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ConLymphNet: A Generalizable Region-Constrained Deep Learning Architecture for Precise Abdominal Lymph Node
Pankaj Gupta1,2, Shubham Saini1, Anjali Aggarwal1
1Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Purpose:
Accurate identification and segmentation of abdominal lymph nodes on computed tomography (CT) is crucial for cancer staging and treatment planning but remains a challenging and time-consuming radiologic task. We developed and validated ConLymphNet, a deep learning-based approach for automated abdominal lymph node segmentation using vertebral landmarks as anatomic reference points to standardize the region of interest.
Materials And Methods:
We implemented a novel preprocessing pipeline incorporating vertebral landmark-based region selection followed by a 3D nnUNet segmentation model. The model was trained on 481 contrast-enhanced CT scans from patients with gallbladder cancer (GBC) and validated on external data sets including GBC (n = 54), public lymph node (n = 81), and multicancer data sets (n = 606). Performance was compared with three radiologists of varying experience levels. Interobserver agreement among radiologists and the incremental value of artificial intelligence (AI)-assisted reading were also assessed. To support reproducibility and future research, we also contribute 45 expert-verified lymph node segmentations for cases from public multicancer data sets.
Results:
ConLymphNet achieved mean Dice coefficients of 0.696 ± 0.179, 0.631 ± 0.187, and 0.639 ± 0.176 and low false-positive rates of 0.78 ± 0.35, 0.81 ± 0.33, 0.93 ± 0.47/volume on internal cross-validation, external GBC, and public lymph node data sets, respectively. Performance varied by lymph node location (P = .0080) and size (P = .0444), with larger nodes yielding better results. The model's detection rate (89.6%) was comparable with experienced residents (89.2%) but with reduced processing time (28.7 ± 12.4s v 165.3 ± 47.8 s). AI assistance improved radiologists' performance significantly, particularly for less experienced readers (detection rate +20.2%, segmentation accuracy +13.0%, P < .001), while reducing false positives by 33.3%.
Conclusion:
ConLymphNet demonstrates reasonable performance across diverse cancer types and imaging protocols, offering segmentation accuracy comparable with radiologists with substantially faster processing times.
