arXiv:2607.11949eess.IVcs.AI2026-07

AI系统自动勾画宫颈癌放疗靶区,显著提升效率与精度。

BAT-RM: A Boundary-Aware Transformer with Region-Aware Multi-Directional Mamba for Clinically Deployed Cervical Cancer Radiotherapy Auto-Contouring

论文配图:BAT-RM: A Boundary-Aware Transformer with Region-Aware Multi-Directional Mamba for Clinically Deployed Cervical Cancer Radiotherapy Auto-Contouring
图 1 · 摘自论文原文
  • 融合边界感知注意力与多方向状态空间模型,高效建模长程上下文。
  • 在7类解剖结构上优于基线,关键靶区勾画误差降低,时间节省超80%。
  • 临床部署后实现当日治疗,适合资源紧缺地区推广使用。

我们提出一个临床部署的宫颈癌放疗计划自动勾画系统,核心为边界感知变压器与区域感知多方向Mamba(BAT-RM)混合架构,结合Sobel门控边界注意力、线性时间多方向Mamba模块和边界-骨架引导融合门。该设计实现长距离上下文建模的线性时间复杂度,避免全空间自注意力的二次开销。整个流程涵盖多机构数据收集、严格间评估质量保障、独立队列外部验证,以及兼容Varian、RayStation和Monaco的Web临床界面。相较于四个基线模型,BAT-RM在七类解剖结构上表现更优,目标体积(包括GTV和CTV)及危及器官(如直肠和膀胱)的勾画均有统计学显著提升。13名放射肿瘤医师参与的前瞻性多中心读者研究显示,AI辅助使初级医生的交并比从0.899提升至0.965,接近资深水平,同时减少80%以上勾画时间。系统还降低了专家咨询率,提升了读片者一致性,体现效率与质控双提升。在合作医院临床部署后,患者等待时间由数日缩短至数小时,无需增加人员即可实现常规病例当日或次日开始治疗。BAT-RM表明,从数据整理到临床落地的严谨研究流程可直接转化为资源受限地区患者的切实获益。

原文摘要 · Abstract (English)

We present a clinically deployed end-to-end auto-contouring system for cervical cancer radiotherapy planning, anchored by the Boundary-Aware Transformer with Region-Aware Mamba (BAT-RM), a hybrid architecture that integrates Sobel-gated boundary attention, a linear-time, multi-directional Mamba module for long-range context, and a boundary-skeleton-guided fusion gate. This design achieves linear-time complexity for long-range context modeling, avoiding the quadratic cost of full spatial self-attention. The full pipeline spans multi-institutional data collection, rigorous inter-rater quality assurance, external validation in an independent cohort, and a web-based clinical interface natively compatible with Varian, RayStation, and Monaco. Against four baselines, BAT-RM achieves superior performance across seven anatomical classes, with statistically significant improvements in target volumes, including GTV and CTV, and in organs at risk such as the rectum and bladder. A prospective multi-center reader study involving 13 radiation oncologists demonstrated that AI assistance elevates junior oncologists' IoU from 0.899 to 0.965, approaching senior-level accuracy, while reducing contouring time by more than 80%. The system also reduced expert consultation rates and improved inter-reader consistency, reflecting gains in both efficiency and quality assurance. Following clinical deployment at a partner hospital, the system reduced patient wait times from days to hours without additional staffing, enabling same-day or next-day initiation of treatment for routine cases. BAT-RM demonstrates that a rigorous research pipeline, from data curation to clinical deployment, can translate directly into measurable patient benefit in resource-constrained settings where the demand for radiotherapy far exceeds specialist capacity.

放疗自动化医学图像分割临床部署AI医疗

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