Daily Papers

Connectionist Temporal Classification (CTC) and attention mechanism are two main approaches used in recent scene text recognition works. Compared with attention-based methods, CTC decoder has a much shorter inference time, yet a lower accuracy. To design an efficient and effective model, we propose the guided training of CTC (GTC), where CTC model learns a better alignment and feature representations from a more powerful attentional guidance. With the benefit of guided training, CTC model achieves robust and accurate prediction for both regular and irregular scene text while maintaining a fast inference speed. Moreover, to further leverage the potential of CTC decoder, a graph convolutional network (GCN) is proposed to learn the local correlations of extracted features. Extensive experiments on standard benchmarks demonstrate that our end-to-end model achieves a new state-of-the-art for regular and irregular scene text recognition and needs 6 times shorter inference time than attentionbased methods.

Optical character recognition (OCR) technology has been widely used in various scenes, as shown in Figure 1. Designing a practical OCR system is still a meaningful but challenging task. In previous work, considering the efficiency and accuracy, we proposed a practical ultra lightweight OCR system (PP-OCR), and an optimized version PP-OCRv2. In order to further improve the performance of PP-OCRv2, a more robust OCR system PP-OCRv3 is proposed in this paper. PP-OCRv3 upgrades the text detection model and text recognition model in 9 aspects based on PP-OCRv2. For text detector, we introduce a PAN module with large receptive field named LK-PAN, a FPN module with residual attention mechanism named RSE-FPN, and DML distillation strategy. For text recognizer, the base model is replaced from CRNN to SVTR, and we introduce lightweight text recognition network SVTR LCNet, guided training of CTC by attention, data augmentation strategy TextConAug, better pre-trained model by self-supervised TextRotNet, UDML, and UIM to accelerate the model and improve the effect. Experiments on real data show that the hmean of PP-OCRv3 is 5% higher than PP-OCRv2 under comparable inference speed. All the above mentioned models are open-sourced and the code is available in the GitHub repository PaddleOCR which is powered by PaddlePaddle.

The gap between speech and text modalities is a major challenge in speech-to-text translation (ST). Different methods have been proposed to reduce this gap, but most of them require architectural changes in ST training. In this work, we propose to mitigate this issue at the pre-training stage, requiring no change in the ST model. First, we show that the connectionist temporal classification (CTC) loss can reduce the modality gap by design. We provide a quantitative comparison with the more common cross-entropy loss, showing that pre-training with CTC consistently achieves better final ST accuracy. Nevertheless, CTC is only a partial solution and thus, in our second contribution, we propose a novel pre-training method combining CTC and optimal transport to further reduce this gap. Our method pre-trains a Siamese-like model composed of two encoders, one for acoustic inputs and the other for textual inputs, such that they produce representations that are close to each other in the Wasserstein space. Extensive experiments on the standard CoVoST-2 and MuST-C datasets show that our pre-training method applied to the vanilla encoder-decoder Transformer achieves state-of-the-art performance under the no-external-data setting, and performs on par with recent strong multi-task learning systems trained with external data. Finally, our method can also be applied on top of these multi-task systems, leading to further improvements for these models. Code and pre-trained models are available at https://github.com/formiel/fairseq.

CTC compressor can be an effective approach to integrate audio encoders to decoder-only models, which has gained growing interest for different speech applications. In this work, we propose a novel CTC compressor based joint speech and text training (CJST) framework for decoder-only ASR. CJST matches speech and text modalities from both directions by exploring a simple modality adaptor and several features of the CTC compressor, including sequence compression, on-the-fly forced peaky alignment and CTC class embeddings. Experimental results on the Librispeech and TED-LIUM2 corpora show that the proposed CJST achieves an effective text injection without the need of duration handling, leading to the best performance for both in-domain and cross-domain scenarios. We also provide a comprehensive study on CTC compressor, covering various compression modes, edge case handling and behavior under both clean and noisy data conditions, which reveals the most robust setting to use CTC compressor for decoder-only models.

