# Unleashing the Strengths of Unlabeled Data in Pan-cancer Abdominal Organ Quantification: the FLARE22 Challenge

arXiv: https://arxiv.org/abs/2308.05862 · HTML: https://mlsanity.com/paper/2308.05862/

## Key facts

- Cited by 50 papers in the map (data through 14 Oct 2026).
- Builds on 16 of its 60 references that are in the map.
- First posted on arXiv 10 Aug 2023.

## Builds on (most cited first, 16 of 16)

- [Adam: A Method for Stochastic Optimization](https://mlsanity.com/paper/1412.6980/) (2014)
- [An Image is Worth 16x16 Words: Transformers for Image Recognition at Scale](https://mlsanity.com/paper/2010.11929/) (2020)
- [PyTorch: An Imperative Style, High-Performance Deep Learning Library](https://mlsanity.com/paper/1912.01703/) (2019)
- [V-Net: Fully Convolutional Neural Networks for Volumetric Medical Image Segmentation](https://mlsanity.com/paper/1606.04797/) (2016)
- [The Medical Segmentation Decathlon](https://mlsanity.com/paper/2106.05735/) (2021)
- [TotalSegmentator: robust segmentation of 104 anatomical structures in CT images](https://mlsanity.com/paper/2208.05868/) (2022)
- [Identifying the Best Machine Learning Algorithms for Brain Tumor Segmentation, Progression Assessment, and Overall Survival Prediction in the BRATS Challenge](https://mlsanity.com/paper/1811.02629/) (2018)
- [The Liver Tumor Segmentation Benchmark (LiTS)](https://mlsanity.com/paper/1901.04056/) (2019)
- [AMOS: A Large-Scale Abdominal Multi-Organ Benchmark for Versatile Medical Image Segmentation](https://mlsanity.com/paper/2206.08023/) (2022)
- [AbdomenCT-1K: Is Abdominal Organ Segmentation A Solved Problem?](https://mlsanity.com/paper/2010.14808/) (2020)
- [The state of the art in kidney and kidney tumor segmentation in contrast-enhanced CT imaging: Results of the KiTS19 Challenge](https://mlsanity.com/paper/1912.01054/) (2019)
- [DeepOrgan: Multi-level Deep Convolutional Networks for Automated Pancreas Segmentation](https://mlsanity.com/paper/1506.06448/) (2015)
- [Why rankings of biomedical image analysis competitions should be interpreted with care](https://mlsanity.com/paper/1806.02051/) (2018)
- [Methods and open-source toolkit for analyzing and visualizing challenge results](https://mlsanity.com/paper/1910.05121/) (2019)
- [BIAS: Transparent reporting of biomedical image analysis challenges](https://mlsanity.com/paper/1910.04071/) (2019)
- [Labeling instructions matter in biomedical image analysis](https://mlsanity.com/paper/2207.09899/) (2022)

