Multimodal Slice Interaction Network Enhanced by Transfer Learning for Precise Segmentation of Internal Gross Tumor Volume in Lung Cancer PET/CT Imaging

Lung cancer remains the leading cause of cancerrelated deaths globally. Accurate delineation of internal gross tumor volume (IGTV) in PET/CT imaging is pivotal for optimal radiation therapy in mobile tumors such as lung cancer to account for tumor motion, yet is hindered by the limited availability of annotated IGTV datasets and attenuated PET signal intensity at tumor boundaries. In this study, we present a transfer learningbased methodology utilizing a multimodal interactive perception network with MAMBA, pre-trained on extensive gross tumor volume (GTV) datasets and subsequently fine-tuned on a private IGTV cohort. This cohort constitutes the PET/CT subset of the Lung-cancer Unified Cross-modal Imaging Dataset (LUCID). To further address the challenge of weak PET intensities in IGTV peripheral slices, we introduce a slice interaction module (SIM) within a 2.5D segmentation framework to effectively model inter-slice relationships. Our proposed module integrates channel and spatial attention branches with depthwise convolutions, enabling more robust learning of slice-to-slice dependencies and thereby improving overall segmentation performance. A comprehensive experimental evaluation demonstrates that our approach achieves a Dice of 0.609 on the private IGTV dataset, substantially surpassing the conventional baseline score of 0.385. This work highlights the potential of transfer learning, coupled with advanced multimodal techniques and a SIM to enhance the reliability and clinical relevance of IGTV segmentation for lung cancer radiation therapy planning.