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Automated Lesion Segmentation in Whole-Body FDG-PET/CT

Sergios Gatidis; Thomas Küstner; Michael Ingrisch; Matthias Fabritius; Clemens Cyran

Positron Emission Tomography / Computed Tomography (PET/CT) is an integral part of the diagnostic workup for various malignant solid tumor entities. Due to its wide applicability, Fluorodeoxyglucose (FDG) is the most widely used PET tracer in an oncological setting reflecting glucose consumption of tissues, e.g. typically increased glucose consumption of tumor lesions.

As part of the clinical routine analysis, PET/CT is mostly analyzed in a qualitative way by experienced medical imaging experts. Additional quantitative evaluation of PET information would potentially allow for more precise and individualized diagnostic decisions.

A crucial initial processing step for quantitative PET/CT analysis is segmentation of tumor lesions enabling accurate feature extraction, 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. Automation of this task is thus necessary for widespread clinical implementation of comprehensive PET image analysis. Recent progress in automated PET/CT lesions segmentation using deep learning methods has demonstrated the principle feasibility of this task. However, despite these recent advances tumor lesion detection and segmentation in whole-body PET/CT is still a challenging task. The specific difficulty of lesion segmentation in FDG-PET lies in the fact that not only tumor lesions but also healthy organs (e.g. the brain) can have significant FDG uptake; avoiding false positive segmentations can thus be difficult. One bottleneck for progress in automated PET lesion segmentation is the limited availability of training data that would allow for algorithm development and optimization.

To promote research on machine learning-based automated tumor lesion segmentation on whole-body FDGPET/CT data we propose the autoPET challenge and provide a large, publicly available training data set.

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