Recurrence-free Survival Prediction under the Guidance of Automatic Gross Tumor Volume Segmentation for Head and Neck Cancers

For Head and Neck Cancers (HNC) patient management, automatic gross tumor volume (GTV) segmentation and accurate pre-treatment cancer recurrence prediction are of great importance to assist physicians in designing personalized management plans, which have the potential to improve the treatment outcome and quality of life for HNC patients. In this paper, we developed an automated primary tumor (GTVp) and lymph nodes (GTVn) segmentation method based on combined pre-treatment positron emission tomography/computed tomography (PET/CT) scans of HNC patients. We extracted radiomics features from the segmented tumor volume and constructed a multi-modality tumor recurrence-free survival (RFS) prediction model, which fused the prediction results from separate CT radiomics, PET radiomics, and clinical models. We performed 5-fold cross-validation to train and evaluate our methods on the MICCAI 2022 HEad and neCK TumOR segmentation and outcome prediction challenge (HECKTOR) dataset. The ensemble prediction results on the testing cohort achieved Dice scores of 0.77 and 0.73 for GTVp and GTVn segmentation, respectively, and a C-index value of 0.67 for RFS prediction. The code is publicly available (https://github.com/wangkaiwan/HECKTOR-2022-AIRT). Our team's name is AIRT.