HEad and neCK TumOR (HECKTOR) 2025: Benchmark of Segmentation, Diagnosis, and Prognosis in Multimodal PET/CT
Mohamed bin Zayed University of Artificial Intelligence (MBZUAI)（穆罕默德·本·扎耶德人工智能大学）；Amsterdam UMC（阿姆斯特丹大学医学中心）；The Netherlands Cancer Institute（荷兰癌症研究所）；Radboud University Medical Centre（拉德堡德大学医学中心）；University College London（伦敦大学学院）；Imperial College London（帝国理工学院）；Shenzhen Technology University（深圳技术大学）；Shenzhen University（深圳大学）；Newland Digital Technology（新大陆数字技术）；The University of Sydney（悉尼大学）；Shanghai Jiao Tong University（上海交通大学）；University Hospital, Nantes（南特大学医院）；Nantes Université, Centrale Nantes, CNRS, LS2N（南特大学、南特中央理工学院、法国国家科学研究中心、LS2N实验室）；Hangzhou Dianzi University（杭州电子科技大学）；Tsinghua University（清华大学）；Central South University（中南大学）；University of Glasgow（格拉斯哥大学）；China Mobile System Integration Co., Ltd.（中移系统集成有限公司）；Subtle Medical Inc.（Subtle Medical公司）；University Hospital, LMU Munich（慕尼黑大学医院）；Munich Center for Machine Learning（慕尼黑机器学习中心）；BC Cancer Research Institute（不列颠哥伦比亚癌症研究所）；HES-SO Valais-Wallis University of Applied Sciences and Arts（HES-SO瓦莱州应用科学与艺术大学）；Lausanne University Hospital (CHUV)（洛桑大学医院）；LaTIM, INSERM, UMR 1101, Univ Brest（LaTIM实验室、法国国家健康与医学研究院、UMR 1101、布雷斯特大学）
Numan Saeed, Salma Hassan, Shahad Hardan, Lishan Cai, Xinglong Liang, Moona Mazher, Abdul Qayyum, Yansong Bu, Mengye Lyu, Yue Lin, Mingyuan Meng, Chuanyi Huang, Lisheng Wang, Dalal Chamseddine, Shamimeh Ahrari, Beining Wu, Yifei Chen, Fuyou Mao, Hao Zhang, Baixiang Zhao, Surajit Ray, Muzi Guo, Lei Xiang, Jakob Dexl, Michael Ingrisch, Adrien Depeursinge, Arman Rahmim, Mathieu Hatt, Vincent Andrearczyk, Mohammad Yaqub
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17 pages, 4 figures, 4 tables. Overview paper for the HECKTOR 2025 challenge, held as a satellite event at MICCAI 2025. Challenge website: https://hecktor.grand-challenge.org/
Head and neck cancers (HNC) represent a significant global health burden, with accurate tumor delineation being essential for effective radiotherapy planning. The complexity of the oropharyngeal anatomy, combined with the heterogeneous appearance of tumors on imaging, makes manual segmentation time-intensive and subject to inter-observer variability. Beyond segmentation, predicting long-term clinical outcomes, such as recurrence-free survival (RFS), and determining human papillomavirus (HPV) status from noninvasive imaging, remain challenging yet clinically valuable goals. The HECKTOR 2025 challenge addresses these needs by establishing a comprehensive benchmark for automated HNC analysis using multimodal PET/CT imaging and electronic health records. Building on previous editions (2020-2022), this challenge features an expanded multi-institutional dataset comprising over 1,100 patients from 10 centers worldwide. Participants were tasked with three complementary objectives: (1) segmenting primary gross tumor volumes (GTVp) and metastatic lymph nodes (GTVn), (2) predicting recurrence-free survival, and (3) classifying HPV status. The challenge attracted 35 registered teams, with 15 final submissions evaluated on a held-out test set. Top-performing algorithms achieved a mean Dice similarity coefficient of 0.75 for segmentation, a concordance index of 0.66 for survival prediction, and a balanced accuracy of 0.56 for HPV classification. This paper presents a comprehensive analysis of the submitted methodologies, evaluates their performance across different lesion characteristics, and discusses their implications for clinical translation in automated oncology workflows and decision support systems.