We present a state-of-the-art end-to-end Automatic Speech Recognition (ASR) model. We learn to listen and write characters with a joint Connectionist Temporal Classification (CTC) and attention-based encoder-decoder network. The encoder is a deep Convolutional Neural Network (CNN) based on the VGG network. The CTC network sits on top of the encoder and is jointly trained with the attention-based decoder. During the beam search process, we combine the CTC predictions, the attention-based decoder predictions and a separately trained LSTM language model. We achieve a 5-10\% error reduction compared to prior systems on spontaneous Japanese and Chinese speech, and our end-to-end model beats out traditional hybrid ASR systems.

Deep learning models have demonstrated exceptional performance across a wide range of computer vision tasks. However, their performance often degrades significantly when faced with distribution shifts, such as domain or dataset changes. Test-Time Training (TTT) has emerged as an effective method to enhance model robustness by incorporating an auxiliary unsupervised task during training and leveraging it for model updates at test time. In this work, we introduce CTA (Cross-Task Alignment), a novel approach for improving TTT. Unlike existing TTT methods, CTA does not require a specialized model architecture and instead takes inspiration from the success of multi-modal contrastive learning to align a supervised encoder with a self-supervised one. This process enforces alignment between the learned representations of both models, thereby mitigating the risk of gradient interference, preserving the intrinsic robustness of self-supervised learning and enabling more semantically meaningful updates at test-time. Experimental results demonstrate substantial improvements in robustness and generalization over the state-of-the-art on several benchmark datasets.

Connectionist Temporal Classification (CTC) is a widely used method for automatic speech recognition (ASR), renowned for its simplicity and computational efficiency. However, it often falls short in recognition performance. In this work, we propose the Consistency-Regularized CTC (CR-CTC), which enforces consistency between two CTC distributions obtained from different augmented views of the input speech mel-spectrogram. We provide in-depth insights into its essential behaviors from three perspectives: 1) it conducts self-distillation between random pairs of sub-models that process different augmented views; 2) it learns contextual representation through masked prediction for positions within time-masked regions, especially when we increase the amount of time masking; 3) it suppresses the extremely peaky CTC distributions, thereby reducing overfitting and improving the generalization ability. Extensive experiments on LibriSpeech, Aishell-1, and GigaSpeech datasets demonstrate the effectiveness of our CR-CTC. It significantly improves the CTC performance, achieving state-of-the-art results comparable to those attained by transducer or systems combining CTC and attention-based encoder-decoder (CTC/AED). We release our code at https://github.com/k2-fsa/icefall.

Image generation using diffusion models have demonstrated outstanding learning capabilities, effectively capturing the full distribution of the training dataset. They are known to generate wide variations in sampled images, albeit with a trade-off in image fidelity. Guided sampling methods, such as classifier guidance (CG) and classifier-free guidance (CFG), focus sampling in well-learned high-probability regions to generate images of high fidelity, but each has its limitations. CG is computationally expensive due to the use of back-propagation for classifier gradient descent, while CFG, being gradient-free, is more efficient but compromises class label alignment compared to CG. In this work, we propose an efficient guidance method that fully utilizes a pre-trained classifier without using gradient descent. By using the classifier solely in inference mode, a time-adaptive reference class label and corresponding guidance scale are determined at each time step for guided sampling. Experiments on both class-conditioned and text-to-image generation diffusion models demonstrate that the proposed Gradient-free Classifier Guidance (GFCG) method consistently improves class prediction accuracy. We also show GFCG to be complementary to other guided sampling methods like CFG. When combined with the state-of-the-art Autoguidance (ATG), without additional computational overhead, it enhances image fidelity while preserving diversity. For ImageNet 512times512, we achieve a record FD_{DINOv2} of 23.09, while simultaneously attaining a higher classification Precision (94.3%) compared to ATG (90.2%)

