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Main Authors: Beirami, Sogand, Esmaeilzadeh, Zahra, Gomaa, Ahmed, Stephan, Pluvio, Sheth, Ishita, Weissmann, Thomas, Szkitsak, Juliane, Schubert, Philipp, Huang, Yixing, Schwarz, Annette, Corradini, Stefanie, Putz, Florian
Format: Preprint
Published: 2026
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Online Access:https://arxiv.org/abs/2604.10130
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author Beirami, Sogand
Esmaeilzadeh, Zahra
Gomaa, Ahmed
Stephan, Pluvio
Sheth, Ishita
Weissmann, Thomas
Szkitsak, Juliane
Schubert, Philipp
Huang, Yixing
Schwarz, Annette
Corradini, Stefanie
Putz, Florian
author_facet Beirami, Sogand
Esmaeilzadeh, Zahra
Gomaa, Ahmed
Stephan, Pluvio
Sheth, Ishita
Weissmann, Thomas
Szkitsak, Juliane
Schubert, Philipp
Huang, Yixing
Schwarz, Annette
Corradini, Stefanie
Putz, Florian
contents Background: Manual delineation of target volumes in head and neck cancer (HNC) remains a significant bottleneck in radiotherapy planning, characterized by high inter-observer variability and time consumption. This study evaluates the integration of a Volume-Aware (VA) Dice loss function into a self-configuring deep learning framework to enhance the auto-segmentation of primary tumors (PT) and metastatic lymph nodes (LN) for adaptive MR-guided radiotherapy. We investigate how volume-sensitive weighting affects the detection of small, anatomically complex nodal metastases compared to conventional loss functions. Methods: Utilizing the HNTS-MRG 2024 dataset, we implemented an nnU-Net ResEnc M architecture. We conducted a multi-label segmentation task, comparing a standard Dice loss baseline against two Volume-Aware configurations: a "Dual Mask" setup (VA loss on both PT and LN) and a "Selective LN Mask" setup (VA loss on LN only). Evaluation metrics included volumetric Dice scores, surface-based metrics (SDS, MSD, HD95), and lesion-wise binary detection sensitivity and precision. Results: The Selective LN Mask configuration achieved the highest LN Volumetric Dice Score (0.758 vs. 0.734 baseline) and significantly improved LN Lesion-Wise Detection Sensitivity (84.93% vs. 81.80%). However, a critical trade-off was observed; PT detection precision declined significantly in the selective setup (63.65% vs. 81.27%). The Dual Mask configuration provided the most balanced performance across both targets, maintaining primary tumor precision at 82.04% while improving LN sensitivity to 83.46%. Conclusions: A volume-sensitive loss function mitigated the under-representation of small metastatic lesions in HNC. While selective weighting yielded the best nodal detection, a dual-mask approach is required in multi-label tasks to maintain segmentation accuracy for larger primary tumor volumes.
format Preprint
id arxiv_https___arxiv_org_abs_2604_10130
institution arXiv
publishDate 2026
record_format arxiv
spellingShingle Improving Deep Learning-Based Target Volume Auto-Delineation for Adaptive MR-Guided Radiotherapy in Head and Neck Cancer: Impact of a Volume-Aware Dice Loss
Beirami, Sogand
Esmaeilzadeh, Zahra
Gomaa, Ahmed
Stephan, Pluvio
Sheth, Ishita
Weissmann, Thomas
Szkitsak, Juliane
Schubert, Philipp
Huang, Yixing
Schwarz, Annette
Corradini, Stefanie
Putz, Florian
Computer Vision and Pattern Recognition
Background: Manual delineation of target volumes in head and neck cancer (HNC) remains a significant bottleneck in radiotherapy planning, characterized by high inter-observer variability and time consumption. This study evaluates the integration of a Volume-Aware (VA) Dice loss function into a self-configuring deep learning framework to enhance the auto-segmentation of primary tumors (PT) and metastatic lymph nodes (LN) for adaptive MR-guided radiotherapy. We investigate how volume-sensitive weighting affects the detection of small, anatomically complex nodal metastases compared to conventional loss functions. Methods: Utilizing the HNTS-MRG 2024 dataset, we implemented an nnU-Net ResEnc M architecture. We conducted a multi-label segmentation task, comparing a standard Dice loss baseline against two Volume-Aware configurations: a "Dual Mask" setup (VA loss on both PT and LN) and a "Selective LN Mask" setup (VA loss on LN only). Evaluation metrics included volumetric Dice scores, surface-based metrics (SDS, MSD, HD95), and lesion-wise binary detection sensitivity and precision. Results: The Selective LN Mask configuration achieved the highest LN Volumetric Dice Score (0.758 vs. 0.734 baseline) and significantly improved LN Lesion-Wise Detection Sensitivity (84.93% vs. 81.80%). However, a critical trade-off was observed; PT detection precision declined significantly in the selective setup (63.65% vs. 81.27%). The Dual Mask configuration provided the most balanced performance across both targets, maintaining primary tumor precision at 82.04% while improving LN sensitivity to 83.46%. Conclusions: A volume-sensitive loss function mitigated the under-representation of small metastatic lesions in HNC. While selective weighting yielded the best nodal detection, a dual-mask approach is required in multi-label tasks to maintain segmentation accuracy for larger primary tumor volumes.
title Improving Deep Learning-Based Target Volume Auto-Delineation for Adaptive MR-Guided Radiotherapy in Head and Neck Cancer: Impact of a Volume-Aware Dice Loss
topic Computer Vision and Pattern Recognition
url https://arxiv.org/abs/2604.10130