## Built on by (most cited first, 30 of 50)

- [Swin-UMamba: Mamba-based UNet with ImageNet-based pretraining](https://mlsanity.com/paper/2402.03302/) (2024)
- [M3D: Advancing 3D Medical Image Analysis with Multi-Modal Large Language Models](https://mlsanity.com/paper/2404.00578/) (2024)
- [GMAI-MMBench: A Comprehensive Multimodal Evaluation Benchmark Towards General Medical AI](https://mlsanity.com/paper/2408.03361/) (2024)
- [AbdomenAtlas: A Large-Scale, Detailed-Annotated, & Multi-Center Dataset for Efficient Transfer Learning and Open Algorithmic Benchmarking](https://mlsanity.com/paper/2407.16697/) (2024)
- [VISTA3D: A Unified Segmentation Foundation Model For 3D Medical Imaging](https://mlsanity.com/paper/2406.05285/) (2024)
- [SA-Med2D-20M Dataset: Segment Anything in 2D Medical Imaging with 20 Million masks](https://mlsanity.com/paper/2311.11969/) (2023)
- [nnInteractive: Redefining 3D Promptable Segmentation](https://mlsanity.com/paper/2503.08373/) (2025)
- [LKM-UNet: Large Kernel Vision Mamba UNet for Medical Image Segmentation](https://mlsanity.com/paper/2403.07332/) (2024)
- [MedShapeNet -- A Large-Scale Dataset of 3D Medical Shapes for Computer Vision](https://mlsanity.com/paper/2308.16139/) (2023)
- [Touchstone Benchmark: Are We on the Right Way for Evaluating AI Algorithms for Medical Segmentation?](https://mlsanity.com/paper/2411.03670/) (2024)
- [Interactive Medical Image Segmentation: A Benchmark Dataset and Baseline](https://mlsanity.com/paper/2411.12814/) (2024)
- [Automatic Organ and Pan-cancer Segmentation in Abdomen CT: the FLARE 2023 Challenge](https://mlsanity.com/paper/2408.12534/) (2024)
- [MiM: Mask in Mask Self-Supervised Pre-Training for 3D Medical Image Analysis](https://mlsanity.com/paper/2404.15580/) (2024)
- [Rethinking Abdominal Organ Segmentation (RAOS) in the clinical scenario: A robustness evaluation benchmark with challenging cases](https://mlsanity.com/paper/2406.13674/) (2024)
- [How Well Do Supervised 3D Models Transfer to Medical Imaging Tasks?](https://mlsanity.com/paper/2501.11253/) (2025)
- [A Comprehensive Survey of Mamba Architectures for Medical Image Analysis: Classification, Segmentation, Restoration and Beyond](https://mlsanity.com/paper/2410.02362/) (2024)
- [FreeTumor: Advance Tumor Segmentation via Large-Scale Tumor Synthesis](https://mlsanity.com/paper/2406.01264/) (2024)
- [CAT: Coordinating Anatomical-Textual Prompts for Multi-Organ and Tumor Segmentation](https://mlsanity.com/paper/2406.07085/) (2024)
- [Biomedical SAM 2: Segment Anything in Biomedical Images and Videos](https://mlsanity.com/paper/2408.03286/) (2024)
- [SAM2 for Image and Video Segmentation: A Comprehensive Survey](https://mlsanity.com/paper/2503.12781/) (2025)
- [Versatile Medical Image Segmentation Learned from Multi-Source Datasets via Model Self-Disambiguation](https://mlsanity.com/paper/2311.10696/) (2023)
- [xLSTM-UNet can be an Effective 2D & 3D Medical Image Segmentation Backbone with Vision-LSTM (ViL) better than its Mamba Counterpart](https://mlsanity.com/paper/2407.01530/) (2024)
- [HySparK: Hybrid Sparse Masking for Large Scale Medical Image Pre-Training](https://mlsanity.com/paper/2408.05815/) (2024)
- [LesionLocator: Zero-Shot Universal Tumor Segmentation and Tracking in 3D Whole-Body Imaging](https://mlsanity.com/paper/2502.20985/) (2025)
- [CRISP-SAM2: SAM2 with Cross-Modal Interaction and Semantic Prompting for Multi-Organ Segmentation](https://mlsanity.com/paper/2506.23121/) (2025)
- [Towards a Comprehensive, Efficient and Promptable Anatomic Structure Segmentation Model using 3D Whole-body CT Scans](https://mlsanity.com/paper/2403.15063/) (2024)
- [Enhancing the Reliability of Segment Anything Model for Auto-Prompting Medical Image Segmentation with Uncertainty Rectification](https://mlsanity.com/paper/2311.10529/) (2023)
- [MambaMIM: Pre-training Mamba with State Space Token Interpolation and its Application to Medical Image Segmentation](https://mlsanity.com/paper/2408.08070/) (2024)
- [A Short Review and Evaluation of SAM2's Performance in 3D CT Image Segmentation](https://mlsanity.com/paper/2408.11210/) (2024)
- [A-Eval: A Benchmark for Cross-Dataset Evaluation of Abdominal Multi-Organ Segmentation](https://mlsanity.com/paper/2309.03906/) (2023)

## Abstract (arXiv)

Quantitative organ assessment is an essential step in automated abdominal disease diagnosis and treatment planning. Artificial intelligence (AI) has shown great potential to automatize this process. However, most existing AI algorithms rely on many expert annotations and lack a comprehensive evaluation of accuracy and efficiency in real-world multinational settings. To overcome these limitations, we organized the FLARE 2022 Challenge, the largest abdominal organ analysis challenge to date, to benchmark fast, low-resource, accurate, annotation-efficient, and generalized AI algorithms. We constructed an intercontinental and multinational dataset from more than 50 medical groups, including Computed Tomography (CT) scans with different races, diseases, phases, and manufacturers. We independently validated that a set of AI algorithms achieved a median Dice Similarity Coefficient (DSC) of 90.0% by using 50 labeled scans and 2000 unlabeled scans, which can significantly reduce annotation requirements. The best-performing algorithms successfully generalized to holdout external validation sets, achieving a median DSC of 89.5%, 90.9%, and 88.3% on North American, European, and Asian cohorts, respectively. They also enabled automatic extraction of key organ biology features, which was labor-intensive with traditional manual measurements. This opens the potential to use unlabeled data to boost performance and alleviate annotation shortages for modern AI models.