We describe the architecture, training methodology and inference speedups of Granite 5.0 Turbo CTC, a 470 million parameter encoder-only model with an excellent speed-accuracy tradeoff. The architecture uses pyramidal temporal subsampling within Conformer blocks using strided depthwise convolutions, block-diagonal (chunk-wise) self-attention, and conditioning on intermediate predictions from the middle layer. Training highlights are the use of only publicly available data, the novel use of a Muon optimizer, and balanced data sampling. Inference speedups include replacing 1 x 1 convolutions with linear layers and optimizing the attention computation in the Conformer blocks. Collectively, these result in a model that is on the speed-accuracy Pareto frontier of the Open ASR leaderboard for English short-form ASR while being twice as fast as the fastest competitor. The model can be used under a permissive license and downloaded from https://huggingface.co/ibm-granite/granite-speech-5.0-470m-turboctc.

The rapid increase of computed tomography (CT) scans and their time-consuming manual analysis have created an urgent need for robust automated analysis techniques in clinical settings. These aim to assist radiologists and help them managing their growing workload. Existing methods typically generate entire reports directly from 3D CT images, without explicitly focusing on observed abnormalities. This unguided approach often results in repetitive content or incomplete reports, failing to prioritize anomaly-specific descriptions. We propose a new anomaly-guided report generation model, which first predicts abnormalities and then generates targeted descriptions for each. Evaluation on a public dataset demonstrates significant improvements in report quality and clinical relevance. We extend our work by conducting an ablation study to demonstrate its effectiveness.

We present a simple and efficient auxiliary loss function for automatic speech recognition (ASR) based on the connectionist temporal classification (CTC) objective. The proposed objective, an intermediate CTC loss, is attached to an intermediate layer in the CTC encoder network. This intermediate CTC loss well regularizes CTC training and improves the performance requiring only small modification of the code and small and no overhead during training and inference, respectively. In addition, we propose to combine this intermediate CTC loss with stochastic depth training, and apply this combination to a recently proposed Conformer network. We evaluate the proposed method on various corpora, reaching word error rate (WER) 9.9% on the WSJ corpus and character error rate (CER) 5.2% on the AISHELL-1 corpus respectively, based on CTC greedy search without a language model. Especially, the AISHELL-1 task is comparable to other state-of-the-art ASR systems based on auto-regressive decoder with beam search.

Generative modeling has experienced substantial progress in recent years, particularly in text-to-image and text-to-video synthesis. However, the medical field has not yet fully exploited the potential of large-scale foundational models for synthetic data generation. In this paper, we introduce GenerateCT, the first method for text-conditional computed tomography (CT) generation, addressing the limitations in 3D medical imaging research and making our entire framework open-source. GenerateCT consists of a pre-trained large language model, a transformer-based text-conditional 3D chest CT generation architecture, and a text-conditional spatial super-resolution diffusion model. We also propose CT-ViT, which efficiently compresses CT volumes while preserving auto-regressiveness in-depth, enabling the generation of 3D CT volumes with variable numbers of axial slices. Our experiments demonstrate that GenerateCT can produce realistic, high-resolution, and high-fidelity 3D chest CT volumes consistent with medical language text prompts. We further investigate the potential of GenerateCT by training a model using generated CT volumes for multi-abnormality classification of chest CT volumes. Our contributions provide a valuable foundation for future research in text-conditional 3D medical image generation and have the potential to accelerate advancements in medical imaging research. Our code, pre-trained models, and generated data are available at https://github.com/ibrahimethemhamamci/GenerateCT.

In contrast to Connectionist Temporal Classification (CTC) approaches, Sequence-To-Sequence (S2S) models for Handwritten Text Recognition (HTR) suffer from errors such as skipped or repeated words which often occur at the end of a sequence. In this paper, to combine the best of both approaches, we propose to use the CTC-Prefix-Score during S2S decoding. Hereby, during beam search, paths that are invalid according to the CTC confidence matrix are penalised. Our network architecture is composed of a Convolutional Neural Network (CNN) as visual backbone, bidirectional Long-Short-Term-Memory-Cells (LSTMs) as encoder, and a decoder which is a Transformer with inserted mutual attention layers. The CTC confidences are computed on the encoder while the Transformer is only used for character-wise S2S decoding. We evaluate this setup on three HTR data sets: IAM, Rimes, and StAZH. On IAM, we achieve a competitive Character Error Rate (CER) of 2.95% when pretraining our model on synthetic data and including a character-based language model for contemporary English. Compared to other state-of-the-art approaches, our model requires about 10-20 times less parameters. Access our shared implementations via this link to GitHub: https://github.com/Planet-AI-GmbH/tfaip-hybrid-ctc-s2s.