Southern Medical University（南方医科大学）；LaTIM（拉蒂姆实验室）；INSERM（法国国家健康与医学研究院）；Univ Brest（布雷斯特大学）；Chinese Academy of Medical Sciences and Peking Union Medical College（中国医学科学院北京协和医学院）
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 nn…
Head and neck tumor segmentation challenge (HECKTOR) 2022 offers a platform for researchers to compare their solutions to segmentation of tumors and lymph nodes from 3D CT and PET images. In this work, we describe our solution to HECKTOR 2022 segmentation task. We re-sample all images to a common resolution, crop around head and neck region, and train SegResNet semantic segmentation network from MONAI. We use 5-fold cross validation to select best model checkpoints. The final submission is an ensemble of 15 models from 3 runs. Our solution (team name NVAUTO) achieves the 1st place on the HECKT…
LaTIM, INSERM, UMR 1101, University Brest（拉蒂姆研究所、法国国家健康与医学研究院、布雷斯特大学）
Development of robust and accurate fully automated methods for medical image segmentation is crucial in clinical practice and radiomics studies. In this work, we contributed an automated approach for Head and Neck (H&N) primary tumor segmentation in combined positron emission tomography / computed tomography (PET/CT) images in the context of the MICCAI 2020 Head and Neck Tumor segmentation challenge (HECKTOR). Our model was designed on the U-Net architecture with residual layers and supplemented with Squeeze-and-Excitation Normalization. The described method achieved competitive results in cro…
HES-SO Valais-Wallis University of Applied Sciences and Arts Western Switzerland（瑞士西部应用科学与艺术大学瓦莱州分校）；Centre Hospitalier Universitaire Vaudois (CHUV)（沃州大学中心医院）；Centre Hospitalier Universitaire de Poitiers (CHUP)（普瓦捷大学中心医院）；Univ Brest（布雷斯特大学）；INSERM（法国国家健康与医学研究院）；LaTIM（医学信息处理实验室）；Cleveland Clinic Foundation（克利夫兰医学中心基金会）；University of Sherbrooke（舍布鲁克大学）
This paper presents an overview of the second edition of the HEad and neCK TumOR (HECKTOR) challenge, organized as a satellite event of the 24th International Conference on Medical Image Computing and Computer Assisted Intervention (MICCAI) 2021. The challenge is composed of three tasks related to the automatic analysis of PET/CT images for patients with Head and Neck cancer (H&N), focusing on the oropharynx region. Task 1 is the automatic segmentation of H&N primary Gross Tumor Volume (GTVt) in FDG-PET/CT images. Task 2 is the automatic prediction of Progression Free Survival (PFS) from the s…
Mohamed bin Zayed University of Artificial Intelligence（穆罕默德·本·扎耶德人工智能大学）
Accurate prognosis of a tumor can help doctors provide a proper course of treatment and, therefore, save the lives of many. Traditional machine learning algorithms have been eminently useful in crafting prognostic models in the last few decades. Recently, deep learning algorithms have shown significant improvement when developing diagnosis and prognosis solutions to different healthcare problems. However, most of these solutions rely solely on either imaging or clinical data. Utilizing patient tabular data such as demographics and patient medical history alongside imaging data in a multimodal …
SimulaMet（SimulaMet研究院）；Oslo Metropolitan University（奥斯陆城市大学）；UiT The Arctic University of Norway（挪威北极大学）
Head and neck cancers are the fifth most common cancer worldwide, and recently, analysis of Positron Emission Tomography (PET) and Computed Tomography (CT) images has been proposed to identify patients with a prognosis. Even though the results look promising, more research is needed to further validate and improve the results. This paper presents the work done by team MLC for the 2022 version of the HECKTOR grand challenge held at MICCAI 2022. For Task 1, the automatic segmentation task, our approach was, in contrast to earlier solutions using 3D segmentation, to keep it as simple as possible …
University of Texas Southwestern Medical Center（德克萨斯大学西南医学中心）
