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In the Head and Neck\u00a0(HN) region labor-intensive and time-consuming tumor segmentation\u00a0still limits full utilization of MRI-guided adaptive RT. The HN\u00a0Tumor Segmentation for MR-Guided Applications 2024 challenge (HNTS-MRG) aims to improve automatic tumor segmentation on MRI images\u00a0by providing a dataset with reference annotations for the tasks\u00a0of pre-RT and mid-RT planning.<\/jats:p>\n          <jats:p>In this work, we present our approach for the HNTS-MRG challenge. Based on the insights of a thorough literature review we implemented a fast and resource-efficient two-stage segmentation method\u00a0using the nnU-Net architecture with residual encoders as a backbone.\u00a0In our two-stage approach we use the segmentation results of a\u00a0first training round to guide the sampling process for a second refinement stage. For the pre-RT task, we achieved competitive results\u00a0using only the first-stage nnU-Net. For the mid-RT task, we\u00a0could significantly increase the segmentation performance of the\u00a0basic first stage nnU-Net by utilizing the prior knowledge of the pre-RT plan as an additional input for the second stage refinement network. As team alpinists we achieved an aggregated Dice Coefficient\u00a0of 80.97 for the pre-RT and 69.84 for the mid-RT task on the online test set of the challenge. Our code and trained model weights\u00a0for the two-stage nnU-Net approach with residual encoders are available at <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/github.com\/elitap\/hntsmrg24\" ext-link-type=\"uri\">https:\/\/github.com\/elitap\/hntsmrg24<\/jats:ext-link>.<\/jats:p>","DOI":"10.1007\/978-3-031-83274-1_6","type":"book-chapter","created":{"date-parts":[[2025,3,2]],"date-time":"2025-03-02T12:42:39Z","timestamp":1740919359000},"page":"87-98","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Head and\u00a0Neck Tumor Segmentation on\u00a0MRIs with\u00a0Fast and\u00a0Resource-Efficient Staged nnU-Nets"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1034-8361","authenticated-orcid":false,"given":"Elias","family":"Tappeiner","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4520-298X","authenticated-orcid":false,"given":"Christian","family":"Gapp","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6268-7050","authenticated-orcid":false,"given":"Martin","family":"Welk","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8026-7500","authenticated-orcid":false,"given":"Rainer","family":"Schubert","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,3,3]]},"reference":[{"key":"6_CR1","doi-asserted-by":"publisher","unstructured":"Alterio, D., Marvaso, G., Ferrari, A., Volpe, S., Orecchia, R., Jereczek-Fossa, B.A.: Modern radiotherapy for head and neck cancer. 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