Algorithmic efficiency techniques such as distillation (hinton2015distillation) are useful in improving model quality without increasing serving costs, provided a larger teacher model is available for a smaller student model to learn from during training. Standard distillation methods are limited to only forcing the student to match the teacher's outputs. Given the costs associated with training a large model, we believe we should be extracting more useful information from a teacher model than by just making the student match the teacher's outputs. In this paper, we introduce \guide (Guided Initialization and Distillation of Embeddings). \guide can be considered a distillation technique that forces the student to match the teacher in the parameter space. Using \guide we show 25-26\% reduction in the teacher-student quality gap when using large student models (400M - 1B parameters) trained on approx 20B tokens. We also present a thorough analysis demonstrating that \guide can be combined with knowledge distillation with near additive improvements. Furthermore, we show that applying \guide alone leads to substantially better model quality than applying knowledge distillation by itself. Most importantly, \guide introduces no training or inference overhead and hence any model quality gains from our method are virtually free.

Camera-controllable video generation aims to synthesize videos with flexible and physically plausible camera movements. However, existing methods either provide imprecise camera control from text prompts or rely on labor-intensive manual camera trajectory parameters, limiting their use in automated scenarios. To address these issues, we propose a novel Vision-Language-Camera model, termed CT-1 (Camera Transformer 1), a specialized model designed to transfer spatial reasoning knowledge to video generation by accurately estimating camera trajectories. Built upon vision-language modules and a Diffusion Transformer model, CT-1 employs a Wavelet-based Regularization Loss in the frequency domain to effectively learn complex camera trajectory distributions. These trajectories are integrated into a video diffusion model to enable spatially aware camera control that aligns with user intentions. To facilitate the training of CT-1, we design a dedicated data curation pipeline and construct CT-200K, a large-scale dataset containing over 47M frames. Experimental results demonstrate that our framework successfully bridges the gap between spatial reasoning and video synthesis, yielding faithful and high-quality camera-controllable videos and improving camera control accuracy by 25.7% over prior methods.

Open-ended scientific discovery often requires repeatedly proposing and evaluating candidate solutions. LLM-based systems can support this process by generating and refining executable solutions from verifier feedback. Methods such as TTT-Discover use test-time training (TTT) to update the solution-generating LLM from verifier feedback, adapting its generation policy to improve subsequent proposals on the target problem. However, this becomes expensive when reliable execution requires a large model, since training must maintain gradients, optimizer states, and policy statistics while repeatedly generating long, structured outputs. It also complicates credit assignment: outcome-level verifier feedback must jointly evaluate the high-level strategy and its low-level implementation. In this work, we introduce Guidance-TTT, which separates these roles. A compact guidance model is trained at test time to propose high-level strategic changes, while a frozen execution model implements them as complete executable solutions. At each step, the system selects a promising previously discovered solution, proposes a change, executes and verifies it, and updates only the guidance model using an adaptive group-relative RL objective. This concentrates test-time learning on short strategic decisions while retaining the implementation capability of a substantially stronger model without adapting it. Without web access, Guidance-TTT produces strong solutions across four distinct domains: combinatorial optimization (Polyomino Packing), heuristic programming (AHC058), machine learning (Lasso), and GPU kernel optimization (TriMul). Across these tasks, it outperforms the best solutions reported in prior work while remaining competitive with state-of-the-art results on public online leaderboards. Code is available at https://github.com/Human-Agent-Society/reef/tree/guidance-ttt-support.