For Head and Neck Cancers (HNC) patient management, automatic gross tumor volume (GTV) segmentation and accurate pre-treatment cancer recurrence prediction are of great importance to assist physicians in designing personalized management plans, which have the potential to improve the treatment outcome and quality of life for HNC patients. In this paper, we developed an automated primary tumor (GTVp) and lymph nodes (GTVn) segmentation method based on combined pre-treatment positron emission tomography/computed tomography (PET/CT) scans of HNC patients. We extracted radiomics features from the …
Multi-FRuGaL: Multimodal Flexible Redundancy-aware Decomposed Gated Learning for Cancer Diagnosis and Prognosis
Division of Computational Pathology, Department of Pathology and Laboratory Medicine, Indiana University School of Medicine（计算病理学部，病理学与实验室医学部，印第安纳大学医学院）；IU Melvin and Bren Simon Comprehensive Cancer Center（印第安纳大学Melvin和Bren Simon综合癌症中心）；Departments of Biostatistics and Health Data Science（生物统计学与健康数据科学部）；Radiology and Imaging Sciences（放射学与影像科学部）；Neurological Surgery（神经外科）；Indiana University School of Medicine（印第安纳大学医学院）；Department of Computer Science, Luddy School of Informatics, Computing, and Engineering（计算机科学部，Luddy信息、计算与工程学院）
Nanjing University of Science and Technology（南京理工大学）；Nanjing University（南京大学）
Automatic segmentation of head and neck tumors plays an important role in radiomics analysis. In this short paper, we propose an automatic segmentation method for head and neck tumors from PET and CT images based on the combination of convolutional neural networks (CNNs) and hybrid active contours. Specifically, we first introduce a multi-channel 3D U-Net to segment the tumor with the concatenated PET and CT images. Then, we estimate the segmentation uncertainty by model ensembles and define a segmentation quality score to select the cases with high uncertainties. Finally, we develop a hybrid …
BC Cancer Research Institute（不列颠哥伦比亚癌症研究所）；University of British Columbia（不列颠哥伦比亚大学）；Simon Fraser University（西蒙弗雷泽大学）
We utilized a 3D nnU-Net model with residual layers supplemented by squeeze and excitation (SE) normalization for tumor segmentation from PET/CT images provided by the Head and Neck Tumor segmentation chal-lenge (HECKTOR). Our proposed loss function incorporates the Unified Fo-cal and Mumford-Shah losses to take the advantage of distribution, region, and boundary-based loss functions. The results of leave-one-out-center-cross-validation performed on different centers showed a segmentation performance of 0.82 average Dice score (DSC) and 3.16 median Hausdorff Distance (HD), and our results on t…
SwinCross: Cross-modal Swin Transformer for Head-and-Neck Tumor Segmentation in PET/CT Images
Philips Research North America（飞利浦北美研究院）；Massachusetts General Hospital/Harvard Medical School（麻省总医院/哈佛医学院）；The Center for Advanced Medical Computing and Analysis, Massachusetts General Hospital/Harvard Medical School（麻省总医院/哈佛医学院高级医学计算与分析中心）
Dynamic Gradient Sparsification Training for Few-Shot Fine-tuning of CT Lymph Node Segmentation Foundation Model
Sichuan Cancer Hospital and Institute, University of Electronic Science and Technology of China（电子科技大学附属四川省肿瘤医院）；School of Mechanical and Electrical Engineering, University of Electronic Science and Technology of China（电子科技大学机械与电气工程学院）；The Chinese University of Hong Kong（香港中文大学）；Shanghai AI Laboratory（上海人工智能实验室）；Stanford University School of Medicine（斯坦福大学医学院）
The University of Sydney（悉尼大学）；Shanghai Jiao Tong University（上海交通大学）
Outcome prediction is crucial for head and neck cancer patients as it can provide prognostic information for early treatment planning. Radiomics methods have been widely used for outcome prediction from medical images. However, these methods are limited by their reliance on intractable manual segmentation of tumor regions. Recently, deep learning methods have been proposed to perform end-to-end outcome prediction so as to remove the reliance on manual segmentation. Unfortunately, without segmentation masks, these methods will take the whole image as input, such that makes them difficult to foc…
