Ensemble Deep Learning Models for Automated Segmentation of Tumor and Lymph Node Volumes in Head and Neck Cancer...

Automated segmentation of gross tumor volumes (GTVp) and lymph nodes (GTVn) in head and neck cancer using MRI presents a critical challenge with significant potential to enhance radiation oncology workflows. In this study, we developed a deep learning pipeline based on the SegResNet architecture, integrated into the Auto3DSeg framework, to achieve fully-automated segmentation on pre-treatment (pre-RT) and mid-treatment (mid-RT) MRI scans as part of the DLaBella29 team submission to the HNTS-MRG 2024 challenge. For Task 1, we used an ensemble of six SegResNet models with predictions fused via weighted majority voting. The models were pre-trained on both pre-RT and mid-RT image-mask pairs, then fine-tuned on pre-RT data, without any pre-processing. For Task 2, an ensemble of five SegResNet models was employed, with predictions fused using majority voting. Pre-processing for Task 2 involved setting all voxels more than 1 cm from the registered pre-RT masks to background (value 0), followed by applying a bounding box to the image. Post-processing for both tasks included removing tumor predictions smaller than 175-200 mm³ and node predictions under 50-60 mm³. Our models achieved testing DSCagg scores of 0.72 and 0.82 for GTVn and GTVp in Task 1 (pre-RT MRI) and testing DSCagg scores of 0.81 and 0.49 for GTVn and GTVp in Task 2 (mid-RT MRI). This study underscores the feasibility and promise of deep learning-based auto-segmentation for improving clinical workflows in radiation oncology, particularly in adaptive radiotherapy. Future efforts will focus on refining mid-RT segmentation performance and further investigating the clinical implications of automated tumor delineation.