RDS (Rust DICOM Station) is open-source software for medical imaging and radiotherapy research, analysis, and QA, written entirely in Rust. It loads complete radiotherapy studies (CT, MR and PET series, RTSTRUCT, RTDOSE, photon and ion RTPLAN, DICOM SEG, planar images, spatial and deformable registrations, and treatment records) into an integrated environment for visualization, comparison and quantitative analysis. Beyond the classic linked MPR layout and multi-workspace comparison (up to four studies side by side), RDS provides image registration, structure propagation, DRR generation, dose-volume histograms, 4D motion analysis, interactive and AI-assisted segmentation, 3D visualization, and DICOM editing and export. The entire processing stack is native Rust: functionality normally provided through C/C++ or Python frameworks, including elastix- and plastimatch-style registration, ITK-style ray casting, TotalSegmentator, SegVol, and MedSAM2, is re-implemented directly in Rust without bindings to those frameworks.
Two breathing phases of the bundled 4D-Lung patient as two rows of linked MPR views with their RTSTRUCT contours, and the 3D window showing the RTSTRUCT surfaces together with organs auto-segmented by the built-in TotalSegmentator engine.
- Viewing - parallel DICOM loading (compressed syntaxes included), true patient-space geometry, linked axial / sagittal / coronal views in rows you lay out yourself (up to three panes each, the 3D scene among them), W/L presets, dose colorwash and isodose lines, per-beam plan summaries, planar images (DX / CR / RTIMAGE), dark and light themes. Folders or individual files, and the data does not have to be a volume: a portal image, a structure set or a plan opens on its own, in the ordinary tree, with everything that does not need voxels still working.
- Workspaces - up to four (A - D), one row of panes each; a patient ▶ study ▶ series tree per workspace; copy / move / remove / rename at every level with the reference chains kept intact; RT structure sets and segmentation series as tree nodes, contours and masks converting as they move between them; the crosshair, the slice, the zoom and the players synced across every open workspace.
- Image information - what the displayed series actually is, read back out of its own headers: voxel spacing, slice thickness and the gap or overlap between slices, uneven slice positions, matrix and field of view, gantry tilt, frame of reference, kV / mAs / CTDIvol / kernel, rescale and units - with whatever wants a second look named and explained, and a side by side of what two workspaces disagree about before you register them.
- Playback - ▶ on every viewport: through the slices of a view, and through the phases of a 4D group. Playing a group carries the structure set, the segmentation series and the dose of each phase with it and walks the selection down the group in the tree; the phases are read into memory once (under a budget you set) so it runs as a cine rather than a slideshow, and the 3D window breathes with it.
- Patient archive - a local PACS on plain folders and text sidecars: file a study, list patients without opening a DICOM file, load into either workspace, and send the structures and segmentations you drew back as derived objects under the original Study and Frame of Reference UIDs.
- Registration - rigid and B-spline after elastix (pyramids, stochastic sampling, ASGD), dense B-spline after plastimatch (analytic gradient, bending energy, L-BFGS, mean squares or Mattes mutual information) and plastimatch's landmark warp; any of them restricted to one structure or refined on top of a previous result. Every run reports the Dice of the two images before and after it, per-structure Dice on request, 6 DOF, displacement statistics, Jacobian determinant and folding; the vector field draws in the views and in 3D; fusion overlay; DICOM REG and Deformable Spatial Registration read and written; a known-transform simulator for QA. The 4 × 4 transform can also be typed in by hand and used in place of a recovered one - in the registration, in propagation and in transfer by relationship.
- Structure propagation - contours and segmentations carried through a registration by per-voxel pull-back (no holes, any two grids), optionally refined on an enclosing structure first.
- 4D / motion - phases recognised into 4D groups; the reference phase registered to every other, targets propagated and their centroids tracked; peak-to-peak, drift, correlation with a reference structure, ITV generation, a results window with run-vs-run comparison and CSV export; structure comparison (Dice, HD95, surface distance) and transfer by relationship.
- MCP server -
rds-mcp, a second executable that lets an AI assistant drive the station's tools (load, segment, register, propagate, 4D motion, DVH, export) headlessly over the Model Context Protocol, with a ready-made prompt for heart target propagation; workspaces that still name their patient are refused by default and no tool ever returns identifiers. - DRR - plastimatch's exact Siddon tracer and ITK's interpolating ray-cast on one IEC cone-beam geometry, beam's-eye view from an RTPLAN beam, side by side with their difference.
