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This research advances medical imaging by introducing an anatomy-aware, promptable model for whole-body lesion segmentation in PET/CT scans using nnU-Net architectures. The system dynamically refines predictions through interactive scribble prompts and incorporates organ supervision to minimize false positives from physiological uptake without requiring tracer labels at inference. These techniques demonstrate significant stability and performance gains across FDG and PSMA tracers, marking a notable step forward in automated diagnostic support systems.
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Anatomy-Aware Promptable Segmentation with Online Interactive Training for AUTOPET V

arXiv2 min read

arXiv:2608.28461v1 Announce Type: cross Abstract: We present an anatomy-aware, promptable model for whole-body lesion segmentation in FDG and PSMA PET/CT, developed for the AUTOPET V challenge. The proposed method is built as family of nnU-Net-based models and trained in two stages: i) a pre-training stage that produces a strong initial segmentation, and ii) an online interactive stage that learns to exploit scribble prompts, refining the prediction over successive interactions. Anatomical context is incorporated through organ supervision using a single shared head that predicts lesions and organs from the same features, which reduces false positives arising from physiological uptake. Also as the tracer (i.e., FDG/PSMA) is not provided at inference, we add a tracer classifier based on image processing and a random forest over coronal MIP features, routing each study to a combined FDG+PSMA model or to a PSMA-specific model. Across four-fold cross-validation the organ-supervised model achieves the best and most stable performance, the interactive stage improves the Dice score monotonically with each prompt, and PSMA-specific training yields the strongest tracer-wise results.

Abstract:We present an anatomy-aware, promptable model for whole-body lesion segmentation in FDG and PSMA PET/CT, developed for the AUTOPET V challenge. The proposed method is built as family of nnU-Net-based models and trained in two stages: i) a pre-training stage that produces a strong initial segmentation, and ii) an online interactive stage that learns to exploit scribble prompts, refining the prediction over successive interactions. Anatomical context is incorporated through organ supervision using a single shared head that predicts lesions and organs from the same features, which reduces false positives arising from physiological uptake. Also as the tracer (i.e., FDG/PSMA) is not provided at inference, we add a tracer classifier based on image processing and a random forest over coronal MIP features, routing each study to a combined FDG+PSMA model or to a PSMA-specific model. Across four-fold cross-validation the organ-supervised model achieves the best and most stable performance, the interactive stage improves the Dice score monotonically with each prompt, and PSMA-specific training yields the strongest tracer-wise results.

Computer Vision and Pattern Recognition (cs.CV); Artificial Intelligence (cs.AI)

arXiv:2608.28461 [cs.CV]

(or arXiv:2608.28461v1 [cs.CV] for this version)

https://doi.org/10.48550/arXiv.2608.28461 Focus to learn more arXiv-issued DOI via DataCite (pending registration)

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Full text under the publisher's open licence · 266 words

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