Towards Interactive Lesion Segmentation in Whole-Body PET/CT with Promptable Models

Fuente: arXiv
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Auteurs principaux: Rokuss, Maximilian, Kirchhoff, Yannick, Isensee, Fabian, Maier-Hein, Klaus H.
Format: Preprint
Publié: 2025
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author Rokuss, Maximilian
Kirchhoff, Yannick
Isensee, Fabian
Maier-Hein, Klaus H.
author_facet Rokuss, Maximilian
Kirchhoff, Yannick
Isensee, Fabian
Maier-Hein, Klaus H.
contents Whole-body PET/CT is a cornerstone of oncological imaging, yet accurate lesion segmentation remains challenging due to tracer heterogeneity, physiological uptake, and multi-center variability. While fully automated methods have advanced substantially, clinical practice benefits from approaches that keep humans in the loop to efficiently refine predicted masks. The autoPET/CT IV challenge addresses this need by introducing interactive segmentation tasks based on simulated user prompts. In this work, we present our submission to Task 1. Building on the winning autoPET III nnU-Net pipeline, we extend the framework with promptable capabilities by encoding user-provided foreground and background clicks as additional input channels. We systematically investigate representations for spatial prompts and demonstrate that Euclidean Distance Transform (EDT) encodings consistently outperform Gaussian kernels. Furthermore, we propose online simulation of user interactions and a custom point sampling strategy to improve robustness under realistic prompting conditions. Our ensemble of EDT-based models, trained with and without external data, achieves the strongest cross-validation performance, reducing both false positives and false negatives compared to baseline models. These results highlight the potential of promptable models to enable efficient, user-guided segmentation workflows in multi-tracer, multi-center PET/CT. Code is publicly available at https://github.com/MIC-DKFZ/autoPET-interactive
format Preprint
id arxiv_https___arxiv_org_abs_2508_21680
institution arXiv
publishDate 2025
record_format arxiv
spellingShingle Towards Interactive Lesion Segmentation in Whole-Body PET/CT with Promptable Models
Rokuss, Maximilian
Kirchhoff, Yannick
Isensee, Fabian
Maier-Hein, Klaus H.
Computer Vision and Pattern Recognition
Whole-body PET/CT is a cornerstone of oncological imaging, yet accurate lesion segmentation remains challenging due to tracer heterogeneity, physiological uptake, and multi-center variability. While fully automated methods have advanced substantially, clinical practice benefits from approaches that keep humans in the loop to efficiently refine predicted masks. The autoPET/CT IV challenge addresses this need by introducing interactive segmentation tasks based on simulated user prompts. In this work, we present our submission to Task 1. Building on the winning autoPET III nnU-Net pipeline, we extend the framework with promptable capabilities by encoding user-provided foreground and background clicks as additional input channels. We systematically investigate representations for spatial prompts and demonstrate that Euclidean Distance Transform (EDT) encodings consistently outperform Gaussian kernels. Furthermore, we propose online simulation of user interactions and a custom point sampling strategy to improve robustness under realistic prompting conditions. Our ensemble of EDT-based models, trained with and without external data, achieves the strongest cross-validation performance, reducing both false positives and false negatives compared to baseline models. These results highlight the potential of promptable models to enable efficient, user-guided segmentation workflows in multi-tracer, multi-center PET/CT. Code is publicly available at https://github.com/MIC-DKFZ/autoPET-interactive
title Towards Interactive Lesion Segmentation in Whole-Body PET/CT with Promptable Models
topic Computer Vision and Pattern Recognition
url https://arxiv.org/abs/2508.21680