Joint nnU-Net and Radiomics Approaches for Segmentation and Prognosis of Head and Neck Cancers with PET/CT images

Automatic segmentation of head and neck cancer (HNC) tumors and lymph nodes plays a crucial role in the optimization treatment strategy and prognosis analysis. This study aims to employ nnU-Net for automatic segmentation and radiomics for recurrence-free survival (RFS) prediction using pretreatment PET/CT images in multi-center HNC cohort. A multi-center HNC dataset with 883 patients (524 patients for training, 359 for testing) was provided in HECKTOR 2022. A bounding box of the extended oropharyngeal region was retrieved for each patient with fixed size of 224 x 224 x 224 $mm^{3}$. Then 3D nnU-Net architecture was adopted to automatic segmentation of primary tumor and lymph nodes synchronously.Based on predicted segmentation, ten conventional features and 346 standardized radiomics features were extracted for each patient. Three prognostic models were constructed containing conventional and radiomics features alone, and their combinations by multivariate CoxPH modelling. The statistical harmonization method, ComBat, was explored towards reducing multicenter variations. Dice score and C-index were used as evaluation metrics for segmentation and prognosis task, respectively. For segmentation task, we achieved mean dice score around 0.701 for primary tumor and lymph nodes by 3D nnU-Net. For prognostic task, conventional and radiomics models obtained the C-index of 0.658 and 0.645 in the test set, respectively, while the combined model did not improve the prognostic performance with the C-index of 0.648.