, 0.1810 delayed and 0.0814 native; the corresponding detection was 55.6%, 28.1%, 27.6% and 23.8%, while the negative-examination specificity ranged from 50.7% to 81.2%. The detection was lower when all of the documented HCCs were &lt;20 mm. Arterial-plus-venous training increased the mean Dice from 0.2269 to 0.3705 (paired difference +0.1435, 95% CI +0.0520 to +0.2343; p = 0.00223) and reduced the false-positive voxel burden (p = 0.0394), although the binary detection increase was not significant by exact McNemar testing (p = 0.0639). The MRI-to-CT mean Dice was 0.0286. Conclusions: The HCC segmentation performance was strongly domain-sensitive. Multiphasic input improved segmentation quality within the cohort, but reliable clinical use requires substantially broader development and prospective validation.<\/jats:p>","DOI":"10.3390\/tomography12090133","type":"journal-article","created":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T08:16:48Z","timestamp":1789460208000},"page":"133","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Hepatocellular Carcinoma Segmentation on MRI: Five-Fold ATLAS Benchmarking, Phase-Wise External Stress Testing, and Multiphasic OpenSwissHCC Ablation"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7900-2003","authenticated-orcid":false,"given":"George","family":"Sgourakis","sequence":"first","affiliation":[{"name":"East Lancashire Hospitals NHS Trust, Royal Blackburn Teaching Hospital, Haslingden Road, Blackburn BB2 3HH, UK"},{"name":"School of Medicine and Dentistry, University of Lancashire, Preston PR1 2HE, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1450","DOI":"10.1056\/NEJMra1713263","article-title":"Hepatocellular carcinoma","volume":"380","author":"Villanueva","year":"2019","journal-title":"N. 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