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Shadow and Light: Digitally Reconstructed Radiographs for Disease Classification
Benjamin Hou1, Qingqing Zhu2, Tejas Sudarshan Mathai1
1Imaging Biomarkers and Computer-Aided Diagnosis Laboratory, Clinical Center.
Arxiv
|October 1, 2025
Summary
We introduce DRR-RATE, a synthetic chest X-ray dataset with radiology reports and pathology labels. This dataset enables multimodal research and validates AI model performance on diverse pathologies.
Area of Science:
- Medical Imaging
- Artificial Intelligence in Radiology
- Dataset Development
Background:
- Large-scale datasets are crucial for training robust medical AI models.
- Existing chest X-ray datasets may have limitations in view diversity and associated detailed reports.
- Synthetic data generation offers a controllable method to augment real-world medical imaging data.
Purpose of the Study:
- Introduce DRR-RATE, a novel, large-scale synthetic chest X-ray dataset.
- Facilitate research in multimodal AI applications using paired CT, X-ray, text, and labels.
- Evaluate the performance of AI models on this synthetic dataset.
Main Methods:
- Generated 50,188 frontal Digitally Reconstructed Radiographs (DRRs) from the CT-RATE dataset.
- Paired each DRR with radiology text reports and binary labels for 18 pathology classes.
- Utilized DRR generation for controllable inclusion of various imaging views.
Main Results:
- CheXnet achieved sufficient to high AUC scores for six common pathologies when trained/tested on DRR-RATE.
- CheXnet demonstrated accurate out-of-distribution pathology identification when trained on CheXpert.
- Generated DRR images effectively capture pathology features from CT scans.
Conclusions:
- DRR-RATE is a valuable resource for multimodal AI research in medical imaging.
- Synthetic DRRs can effectively represent pathologies for AI model training and validation.
- The dataset supports research into novel AI applications leveraging diverse imaging modalities and reports.