- Dose-volume histograms - cumulative and differential DVHs of any
structures against any dose, sampled on the structure's own lattice;
D95%/D2cc/V20Gymetrics, protocol constraint checking, CSV export; verified against an analytic phantom. - Segmentation - spacing-aware 2D / 3D brush and eraser, geodesic region growing, undo, live 3D surfaces, mask ⇄ RTSTRUCT, DICOM SEG import and export (binary and fractional). The Structure editor edits a segment as a whole the way it edits a structure: keep the largest piece, fill the holes, grow or shrink by millimetres, or trace it into contours and carry on.
- Structure algebra - union / intersection / subtraction / symmetric difference with margins in patient directions (exact ellipsoids), crop, ring, cleanup.
- Body contour - the EXTERNAL structure without the couch, the chair or the mask, on CT and MR, classically or guided by TotalSegmentator's body network.
- Auto-segmentation - TotalSegmentator v2 rebuilt natively (117 structures): official nnU-Net weights converted without Python, a SIMD CPU engine or a wgpu GPU path (no CUDA), mean Dice 0.9995 against the reference.
- Prompt segmentation - SegVol rebuilt natively: box, click or free-text prompts ("liver", "tumor") for the structures no fixed-class model covers.
- Slice propagation - MedSAM2 (SAM 2.1 with its memory bank) rebuilt natively: box a structure on one slice, refine with include / exclude clicks, follow it through the stack at native resolution.
- Tools - DICOM export with an editable tag table, a model manager for every downloadable weight, a folder anonymizer with consistent UID regeneration, a synthetic RT-study generator; every tool window can be moved to its own monitor, and the structure tools live in the modules panel.
One language, one binary. All image processing runs on the CPU with rayon
and caching; the GPU (wgpu: DX12 / Vulkan / Metal) blits the UI and,
optionally, runs the networks. Long operations run on worker threads with
progress and cancellation. The module map, threading model, geometry
conventions and test suites are in
docs/architecture.md.
Requires a Rust toolchain (https://rustup.rs).
cargo build --release
cargo run --release -- data-test/TCIA_4D-LUNG/P102/4DFBCT+RTS
cargo run --release -- data-test/TCIA_4D-LUNG/P102/4DFBCT+RTS data-test/TCIA_4D-LUNG/P102/4DCBCT
cargo test --release
To try prompt segmentation on the bundled patient: put the crosshair on the
tumor, unfold 💬 Prompt segmentation in the Structure auto tools module
(right panel), prompt Box, ▶ Segment.
The engines fetch their weights on first use into one model folder
(%LOCALAPPDATA%\RustDICOMStation\models on Windows,
~/.local/share/RustDICOMStation/models on Linux,
~/Library/Application Support/RustDICOMStation/models on macOS,
~/snap/rust-dicom-station/common/data/models in the snap,
~/.var/app/io.github.alexprotom.rust-dicom-station/data/RustDICOMStation/models
in the Flatpak), movable from any tool window; each engine also has a headless CLI in examples/.
If the program will not start at all, it is almost certainly one thing: a Windows machine advertising a Vulkan driver that cannot create a device. It now falls back to Direct3D 12 by itself, the installer asks which backend to use, and View ▸ Graphics backend changes it afterwards - see docs/viewer.md.
Windows, Linux, macOS, Android tablets, iPads and iPhones are supported; --no-default-features builds a
CPU-only viewer without the GPU inference backend. Every push to main
publishes a release: a Windows installer
(rust-dicom-station-<version>-windows-x86_64.exe - shortcuts, "Open with"
on folders, the VC++ runtime check, optional weight prefetch, uninstaller),
a Linux AppImage, two macOS disk images
(rust-dicom-station-<version>-macos-arm64.dmg and -macos-x86_64.dmg, both
for macOS 12 Monterey and newer, docs/macos.md) and an
Android APK (rust-dicom-station-<version>-android-arm64.apk,
the same viewer on a tablet, docs/android.md) and an
iOS package (rust-dicom-station-<version>-ios.ipa, iPad and iPhone, iOS 15 and newer,
also to TestFlight when configured, docs/ios.md), and puts the snap into the Snap Store (sudo snap install rust-dicom-station, docs/snap.md); the same program
is on Flathub as io.github.alexprotom.rust-dicom-station
(docs/flatpak.md) and, with a tap configured, in Homebrew
as the cask rust-dicom-station. A newer
installer updates an existing installation in place (no second copy,
nothing to uninstall first), Start ▸ Update Rust
DICOM Station fetches the newest release, and the package is published to
winget as RDS.RustDICOMStation (winget install / winget upgrade). The installer is its own crate in
packaging/windows/installer/. No data at hand? Tools ▶ 📐 Generate test
data writes a complete synthetic RT study, data-test/ ships a real
patient - a ten-phase 4DFBCT with an RT Structure Set per phase and the
matching ten-phase 4DCBCT (docs/example-data.md) -
and Tools ▶ 📥 Download test data fetches that folder from GitHub into an
installed copy.
