Abstract:Multi-organ segmentation is a widely applied clinical routine and automated organ segmentation tools dramatically improve the pipeline of the radiologists. Recently, deep learning (DL) based segmentation models have shown the capacity to accomplish such a task. However, the training of the segmentation networks requires large amount of data with manual annotations, which is a major concern due to the data scarcity from clinic. Working with limited data is still common for researches on novel imaging modalities. To enhance the effectiveness of DL models trained with limited data, data augmentation (DA) is a crucial regularization technique. Traditional DA (TDA) strategies focus on basic intra-image operations, i.e. generating images with different orientations and intensity distributions. In contrast, the interimage and object-level DA operations are able to create new images from separate individuals. However, such DA strategies are not well explored on the task of multi-organ segmentation. In this paper, we investigated four possible inter-image DA strategies: CutMix, CarveMix, ObjectAug and AnatoMix, on two organ segmentation datasets. The result shows that CutMix, CarveMix and AnatoMix can improve the average dice score by 4.9, 2.0 and 1.9, compared with the state-of-the-art nnUNet without DA strategies. These results can be further improved by adding TDA strategies. It is revealed in our experiments that Cut-Mix is a robust but simple DA strategy to drive up the segmentation performance for multi-organ segmentation, even when CutMix produces intuitively 'wrong' images. Our implementation is publicly available for future benchmarks.




Abstract:Introduction: Large language models (LLM) have shown great potential in clinical decision support. GPT-5 is a novel LLM system that has been specifically marketed towards oncology use. Methods: Performance was assessed using two complementary benchmarks: (i) the ACR Radiation Oncology In-Training Examination (TXIT, 2021), comprising 300 multiple-choice items, and (ii) a curated set of 60 authentic radiation oncologic vignettes representing diverse disease sites and treatment indications. For the vignette evaluation, GPT-5 was instructed to generate concise therapeutic plans. Four board-certified radiation oncologists rated correctness, comprehensiveness, and hallucinations. Inter-rater reliability was quantified using Fleiss' \k{appa}. Results: On the TXIT benchmark, GPT-5 achieved a mean accuracy of 92.8%, outperforming GPT-4 (78.8%) and GPT-3.5 (62.1%). Domain-specific gains were most pronounced in Dose and Diagnosis. In the vignette evaluation, GPT-5's treatment recommendations were rated highly for correctness (mean 3.24/4, 95% CI: 3.11-3.38) and comprehensiveness (3.59/4, 95% CI: 3.49-3.69). Hallucinations were rare with no case reaching majority consensus for their presence. Inter-rater agreement was low (Fleiss' \k{appa} 0.083 for correctness), reflecting inherent variability in clinical judgment. Errors clustered in complex scenarios requiring precise trial knowledge or detailed clinical adaptation. Discussion: GPT-5 clearly outperformed prior model variants on the radiation oncology multiple-choice benchmark. Although GPT-5 exhibited favorable performance in generating real-world radiation oncology treatment recommendations, correctness ratings indicate room for further improvement. While hallucinations were infrequent, the presence of substantive errors underscores that GPT-5-generated recommendations require rigorous expert oversight before clinical implementation.



Abstract:Multi-organ segmentation in medical images is a widely researched task and can save much manual efforts of clinicians in daily routines. Automating the organ segmentation process using deep learning (DL) is a promising solution and state-of-the-art segmentation models are achieving promising accuracy. In this work, We proposed a novel data augmentation strategy for increasing the generalizibility of multi-organ segmentation datasets, namely AnatoMix. By object-level matching and manipulation, our method is able to generate new images with correct anatomy, i.e. organ segmentation mask, exponentially increasing the size of the segmentation dataset. Initial experiments have been done to investigate the segmentation performance influenced by our method on a public CT dataset. Our augmentation method can lead to mean dice of 76.1, compared with 74.8 of the baseline method.