# Time-Conditioned and Multi-Time Survival Prediction from 2D PET/CT Projections in Lung Cancer

arXiv: https://arxiv.org/abs/2606.12140 · HTML: https://mlsanity.com/paper/2606.12140/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 6 of its 29 references that are in the map.
- First posted on arXiv 10 Jun 2026.

## Builds on (most cited first, 6 of 6)

- [An Image is Worth 16x16 Words: Transformers for Image Recognition at Scale](https://mlsanity.com/paper/2010.11929/) (2020)
- [Grad-CAM: Visual Explanations from Deep Networks via Gradient-based Localization](https://mlsanity.com/paper/1610.02391/) (2016)
- [Multi-Task Learning Using Uncertainty to Weigh Losses for Scene Geometry and Semantics](https://mlsanity.com/paper/1705.07115/) (2017)
- [Time-to-Event Prediction with Neural Networks and Cox Regression](https://mlsanity.com/paper/1907.00825/) (2019)
- [Cross-Attention is All You Need: Adapting Pretrained Transformers for Machine Translation](https://mlsanity.com/paper/2104.08771/) (2021)
- [Time-driven Survival Analysis from FDG-PET/CT in Non-Small Cell Lung Cancer](https://mlsanity.com/paper/2604.06885/) (2026)

## Abstract (arXiv)

Accurate prediction of overall survival (OS) from positron emission tomography/computed tomography (PET/CT) can support personalized treatment and follow-up strategies in oncology. However, the impact of temporal modeling on imaging-based survival prediction remains insufficiently explored. We investigate how different temporal formulations influence survival prediction by developing two complementary approaches: Attention-guided Time-Conditioned Survival (ATCS) and Multi-Time Survival (MTS). We retrospectively analyzed pre-treatment PET/CT images from 848 patients with non-small cell lung cancer (NSCLC), including 556 for model development and 292 for held-out testing. A previously proposed Time-Conditioned Survival (TCS) model was used as a baseline. Models were trained using 5-fold cross-validation and evaluated on the test set using time-dependent area under the curve (AUC) at 6-month intervals from 0.5 to 5 years. Both ATCS and MTS outperformed the baseline TCS model, achieving mean AUCs of 0.794 and 0.793, respectively, compared to 0.767. ATCS performed better at earlier time points (0.5-3 years), whereas MTS performed better at later intervals (3.5-5 years). Combining tumor-specific and tissue-wise PET/CT features improved performance over either input alone. Finer temporal discretization improved short-term prediction, while coarser intervals provided more stable long-term estimates. These findings demonstrate that temporal modeling and input design influence PET/CT-based survival prediction. The proposed approaches enable time-specific survival estimation from pre-treatment imaging and may support improved risk stratification and clinical decision-making.
