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This paper presents the challenge report for the 2021 Kidney and Kidney TumorSegmentation Challenge (KiTS21) held in conjunction with the 2021 internationalconference on Medical Image Computing and Computer Assisted Interventions(MICCAI). KiTS21 is a sequel to its first edition in 2019, and it features avariety of innovations in how the challenge was designed, in addition to alarger dataset. A novel annotation method was used to collect three separateannotations for each region of interest, and these annotations were performedin a fully transparent setting using a web-based annotation tool. Further, theKiTS21 test set was collected from an outside institution, challengingparticipants to develop methods that generalize well to new populations.Nonetheless, the top-performing teams achieved a significant improvement overthe state of the art set in 2019, and this performance is shown to inch evercloser to human-level performance. An in-depth meta-analysis is presenteddescribing which methods were used and how they faired on the leaderboard, aswell as the characteristics of which cases generally saw good performance, andwhich did not. Overall KiTS21 facilitated a significant advancement in thestate of the art in kidney tumor segmentation, and provides useful insightsthat are applicable to the field of semantic segmentation as a whole.

The KiTS21 Challenge: Automatic segmentation of kidneys, renal tumors, and renal cysts in corticomedullary-phase CT