Purpose: Spiking neural networks (SNNs) have recently gained attention as energy-efficient, biologically plausible alternatives to conventional deep learning models. Their application in high-stakes biomedical imaging remains almost entirely unexplored. Methods: This study introduces SNNDeep, the first tailored SNN specifically optimized for binary classification of liver health status from computed tomography (CT) features. To ensure clinical relevance and broad generalizability, the model was developed and evaluated using the Task03\Liver dataset from the Medical Segmentation Decathlon (MSD), a standardized benchmark widely used for assessing performance across diverse medical imaging tasks. We benchmark three fundamentally different learning algorithms, namely Surrogate Gradient Learning, the Tempotron rule, and Bio-Inspired Active Learning across three architectural variants: a fully customized low-level model built from scratch, and two implementations using leading SNN frameworks, i.e., snnTorch and SpikingJelly. Hyperparameter optimization was performed using Optuna. Results: Our results demonstrate that the custom-built SNNDeep consistently outperforms framework-based implementations, achieving a maximum validation accuracy of 98.35%, superior adaptability across learning rules, and significantly reduced training overhead. Conclusion:This study provides the first empirical evidence that low-level, highly tunable SNNs can surpass standard frameworks in medical imaging, especially in data-limited, temporally constrained diagnostic settings, thereby opening a new pathway for neuro-inspired AI in precision medicine.

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