Abstract
Reliable liver segmentation in contrast-enhanced MRI is essential for quantitative hepatic assessment, treatment planning, and longitudinal disease monitoring. However, limited annotated data and scanner- or vendor-dependent intensity variations can cause overfitting and poor generalization to unseen acquisition domains. Moreover, simultaneously achieving robust global localization and precise boundary delineation remains challenging, while predictions may contain isolated false-positive regions outside the main liver component. To address these challenges, we propose CIRSeg, a coarse-to-fine, intensity-robust liver segmentation framework based on nnU-Netv2. CIRSeg combines 3D CutMix with stochastic intensity transfer using either Nyul augmentation or histogram matching to improve robustness to heterogeneous MRI intensities. Its cascaded architecture decouples low-resolution anatomical localization from full-resolution boundary refinement. At inference, source-free test-time adaptation based on confidence-filtered predictions and probability-prior regularization further improves robustness to out-of-distribution inputs. As a final deterministic post-processing step, largest connected component filtering removes isolated false-positive regions. On the CARE 2026 test set, CIRSeg achieves Dice scores of 97.13% and 97.93% on the in-domain and unseen-domain subsets, with corresponding HD95 values of 20.18 mm and 11.30 mm, respectively. These results demonstrate consistently accurate segmentation across both in-domain and unseen acquisition settings. The code is available at https://github.com/jingkunchen/MICCAI_CARE_2026
Links to Paper and Supplementary Materials
Main Paper (Open Access Version): https://papers.miccai.org/miccai-2026-sat/paper/CARE_030.pdf
SharedIt Link: Not yet available
SpringerLink (DOI): Not yet available
Supplementary Material: Not Submitted
Link to Open Review
Open Review Page: https://openreview.net/forum?id=WVSY7xrSQj
BibTex
@InProceedings{XuRuo_CIRSeg_MICCAISAT2026,
author = { Xu, Ruoshi AND Gao, Mingqi AND Luo, Shengda AND Chen, Jingkun},
title = { { CIRSeg: Coarse-to-Fine Intensity-Robust Liver Segmentation with Source-Free Continual Test-Time Adaptation } },
booktitle = {Medical Image Computing and Computer Assisted Intervention -- MICCAI 2026 Workshops and Challenges},
year = {2026},
publisher = {Springer Nature Switzerland},
volume = {LNCS 17273},
month = {pending},
page = {pending}
}