Abstract

Identification of cervical metastatic lymph nodes (LN) on I-131 post-ablation whole-body planar scans (WBS) for cancer staging is crucial for patients with papillary thyroid cancer (PTC). The existing deep network is plagued by instability in finding the under-represented LN classes on highly complex WBS, where end-to-end tuned models that can account for this uncertainty region for multi-class locations are needed. Hence, as a key contribution of this study, we designed a novel leveraging segmentation network with input guidance (LSIG) end-to-end training model without pre and post-processing features that can learn ideal parameter settings depending on the quantity of multiple-object instances. To improve the co-occurrence of classes and control the false positive regions, we proposed a re-weighting negative control (RNC) mechanism that combines two key components, namely the re-weighting (Rw) term and the negative control function (NcF). This unified approximation of weighted training would leverage the network to control and learn the desired weights of true positives towards the LN region. As an end-to-end network training, we utilize a Unet-like convolution neural network (CNN) model. The performance of the LSIG is compared with the CNN-based networks, based on the ground truth (GT) mask developed using post-ablation single-photon emission computed tomography (SPECT/CT). Furthermore, the effectiveness of the two components used in the LSIG framework is evaluated on WBS datasets. Our proposed LSIG with a fully guided (Fg) LS-FgCNN model yielded a superior performance with high AUC value of 94.9%, which is 14.6% higher than the previous network for PTC.

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