University of Warwick（华威大学）；University of Sheffield（谢菲尔德大学）；The Alan Turing Institute（艾伦·图灵研究所）
The aetiology of head and neck squamous cell carcinoma (HNSCC) involves multiple carcinogens such as alcohol, tobacco and infection with human papillomavirus (HPV). As the HPV infection influences the prognosis, treatment and survival of patients with HNSCC, it is important to determine the HPV status of these tumours. In this paper, we propose a novel triplet-ranking loss function and a multiple instance learning pipeline for HPV status prediction. This achieves a new state-of-the-art performance in HPV detection using only the routine H&E stained WSIs on two HNSCC cohorts. Furthermore, a com…
Merging-Diverging Hybrid Transformer Networks for Survival Prediction in Head and Neck Cancer
School of Computer Science, The University of Sydney（悉尼大学计算机科学学院）；Institute of Translational Medicine, Shanghai Jiao Tong University（上海交通大学转化医学研究院）；Royal Prince Alfred Hospital（皇家阿尔弗雷德王子医院）；Med-X Research Institute, Shanghai Jiao Tong University（上海交通大学Med-X研究院）
Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences（中国科学院深圳先进技术研究院）；University of Chinese Academy of Sciences（中国科学院大学）；Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology（华中科技大学同济医学院同济医院）；Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions（深港脑科学创新研究院——深圳基础研究机构）；United Imaging Research Institute of Innovative Medical Equipment（联影创新医疗装备研究院）；Shenzhen Bay Laboratory（深圳湾实验室）
Achieving accurate and automated tumor segmentation plays an important role in both clinical practice and radiomics research. Segmentation in medicine is now often performed manually by experts, which is a laborious, expensive and error-prone task. Manual annotation relies heavily on the experience and knowledge of these experts. In addition, there is much intra- and interobserver variation. Therefore, it is of great significance to develop a method that can automatically segment tumor target regions. In this paper, we propose a deep learning segmentation method based on multimodal positron em…
Segmentation of head and neck (H\&N) tumours and prediction of patient outcome are crucial for patient's disease diagnosis and treatment monitoring. Current developments of robust deep learning models are hindered by the lack of large multi-centre, multi-modal data with quality annotations. The MICCAI 2021 HEad and neCK TumOR (HECKTOR) segmentation and outcome prediction challenge creates a platform for comparing segmentation methods of the primary gross target volume on fluoro-deoxyglucose (FDG)-PET and Computed Tomography images and prediction of progression-free survival in H\&N oropharynge…
Mohamed bin Zayed University of Artificial Intelligence（穆罕默德·本·扎耶德人工智能大学）
When oncologists estimate cancer patient survival, they rely on multimodal data. Even though some multimodal deep learning methods have been proposed in the literature, the majority rely on having two or more independent networks that share knowledge at a later stage in the overall model. On the other hand, oncologists do not do this in their analysis but rather fuse the information in their brain from multiple sources such as medical images and patient history. This work proposes a deep learning method that mimics oncologists' analytical behavior when quantifying cancer and estimating patient…
H2ASeg: Hierarchical Adaptive Interaction and Weighting Network for Tumor Segmentation in PET/CT Images
School of Science, Harbin Institute of Technology (Shenzhen)（哈尔滨工业大学（深圳）理学院）；School of Computer Science and Technology, Harbin Institute of Technology (Shenzhen)（哈尔滨工业大学（深圳）计算机科学与技术学院）
