Abstract: Distribution-free risk control adds organ-specific recall guarantees to frozen segmentation. We calibrate per-organ thresholds for an AMOS-trained nnU-Net, audit transfer to RAOS, and estimate local re-certification cost using case-level voxel false-negative rate (FNR). The AMOS control passes, but $7/12$ organs exceed $\alpha{=}0.10$ after transfer; smaller calibration sets can mask exceedances with conservative or vacuous thresholds. Risk-Controlling Prediction Sets (RCPS) give high-probability control of population-mean risk, whereas Conformal Risk Control (CRC) gives weaker expectation control. Both require exchangeability; fixed and global thresholds give no per-organ guarantee. The Waudby–Smith–Ramdas (WSR) betting bound re-certifies six Tier-1 organs with 25 local cases, versus 30–40 for Hoeffding–Bentkus (HB). CRC needs 10–15 but has a heavier individual-case tail. No Tier-2 organ meets our illustrative precision criterion with 25 cases.
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