Systems and methods are disclosed for manipulating image annotations. One method includes receiving an image of an individual's anatomy； automatically determining, using a processor, one or more annotations for anatomical features identified in the image of the individual's anatomy； determining a dependency or hierarchy between at least two of the one or more annotations for anatomical features identified in the image of the individual's anatomy； and generating, based on the dependency or hierarchy, a workflow prompting a user to manipulate the one or more annotations for anatomical features identified in the image of the individual's anatomy.
