ReXGroundingCT: A 3D Chest CT Dataset for Segmentation of Findings from Free-Text Reports

We present ReXGroundingCT, the first publicly available dataset to link free-text radiology findings with pixel-level segmentations in 3D chest CT scans that is manually annotated. While prior datasets have relied on structured labels or predefined categories, ReXGroundingCT captures the full expressiveness of clinical language represented in free text and grounds it to spatially localized 3D segmentation annotations in volumetric imaging. This addresses a critical gap in medical AI: the ability to connect complex, descriptive text, such as "3 mm nodule in the left lower lobe", to its precise anatomical location in three-dimensional space, a capability essential for grounded radiology report generation systems. The dataset comprises 3,142 non-contrast chest CT scans paired with standardized radiology reports from the CT-RATE dataset. Using a systematic three-stage pipeline, GPT-4 was used to extract positive lung and pleural findings, which were then manually segmented by expert annotators. A total of 8,028 findings across 16,301 entities were annotated, with quality control performed by board-certified radiologists. Approximately 79% of findings are focal abnormalities, while 21% are non-focal. The training set includes up to three representative segmentations per finding, while the validation and test sets contain exhaustive labels for each finding entity. ReXGroundingCT establishes a new benchmark for developing and evaluating sentence-level grounding and free-text medical segmentation models in chest CT. The dataset can be accessed at https://huggingface.co/datasets/rajpurkarlab/ReXGroundingCT.

RT-SRTS: Angle-Agnostic Real-Time Simultaneous 3D Reconstruction and Tumor Segmentation from Single X-Ray Projection

Radiotherapy is one of the primary treatment methods for tumors, but the organ movement caused by respiratory motion limits its accuracy. Recently, 3D imaging from single X-ray projection receives extensive attentions as a promising way to address this issue. However, current methods can only reconstruct 3D image without direct location of the tumor and are only validated for fixed-angle imaging, which fails to fully meet the requirement of motion control in radiotherapy. In this study, we propose a novel imaging method RT-SRTS which integrates 3D imaging and tumor segmentation into one network based on the multi-task learning (MTL) and achieves real-time simultaneous 3D reconstruction and tumor segmentation from single X-ray projection at any angle. Futhermore, we propose the attention enhanced calibrator (AEC) and uncertain-region elaboration (URE) modules to aid feature extraction and improve segmentation accuracy. We evaluated the proposed method on ten patient cases and compared it with two state-of-the-art methods. Our approach not only delivered superior 3D reconstruction but also demonstrated commendable tumor segmentation results. The simultaneous reconstruction and segmentation could be completed in approximately 70 ms, significantly faster than the required time threshold for real-time tumor tracking. The efficacy of both AEC and URE was also validated through ablation studies.