https://alexprotom.github.io/rust-dicom-station/
| docs/viewer.md | Loading folders and single files, workspaces with no volume, MPR views, workspace tree, the four workspaces and comparing them, interaction reference, the graphics backend |
| docs/rt-objects.md | RTSTRUCT, RTDOSE, RTPLAN, REG, RTRECORD, reference chains |
| docs/registration.md | The four registration engines, local registration, analytics, vector fields, fusion, simulator, verification |
| docs/propagation.md | Carrying contours and segmentations across a registration |
| docs/volumes.md | How every volume is calculated: voxels-based, surface-based, planimetry, propagation - the exact formulas |
| docs/motion-4d.md | 4D groups, the motion / ITV workflow, results, structure comparison and transfer |
| docs/drr.md | Digitally reconstructed radiographs: the two projectors and the geometry |
| docs/dvh.md | Dose-volume histograms: curves, metrics, constraint checking, export |
| docs/segmentation.md | Brush / eraser / region growing, 3D view, mask → RTSTRUCT |
| docs/contours.md | Drawing and editing structures as contours: the draw row and the Structure editor, live wire, smart brush, interpolation, POIs, templates, locking |
| docs/generators.md | Structures without drawing: grey level (HU or SUV), shapes, isodose, field of view |
| docs/structure-algebra.md | Boolean operations, margins, cropping, cleanup |
| docs/body-contour.md | The body / EXTERNAL contour on CT and MR, verification |
| docs/auto-segmentation.md | The pure-Rust TotalSegmentator: models, pipeline, engines, validation, classes, licensing |
| docs/segvol.md | Prompt-driven segmentation: the SegVol re-implementation |
| docs/medsam2.md | Propagating a prompt through a stack: the MedSAM2 re-implementation |
| docs/pacs.md | The local patient archive: window, on-disk layout, filing, loading, sending changes back |
| docs/export-and-tools.md | DICOM export, the model manager, anonymizer, test-data generator and download |
| docs/mcp.md | The MCP server: tools, the heart workflow prompt, patient-identity safety, configuration |
| docs/architecture.md | Design, functional overview, module map, threading, the model folder, conventions, testing |
| docs/release-versioning.md | How versions and releases are produced |
| docs/snap.md | The Linux snap: confinement, where its files are, the MCP server in it, building and publishing |
| docs/flatpak.md | The Flatpak: the sandbox, where its files are, the MCP server in it, building and submitting to Flathub |
| docs/macos.md | The macOS package: the two disk images, the first launch, Metal, where its files are, building, signing, notarisation, Homebrew |
| docs/android.md | The Android package: installing, all files access, what differs on a tablet, where its files are, building and signing |
| docs/ios.md | The iOS package for iPad and iPhone: installing (TestFlight, ad hoc, sideloading), getting studies onto the device, what differs on a tablet and a phone, where its files are, building, signing and releasing |
| docs/example-data.md | Bundled patient data, source and citations |
| packaging/README.md | The packaging folder: one subfolder per platform, what each builds and where |
| packaging/windows/installer/README.md | The Windows installer: building it, what it installs, updating, winget, silent switches |
The code is MIT-licensed, so commercial use is permitted. The MIT License covers this project's own code; the third-party Rust libraries RDS depends on keep their own licences, reproduced in THIRD-PARTY-NOTICES.txt. If you publish work produced with RDS, a citation is appreciated: see CITATION.cff.
The bundled example data is TCIA 4D-Lung patient P102, redistributed under CC BY 3.0 (cite it as described in docs/example-data.md). Auto-segmentation uses TotalSegmentator's Apache-2.0 "total"-task weights (cite Wasserthal et al. (Radiology AI 2023) and nnU-Net (Isensee et al., Nature Methods 2021) as described in docs/auto-segmentation.md). Prompt segmentation re-implements SegVol (Du et al., NeurIPS 2024) and slice propagation MedSAM2 (Ma et al., 2025); their weights are only ever downloaded from Hugging Face to your own machine at your request and are never redistributed; see docs/segvol.md and docs/medsam2.md.
This software is a viewer for research and QA convenience. Not a medical device, neither CE-marked nor FDA-cleared, and not for clinical decision-making. The ADDITIONAL NOTICE in LICENSE.txt states this in full. It is a statement of fact about the software, not a condition of the MIT License, which permits commercial use.