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原文摘要

Early detection and follow-up of pancreatic cystic lesions (PCLs) are crucial, as some of their subtypes, such as mucinous cystic neoplasms (MCNs) and intraductal papillary mucinous neoplasms, carry a significant risk of malignant transformation. Although most AI studies investigating PCLs rely on computed tomography (CT) scans, magnetic resonance imaging (MRI) offers superior soft tissue contrast, making it highly suitable for PCLs assessment. In this work, we propose an anatomy-aware two-stage deep learning framework for automated PCLs segmentation on abdominal MRI scans. First, a publicly available pancreas segmentation model is used to localize the pancreas. Then, we introduce the anatomyaware PCLSegNet, which incorporates anatomical priors as guidance for pancreas and PCLs segmentation. To address the class imbalance problem, we develop a Class-Specific ErrorWeighted (CSEW) loss function. Postprocessing is applied through anatomical constraints.Our proposed method outperforms multi-organ segmentation models such as TotalSegmentator, achieving substantially higher Dice scores for pancreas segmentation. Moreover, it also achieves a superior normalized surface Dice (NSD) and recall for PCLs segmentationcompared to other state-of-the-art models like nnU-Net, while also notably reducing the false negative rate, facilitating the automatic early detection and the noninvasive imaging-based assessment of PCLs.