医生验证+时间上下文,提升胰腺癌病灶追踪准确率
Exploiting Longitudinal Context in Clinician-Verified Interactive Lesion Tracking

- 医生确认配准结果后,模型融合历史外观与时间差异信息进行分割
- 相比从零训练,合成数据预训练使Dice分数提升4.5点
- 适合需要高精度且可干预的临床病灶追踪场景
跨序列CT扫描中的肿瘤病灶追踪对肿瘤疗效评估至关重要。现有自动方法在自动化与可纠错性间存在根本权衡:端到端追踪虽自动化程度高,但无法纠正隐性失败;解耦的配准-分割流程允许医生验证,却丢弃了病灶的历史外观信息,在模糊情况下限制了精度。本文提出一种验证追踪范式:医生验证注册生成的提示,模型利用该提示与基础病灶外观共同解决分割歧义。我们构建了一个统一框架,结合早期空间提示融合与潜在时间差异加权,实现纵向信息驱动的分割。为应对数据稀缺问题,采用大规模合成数据预训练,证明对利用纵向上下文至关重要,相比从零训练性能提升最高达4.5个Dice点。本方法在MICCAI autoPET IV挑战赛中获得第一名。我们进一步构建并发布PanTrack——一个全新的纵向胰腺癌基准数据集,用于评估分布外泛化能力。实验表明,无论全自动还是验证追踪设置下,模型均优于先前工作,提供自动化与控制之间的临床安全中间路径。代码、模型与数据集将公开于https://github.com/MIC-DKFZ/LongiSeg。
原文摘要 · Abstract (English)
Tracking tumor lesions across serial CT scans is essential for oncological response assessment. Existing automated methods face a fundamental trade-off: end-to-end trackers achieve high automation but offer no opportunity to correct silent tracking failures, while decoupled registration-segmentation pipelines permit user verification yet discard the lesion's prior appearance, limiting accuracy in ambiguous cases. In this work, we propose a Verified Tracking paradigm: a clinician verifies a registration-proposed prompt, which the model leverages alongside the baseline lesion appearance to resolve segmentation ambiguities. We present a unified framework combining early spatial prompt fusion with latent temporal difference weighting for longitudinally-informed segmentation. To address data scarcity, we leverage large-scale synthetic pretraining, proving essential for exploiting longitudinal context, improving performance by up to 4.5 Dice points over training from scratch. Our approach secured first place in the MICCAI autoPET IV challenge. We further curate and release PanTrack, a new longitudinal pancreatic cancer benchmark, to assess out-of-distribution generalization. Experiments show that our model outperforms prior work in both fully automatic and the proposed verified tracking setting offering a clinically safe middle ground between automation and control. Code, model and dataset will be released at https://github.com/MIC-DKFZ/LongiSeg
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