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However, detecting rectal cancer in MRI scans is challenging due to image complexity and the need for precise localization. While transformer-based object detection has excelled in natural images, applying these models to medical data is hindered by limited medical imaging resources. To address this, we propose the Spatially Prioritized Detection Transformer (SP DETR), which incorporates a Spatially Prioritized (SP) Decoder to constrain anchor boxes to regions of interest (ROI) based on anatomical maps, focusing the model on areas most likely to contain cancer. Additionally, the SP cross-attention mechanism refines the learning of anchor box offsets. To improve small cancer detection, we introduce the Global Context-Guided Feature Fusion Module (GCGFF), leveraging a transformer encoder for global context and a Globally-Guided Semantic Fusion Block (GGSF) to enhance high-level semantic features. Experimental results show that our model significantly improves detection accuracy, especially for small rectal cancers, demonstrating the effectiveness of integrating anatomical priors with transformer-based models for clinical applications.<\/jats:p>","DOI":"10.1177\/08953996251370580","type":"journal-article","created":{"date-parts":[[2025,8,25]],"date-time":"2025-08-25T15:45:13Z","timestamp":1756136713000},"page":"1059-1070","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Anatomy-aware transformer-based model for precise rectal cancer detection and localization in MRI scans"],"prefix":"10.1177","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-0044-8737","authenticated-orcid":false,"given":"Shanshan","family":"Li","sequence":"first","affiliation":[{"name":"University of Electronic Science and Technology of China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Radiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yao","family":"Hong","sequence":"additional","affiliation":[{"name":"Department of Radiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei","family":"Yuan","sequence":"additional","affiliation":[{"name":"Pray-medical Technology, Hangzhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jihong","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Radiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China"},{"name":"Key Laboratory for Biomedical Engineering of Ministry of Education, Zhejiang University, Hangzhou, China"},{"name":"Cancer Center, Zhejiang University, Hangzhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,8,25]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21660"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21601"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(22)00156-X"},{"key":"e_1_3_3_5_2","doi-asserted-by":"crossref","unstructured":"Baumgartner M J\u00e4ger PF Isensee F et al. nndetection: A self-configuring method for medical object detection. 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