Collecting audio-text pairs is expensive; however, it is much easier to access text-only data. Unless using shallow fusion, end-to-end automatic speech recognition (ASR) models require architecture modifications or additional training schemes to use text-only data. Inspired by recent advances in decoder-only language models (LMs), such as GPT-3 and PaLM adopted for speech-processing tasks, we propose using a decoder-only architecture for ASR with simple text augmentation. To provide audio information, encoder features compressed by CTC prediction are used as prompts for the decoder, which can be regarded as refining CTC prediction using the decoder-only model. Because the decoder architecture is the same as an autoregressive LM, it is simple to enhance the model by leveraging external text data with LM training. An experimental comparison using LibriSpeech and Switchboard shows that our proposed models with text augmentation training reduced word error rates from ordinary CTC by 0.3% and 1.4% on LibriSpeech test-clean and testother set, respectively, and 2.9% and 5.0% on Switchboard and CallHome. The proposed model had advantage on computational efficiency compared with conventional encoder-decoder ASR models with a similar parameter setup, and outperformed them on the LibriSpeech 100h and Switchboard training scenarios.

Large language models (LLMs) are increasingly expected to orchestrate diverse tools over long-horizon tasks. Existing agents typically use Direct Tool Calling (DTC), where the model invokes tools sequentially, and tool responses accumulate in the model context, which can lead to context rot and orchestration breakdown. In contrast, Programmatic Tool Calling (PTC) invokes tools through executable code and stores intermediate results in runtime variables rather than appending them to the context. Prior work has explored PTC mainly as an inference-time optimization, but its benefits for agentic training remain unclear, and suitable verifiable training tasks are scarce. In this work, we introduce ProgAgent, a full PTC training stack, comprising a pipeline for synthesizing verifiable long-horizon tasks, a lightweight PTC runtime, and a two-stage training recipe. Using only 215 tasks instantiated at four environment scales, ProgAgent yields higher pass rates than the evaluated baselines of comparable size across four benchmarks. On LOCA-bench, ProgAgent-14B achieves a 30.7% pass rate at a 64k-token environment state, where these baselines score zero. Cross-harness experiments show that PTC-trained models outperform DTC-trained models under both evaluation interfaces, suggesting that the benefits of PTC training extend beyond the interface.

Typical diffusion models are trained to accept a particular form of conditioning, most commonly text, and cannot be conditioned on other modalities without retraining. In this work, we propose a universal guidance algorithm that enables diffusion models to be controlled by arbitrary guidance modalities without the need to retrain any use-specific components. We show that our algorithm successfully generates quality images with guidance functions including segmentation, face recognition, object detection, and classifier signals. Code is available at https://github.com/arpitbansal297/Universal-Guided-Diffusion.

Computed tomography (CT) is a central to three-dimensional medical imaging, yet CT-based artificial intelligence remains fragmented across task-specific models for segmentation, classification, registration, and report analysis. Here we present FlexiCT, a family of CT foundation models trained by agglomerative continual pretraining on 266,227 CT volumes from 56 publicly available datasets, forming a large-scale public resource for CT representation learning. FlexiCT uses agglomerative pretraining across three stages: two-dimensional axial pretraining, three-dimensional anatomical pretraining and report-guided semantic alignment. This training strategy supports slice-level, volume-level and vision-language analysis. Across five downstream task families (segmentation, classification, registration, vision-language understanding and clinical retrieval), FlexiCT matches or exceeds prior task-specific approaches on multiple benchmarks. Its embeddings further organize CT scans along gradients associated with various tumor stages, suggesting that CT foundation models can capture imaging features relevant to disease phenotype characterization. Code is available at https://github.com/ricklisz/FlexiCT

