# Whole-body tumor segmentation of 18F -FDG PET/CT using a cascaded and ensembled convolutional neural networks

arXiv: https://arxiv.org/abs/2210.08068 · HTML: https://mlsanity.com/paper/2210.08068/

## Key facts

- Cited by 2 papers in the map (data through 14 Oct 2026).
- Builds on 3 of its 8 references that are in the map.
- First posted on arXiv 14 Oct 2022.

## Builds on (most cited first, 3 of 3)

- [PyTorch: An Imperative Style, High-Performance Deep Learning Library](https://mlsanity.com/paper/1912.01703/) (2019)
- [Decoupled Weight Decay Regularization](https://mlsanity.com/paper/1711.05101/) (2017)
- [CNN-based Segmentation of Medical Imaging Data](https://mlsanity.com/paper/1701.03056/) (2017)

## Built on by (most cited first, 2 of 2)

- [Mirror U-Net: Marrying Multimodal Fission with Multi-task Learning for Semantic Segmentation in Medical Imaging](https://mlsanity.com/paper/2303.07126/) (2023)
- [When Two Tracers Disagree: An Investigation of Multimodal Fusion for Clinical PET/CT Segmentation](https://mlsanity.com/paper/2608.19063/) (2026)

## Abstract (arXiv)

Background: A crucial initial processing step for quantitative PET/CT analysis is the segmentation of tumor lesions enabling accurate feature ex-traction, tumor characterization, oncologic staging, and image-based therapy response assessment. Manual lesion segmentation is however associated with enormous effort and cost and is thus infeasible in clinical routine. Goal: The goal of this study was to report the performance of a deep neural network designed to automatically segment regions suspected of cancer in whole-body 18F-FDG PET/CT images in the context of the AutoPET challenge. Method: A cascaded approach was developed where a stacked ensemble of 3D UNET CNN processed the PET/CT images at a fixed 6mm resolution. A refiner network composed of residual layers enhanced the 6mm segmentation mask to the original resolution. Results: 930 cases were used to train the model. 50% were histologically proven cancer patients and 50% were healthy controls. We obtained a dice=0.68 on 84 stratified test cases. Manual and automatic Metabolic Tumor Volume (MTV) were highly correlated (R2 = 0.969,Slope = 0.947). Inference time was 89.7 seconds on average. Conclusion: The proposed algorithm accurately segmented regions suspicious for cancer in whole-body 18F -FDG PET/CT images.