EA-StrongSORT: An Efficient Attention StrongSORT Framework for Detection-Based Tumor Tracking in Cine-MRI TrackRAD2025 Dataset

MRI-guided radiotherapy (MRIgRT) enables the real-time visualization of tumor motion, allowing adaptive radiation delivery based on dynamic anatomical changes. However, respiratory-induced tumor motion remains a major challenge, particularly for thoracic and abdominal tumors. Continuous tumor motion may reduce treatment accuracy and increase radiation exposure to surrounding healthy tissues. Therefore, reliable and efficient tumor tracking is essential for real-time motion management in MRI-guided radiotherapy. Recent advances in artificial intelligence have demonstrated significant potential for medical image analysis; however, many existing tumor tracking approaches rely on segmentation-based methods that require detailed annotations and complex processing, which can limit their use in real-time clinical environments. In this work, we propose a detection-based tumor tracking framework that integrates the YOLOv11 object detection model with an enhanced StrongSORT tracking algorithm (EA-StrongSORT). The proposed approach replaces the conventional re-identification backbone with a lightweight EfficientNetV2 architecture augmented with an Efficient Channel Attention (ECA) mechanism. The overall framework follows a tracking-by-detection concept, where tumor regions are first detected and subsequently associated across frames. The proposed framework is evaluated on the TrackRAD2025 dataset using multiple YOLOv11 variants to analyze the balance between performance and model complexity. Experimental results demonstrate that the lightweight YOLOv11n model achieves the best detection performance, with a precision of 0.912, recall of 0.607, mean Average Precision (mAP) of 0.771, and mAP50--95 of 0.608. Furthermore, the proposed tracking framework achieves stable temporal association, with Multiple-Object Tracking Accuracy (MOTA) scores exceeding 91% and Higher-Order Tracking Accuracy (HOTA) scores around 90%. The proposed framework demonstrates the potential of detection-based tumor localization and tracking for real-time MRI-guided radiotherapy applications.