# H2ASeg: Hierarchical Adaptive Interaction and Weighting Network for Tumor Segmentation in PET/CT Images

arXiv: https://arxiv.org/abs/2403.18339 · HTML: https://mlsanity.com/paper/2403.18339/

## Key facts

- Cited by 2 papers in the map (data through 14 Oct 2026).
- Builds on 11 of its 27 references that are in the map.
- First posted on arXiv 27 Mar 2024.

## Builds on (most cited first, 11 of 11)

- [An Image is Worth 16x16 Words: Transformers for Image Recognition at Scale](https://mlsanity.com/paper/2010.11929/) (2020)
- [V-Net: Fully Convolutional Neural Networks for Volumetric Medical Image Segmentation](https://mlsanity.com/paper/1606.04797/) (2016)
- [3D U-Net: Learning Dense Volumetric Segmentation from Sparse Annotation](https://mlsanity.com/paper/1606.06650/) (2016)
- [UNETR: Transformers for 3D Medical Image Segmentation](https://mlsanity.com/paper/2103.10504/) (2021)
- [Swin UNETR: Swin Transformers for Semantic Segmentation of Brain Tumors in MRI Images](https://mlsanity.com/paper/2201.01266/) (2022)
- [TransBTS: Multimodal Brain Tumor Segmentation Using Transformer](https://mlsanity.com/paper/2103.04430/) (2021)
- [Transformers in Medical Imaging: A Survey](https://mlsanity.com/paper/2201.09873/) (2022)
- [nnFormer: Interleaved Transformer for Volumetric Segmentation](https://mlsanity.com/paper/2109.03201/) (2021)
- [mmFormer: Multimodal Medical Transformer for Incomplete Multimodal Learning of Brain Tumor Segmentation](https://mlsanity.com/paper/2206.02425/) (2022)
- [NestedFormer: Nested Modality-Aware Transformer for Brain Tumor Segmentation](https://mlsanity.com/paper/2208.14876/) (2022)
- [Mirror U-Net: Marrying Multimodal Fission with Multi-task Learning for Semantic Segmentation in Medical Imaging](https://mlsanity.com/paper/2303.07126/) (2023)

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

- [Dynamic Pseudo Label Optimization in Point-Supervised Nuclei Segmentation](https://mlsanity.com/paper/2406.16427/) (2024)
- [Label tree semantic losses for rich multi-class medical image segmentation](https://mlsanity.com/paper/2507.15777/) (2025)

## Abstract (arXiv)

Positron emission tomography (PET) combined with computed tomography (CT) imaging is routinely used in cancer diagnosis and prognosis by providing complementary information. Automatically segmenting tumors in PET/CT images can significantly improve examination efficiency. Traditional multi-modal segmentation solutions mainly rely on concatenation operations for modality fusion, which fail to effectively model the non-linear dependencies between PET and CT modalities. Recent studies have investigated various approaches to optimize the fusion of modality-specific features for enhancing joint representations. However, modality-specific encoders used in these methods operate independently, inadequately leveraging the synergistic relationships inherent in PET and CT modalities, for example, the complementarity between semantics and structure. To address these issues, we propose a Hierarchical Adaptive Interaction and Weighting Network termed H2ASeg to explore the intrinsic cross-modal correlations and transfer potential complementary information. Specifically, we design a Modality-Cooperative Spatial Attention (MCSA) module that performs intra- and inter-modal interactions globally and locally. Additionally, a Target-Aware Modality Weighting (TAMW) module is developed to highlight tumor-related features within multi-modal features, thereby refining tumor segmentation. By embedding these modules across different layers, H2ASeg can hierarchically model cross-modal correlations, enabling a nuanced understanding of both semantic and structural tumor features. Extensive experiments demonstrate the superiority of H2ASeg, outperforming state-of-the-art methods on AutoPet-II and Hecktor2022 benchmarks. The code is released at https://github.com/JinPLu/H2ASeg.