Anatomy-Guided 3D Graph Networks for Couinaud Segmentation in Tumor Affected Livers

Image-based liver Couinaud segmentation is designed to automatically provide the locations of suspicious objects in liver CT/MR images. Once achieved, the physicians will be guided to the target slice and area where the suspicious node is located. However, conventional algorithms trained primarily on healthy liver images often fail to generalize to Hepatocellular Carcinoma (HCC) cases due to pathological structural distortions. In this work, we propose a robust two-stage framework that integrates a 3D Unet with a 3D Anatomical Structure-Guided Graph Convolutional Network (3D GCN). This two-stage strategy effectively isolates the liver volume to eliminate structural noise from neighboring organs, such as the spleen, allowing the framework to focus exclusively on the complex 3D anatomical relationships among the eight segments. To ensure the topological consistency required for global spatial reasoning, we implement a standardized preprocessing pipeline that normalizes liver-only volumes to exactly 50 frames along the z-axis. By combining a lightweight 3D UNet backbone with the 3D GCN for refined boundary reasoning, our model demonstrates superior generalization performance on unseen clinical datasets, achieving a mean Dice score of 0.828 in blind testing. By releasing our code and pretrained weights, we aim to provide the first publicly available deep learning resource for robust Couinaud segmentation.