autoPET IV challenge: Incorporating organ supervision and human guidance for lesion segmentation in PET/CT

Abstract: Lesion Segmentation in PET/CT scans is an essential part of modern oncological workflows. To address the challenges of time-intensive manual annotation and high inter-observer variability, the autoPET challenge series seeks to advance automated segmentation methods in complex multi-tracer and multi-center settings. Building on this foundation, autoPET IV introduces a human-in-the-loop scenario to efficiently utilize interactive human guidance in segmentation tasks. In this work, we incorporated tracer classification, organ supervision and simulated clicks guidance into the nnUNet Residual Encoder framework, forming an integrated pipeline that demonstrates robust performance in a fully automated (zero-guidance) context and efficiently leverages iterative interactions to progressively enhance segmentation accuracy.