Supervised synthetic CT (sCT) generation is commonly trained and evaluated as voxel-wise regression against registered reference CT images. In practice, MRI-CT and CBCT-CT pairs are aligned through registration procedures that leave residual misalignments. These residuals are not independent intensity noise but spatially coherent geometric discrepancies that act as structured label noise. We investigate how this registration-induced bias affects supervised MRI-to-CT and CBCT-to-CT synthesis on 1,784 paired patients covering five anatomical regions. Voxel-wise scores strongly depend on the consistency between the registration used to build the training targets and the one used for evaluation: models score best when both conventions match, showing that networks partly learn the geometric convention of the registration pipeline and that standard metrics reward it. Training on more anatomically consistent registrations reduces prediction variability and improves out-of-distribution robustness, and CT-only controls show that registration alone produces metric errors in the range of top challenge submissions. To mitigate the limits of voxel-wise supervision, we introduce a perceptual loss computed in the feature space of a pretrained Segment Anything encoder. Compared with MAE-only and VGG-based objectives, it improves downstream segmentation and yields sharper, more structurally coherent sCT. Perceptual and voxel-wise metrics disagree under imperfect alignment and agree when the evaluation geometry is reliable. These results identify registration-induced bias as a central confounder in supervised sCT generation and argue for complementing voxel-wise agreement with anatomy-oriented evaluation criteria.

Connectionist temporal classification (CTC)-based scene text recognition (STR) methods, e.g., SVTR, are widely employed in OCR applications, mainly due to their simple architecture, which only contains a visual model and a CTC-aligned linear classifier, and therefore fast inference. However, they generally exhibit worse accuracy than encoder-decoder-based methods (EDTRs) due to struggling with text irregularity and linguistic missing. To address these challenges, we propose SVTRv2, a CTC model endowed with the ability to handle text irregularities and model linguistic context. First, a multi-size resizing strategy is proposed to resize text instances to appropriate predefined sizes, effectively avoiding severe text distortion. Meanwhile, we introduce a feature rearrangement module to ensure that visual features accommodate the requirement of CTC, thus alleviating the alignment puzzle. Second, we propose a semantic guidance module. It integrates linguistic context into the visual features, allowing CTC model to leverage language information for accuracy improvement. This module can be omitted at the inference stage and would not increase the time cost. We extensively evaluate SVTRv2 in both standard and recent challenging benchmarks, where SVTRv2 is fairly compared to popular STR models across multiple scenarios, including different types of text irregularity, languages, long text, and whether employing pretraining. SVTRv2 surpasses most EDTRs across the scenarios in terms of accuracy and inference speed. Code: https://github.com/Topdu/OpenOCR.

Recent 3D CT vision-language models align volumes with reports via contrastive pretraining, but typically rely on limited public data and provide only coarse global supervision. We train a 3D CT vision-language model on 98k report-volume pairs (50k patients) collected at a single hospital, combined with public datasets, using SigLIP-style contrastive pretraining together with prompt-based disease supervision in the shared vision-text embedding space. On CT-RATE, our model achieves state-of-the-art text-to-image retrieval (R@10 31.5 vs. 22.2) and competitive disease classification (AUC 83.8 vs. 83.8), with consistent results on Rad-ChestCT (AUC 77.0 vs. 77.3). We further observe that radiologists routinely reference specific images within their reports (e.g., ``series X, image Y''), linking textual descriptions to precise axial locations. We automatically mine 262k such snippet-slice pairs and introduce the task of intra-scan snippet localization -- predicting the axial depth referred to by a text snippet -- reducing mean absolute error to 36.3 mm at 12 mm feature resolution, compared with 67.0 mm for the best baseline. Adding this localization objective leaves retrieval and classification broadly unchanged within confidence bounds, yielding a single unified model for retrieval, classification, and intra-scan grounding.

