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EviGround-CT: Sentence-to-Volume Grounding for Verifying LLM-Generated Chest CT Reports

Ziyuan Li Juncheng Ni Feng Li
Oct 2026
Machine Learning Natural Language Processing Computer Vision

Abstract

Chest computed tomography (CT) reports generated by large language models (LLMs) can describe positive findings that lack localized evidence in the scan. We propose EviGround-CT to verify these findings after report generation. A deterministic extractor identifies positive finding sentences, and a 3D grounding model predicts an evidence mask for each sentence. Using the full sentence retains anatomical location, laterality, and descriptive modifiers in the grounding query. We evaluate report generation on CT-RATE, and grounding and verification on a held-out 100-case ReXGroundingCT subset. Using the available annotations, sentence-grounded verification raises evidence-supported precision (ESP) from 0.263 to 0.365 across 137 extracted in-scope positives, compared with category conditioning. The corresponding unsupported positive finding rate falls from 0.737 to 0.635. The paired case-level bootstrap ESP difference is +0.102 (95% confidence interval: [0.028, 0.181]). The predicted masks associate individual report statements with spatial evidence that can be inspected alongside the CT.

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