# Lymph Node Gross Tumor Volume Detection in Oncology Imaging via Relationship Learning Using Graph Neural Network

arXiv: https://arxiv.org/abs/2008.13013 · HTML: https://mlsanity.com/paper/2008.13013/

## Key facts

- Cited by 12 papers in the map (data through 14 Oct 2026).
- First posted on arXiv 29 Aug 2020.

## Built on by (most cited first, 12 of 12)

- [Graph Representation Learning in Biomedicine](https://mlsanity.com/paper/2104.04883/) (2021)
- [Graph-Based Deep Learning for Medical Diagnosis and Analysis: Past, Present and Future](https://mlsanity.com/paper/2105.13137/) (2021)
- [A Survey on Graph Neural Networks and Graph Transformers in Computer Vision: A Task-Oriented Perspective](https://mlsanity.com/paper/2209.13232/) (2022)
- [Continual Segment: Towards a Single, Unified and Accessible Continual Segmentation Model of 143 Whole-body Organs in CT Scans](https://mlsanity.com/paper/2302.00162/) (2023)
- [Multimodal Data Integration for Oncology in the Era of Deep Neural Networks: A Review](https://mlsanity.com/paper/2303.06471/) (2023)
- [Multi stain graph fusion for multimodal integration in pathology](https://mlsanity.com/paper/2204.12541/) (2022)
- [DeepStationing: Thoracic Lymph Node Station Parsing in CT Scans using Anatomical Context Encoding and Key Organ Auto-Search](https://mlsanity.com/paper/2109.09271/) (2021)
- [Graph Convolutional Networks for Multi-modality Medical Imaging: Methods, Architectures, and Clinical Applications](https://mlsanity.com/paper/2202.08916/) (2022)
- [Lymph Node Graph Neural Networks for Cancer Metastasis Prediction](https://mlsanity.com/paper/2106.01711/) (2021)
- [Multi-institutional Validation of Two-Streamed Deep Learning Method for Automated Delineation of Esophageal Gross Tumor Volume using planning-CT and FDG-PETCT](https://mlsanity.com/paper/2110.05280/) (2021)
- [Integrating features from lymph node stations for metastatic lymph node detection](https://mlsanity.com/paper/2301.03202/) (2023)
- [iPac: Incorporating Intra-image Patch Context into Graph Neural Networks for Medical Image Classification](https://mlsanity.com/paper/2510.23504/) (2025)

## Abstract (arXiv)

Determining the spread of GTVLN is essential in defining the respective resection or irradiating regions for the downstream workflows of surgical resection and radiotherapy for many cancers. Different from the more common enlarged lymph node (LN), GTVLN also includes smaller ones if associated with high positron emission tomography signals and/or any metastasis signs in CT. This is a daunting task. In this work, we propose a unified LN appearance and inter-LN relationship learning framework to detect the true GTVLN. This is motivated by the prior clinical knowledge that LNs form a connected lymphatic system, and the spread of cancer cells among LNs often follows certain pathways. Specifically, we first utilize a 3D convolutional neural network with ROI-pooling to extract the GTVLN's instance-wise appearance features. Next, we introduce a graph neural network to further model the inter-LN relationships where the global LN-tumor spatial priors are included in the learning process. This leads to an end-to-end trainable network to detect by classifying GTVLN. We operate our model on a set of GTVLN candidates generated by a preliminary 1st-stage method, which has a sensitivity of >85% at the cost of high false positive (FP) (>15 FPs per patient). We validate our approach on a radiotherapy dataset with 142 paired PET/RTCT scans containing the chest and upper abdominal body parts. The proposed method significantly improves over the state-of-the-art (SOTA) LN classification method by 5.5% and 13.1% in F1 score and the averaged sensitivity value at 2, 3, 4, 6 FPs per patient, respectively.