NPCNet: Jointly Segment Primary Nasopharyngeal Carcinoma Tumors and Metastatic Lymph Nodes in MR Images.

Nasopharyngeal carcinoma (NPC) is a malignant tumor whose survivability is greatly improved if early diagnosis and timely treatment are provided. Accurate segmentation of both the primary NPC tumors and metastatic lymph nodes (MLNs) is crucial for patient staging and radiotherapy scheduling. However, existing studies mainly focus on the segmentation of primary tumors, eliding the recognition of MLNs, and thus fail to comprehensively provide a landscape for tumor identification. There are three main challenges in segmenting primary NPC tumors and MLNs: variable location, variable size, and irregular boundary. To address these challenges, we propose an automatic segmentation network, named by NPCNet, to achieve segmentation of primary NPC tumors and MLNs simultaneously. Specifically, we design three modules, including position enhancement module (PEM), scale enhancement module (SEM), and boundary enhancement module (BEM), to address the above challenges. First, the PEM enhances the feature representations of the most suspicious regions. Subsequently, the SEM captures multiscale context information and target context information. Finally, the BEM rectifies the unreliable predictions in the segmentation mask. To that end, extensive experiments are conducted on our dataset of 9124 samples collected from 754 patients. Empirical results demonstrate that each module realizes its designed functionalities and is complementary to the others. By incorporating the three proposed modules together, our model achieves state-of-the-art performance compared with nine popular models.