# An Automated Radiomics Framework for Postoperative Survival Prediction in Colorectal Liver Metastases using Preoperative MRI

arXiv: https://arxiv.org/abs/2603.10216 · HTML: https://mlsanity.com/paper/2603.10216/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 12 of its 37 references that are in the map.
- First posted on arXiv 10 Mar 2026.

## Builds on (most cited first, 12 of 12)

- [Segment Anything](https://mlsanity.com/paper/2304.02643/) (2023)
- [SAM 2: Segment Anything in Images and Videos](https://mlsanity.com/paper/2408.00714/) (2024)
- [UNETR: Transformers for 3D Medical Image Segmentation](https://mlsanity.com/paper/2103.10504/) (2021)
- [SAM 3: Segment Anything with Concepts](https://mlsanity.com/paper/2511.16719/) (2025)
- [Vision Transformer Adapter for Dense Predictions](https://mlsanity.com/paper/2205.08534/) (2022)
- [Medical SAM 2: Segment medical images as video via Segment Anything Model 2](https://mlsanity.com/paper/2408.00874/) (2024)
- [Improving the Generalization of Segmentation Foundation Model under Distribution Shift via Weakly Supervised Adaptation](https://mlsanity.com/paper/2312.03502/) (2023)
- [A generalizable 3D framework and model for self-supervised learning in medical imaging](https://mlsanity.com/paper/2501.11755/) (2025)
- [Is SAM 2 Better than SAM in Medical Image Segmentation?](https://mlsanity.com/paper/2408.04212/) (2024)
- [AMINN: Autoencoder-based Multiple Instance Neural Network Improves Outcome Prediction of Multifocal Liver Metastases](https://mlsanity.com/paper/2012.06875/) (2020)
- [Unsupervised Clustering of Quantitative Imaging Phenotypes using Autoencoder and Gaussian Mixture Model](https://mlsanity.com/paper/1909.02953/) (2019)
- [Live(r) Die: Predicting Survival in Colorectal Liver Metastasis](https://mlsanity.com/paper/2509.08935/) (2025)

## Abstract (arXiv)

While colorectal liver metastasis (CRLM) is potentially curable via hepatectomy, patient outcomes remain highly heterogeneous. Postoperative survival prediction is necessary to avoid non-beneficial surgeries and guide personalized therapy. In this study, we present an automated AI-based framework for postoperative CRLM survival prediction using pre- and post-contrast MRI. We performed a retrospective study of 227 CRLM patients who had gadoxetate-enhanced MRI prior to curative-intent hepatectomy between 2013 and 2020. We developed a survival prediction framework comprising an anatomy-aware segmentation pipeline followed by a radiomics pipeline. The segmentation pipeline learns liver, CRLMs, and spleen segmentation from partially-annotated data, leveraging promptable foundation models to generate pseudo-labels. To support this pipeline, we propose SAMONAI, a prompt propagation algorithm that extends Segment Anything Model to 3D point-based segmentation. Predicted pre- and post-contrast segmentations are then fed into our radiomics pipeline, which extracts per-tumor features and predicts survival using SurvAMINN, an autoencoder-based multiple instance neural network for time-to-event survival prediction. SurvAMINN jointly learns dimensionality reduction and survival prediction from right-censored data, emphasizing high-risk metastases. We compared our framework against established methods and biomarkers using univariate and multivariate Cox regression. Our segmentation pipeline achieves median Dice scores of 0.96 (liver) and 0.93 (spleen), driving a CRLM segmentation Dice score of 0.78 and a detection F1-score of 0.79. Accurate segmentation enables our radiomics pipeline to achieve a survival prediction C-index of 0.69. Our results show the potential of integrating segmentation algorithms with radiomics-based survival analysis to deliver accurate and automated CRLM outcome prediction.