RT-Super: Learning Tumor Segmentation from Longitudinal Images and Reports

Multi-tumor segmentation is important for early cancer detection and allows radiologists to visualize, verify, and understand AI predictions. However, tumor segmentation masks are expensive, time-consuming, and unavailable for many tumor types in public data. Instead, hospitals have vast, readily available data that can guide segmentation: radiology reports, longitudinal images, and multi-phase images. We use this readily available data to substitute for tumor masks in training AI for tumor segmentation. To this end, we propose a new architecture, RT-Super. It has a teacher network, which analyzes the patient's longitudinal images and reports to create high-quality tumor masks. These masks train a student network, which sees a single image and no report. At inference, when longitudinal images and reports are unavailable, we use the student. RT-Super uses a new CNN-Transformer architecture and novel Consistency Losses that exploit tumor location consistency across longitudinal images. We train RT-Super to segment esophagus, uterus and spleen tumors, which have few or no public masks. Even without training masks, RT-Super can segment these tumors and surpass public AI models. Overall, we demonstrate that learning from longitudinal images, multi-phase images, and reports can overcome mask scarcity and advance multi-cancer detection and segmentation. Code: https://github.com/MrGiovanni/RT-Super