We present NV-Reason-CT, a generative vision--language model for chest and abdominal CT combining native 3D visual encoding with radiologist-guided reasoning. The model couples a native 3D vision transformer with a language model, passing all visual tokens and their explicit 3D coordinates into language decoding without further spatial token merging. This retains volumetric spatial information within the vision encoder and through the language model's positional encoding during joint processing with text. We train on a curated corpus of approximately 550,000 multimodal instruction examples from 70,111 unique CT image inputs, combining standardized reports, abnormality-focused and anatomy-specific questions, multi-turn interactions, and radiologist-authored reasoning from recorded and transcribed expert CT interpretations. Expert annotations provide direct supervision and guide additional report-grounded synthetic reasoning. End-to-end supervised fine-tuning (SFT) is followed by Group Relative Policy Optimization (GRPO), with verifiable rewards over chest and abdominal abnormality sets. The model supports abnormality classification, report generation, and interactive reasoning with reviewable observations, differential diagnoses, and uncertainty. Evaluation spans public CT benchmarks and a held-out NIH cohort. On CT-RATE, NV-Reason-CT achieves a macro-F1 of 0.614 and macro-AUROC of 0.871 without a task-specific classification head; generated reports achieve a report-derived macro-F1 of 0.592. In a preliminary study with expert radiologists, AI-assisted review received favorable confidence ratings and was associated with a 50% reduction in average reported interpretation and reporting time. We release the model and training code to support reproducible research on explainable AI for volumetric medical imaging.

Continual Test-Time Adaptation (CTTA) aims to adapt a pretrained model to ever-changing environments during the test time under continuous domain shifts. Most existing CTTA approaches are based on the Mean Teacher (MT) structure, which contains a student and a teacher model, where the student is updated using the pseudo-labels from the teacher model, and the teacher is then updated by exponential moving average strategy. However, these methods update the MT model indiscriminately on all parameters of the model. That is, some critical parameters involving sharing knowledge across different domains may be erased, intensifying error accumulation and catastrophic forgetting. In this paper, we introduce Parameter-Selective Mean Teacher (PSMT) method, which is capable of effectively updating the critical parameters within the MT network under domain shifts. First, we introduce a selective distillation mechanism in the student model, which utilizes past knowledge to regularize novel knowledge, thereby mitigating the impact of error accumulation. Second, to avoid catastrophic forgetting, in the teacher model, we create a mask through Fisher information to selectively update parameters via exponential moving average, with preservation measures applied to crucial parameters. Extensive experimental results verify that PSMT outperforms state-of-the-art methods across multiple benchmark datasets. Our code is available at https://github.com/JiaxuTian/PSMT.

Automated radiology report generation from 3D computed tomography (CT) volumes is challenging due to extreme sequence lengths, severe class imbalance, and the tendency of large language models (LLMs) to ignore visual tokens in favor of linguistic priors. We present Ker-VLJEPA-3B, a four-phase curriculum learning framework for free-text report generation from thoracic CT volumes. A phased training curriculum progressively adapts a Llama 3.2 3B decoder to ground its output in visual features from a frozen, self-supervised encoder. Our visual backbone (LeJEPA ViT-Large) is trained via self-supervised joint-embedding prediction on unlabeled CTs, without text supervision. Unlike contrastive models (CLIP, BiomedCLIP), this language-free backbone yields modality-pure representations. Vision-language alignment is deferred to the curriculum's bridge and generation phases. This modality-agnostic design can integrate any self-supervised encoder into an LLM without paired text during foundation training. Methodological innovations include: (1) zone-constrained cross-attention compressing slice embeddings into 32 spatially-grounded visual tokens; (2) PCA whitening of anisotropic LLM embeddings; (3) a positive-findings-only strategy eliminating posterior collapse; (4) warm bridge initialization transferring projection weights; and (5) selective cross-attention freezing with elastic weight consolidation to prevent catastrophic forgetting. Evaluated on the CT-RATE benchmark (2,984 validation volumes, 18 classes), Ker-VLJEPA-3B achieves a macro F1 of 0.429, surpassing the state-of-the-art (U-VLM, macro F1 = 0.414) by 3.6%, and reaching 0.448 (+8.2%) with threshold optimization. Ablation studies confirm 56.6% of generation quality derives from patient-specific visual content. Code and weights are available.

Knowledge Distillation (KD) compresses computationally expensive pre-trained language models (PLMs) by transferring their knowledge to smaller models, allowing their use in resource-constrained or real-time settings. However, most smaller models fail to surpass the performance of the original larger model, resulting in sacrificing performance to improve inference speed. To address this issue, we propose Co-Training and Co-Distillation (CTCD), a novel framework that improves performance and inference speed together by co-training two models while mutually distilling knowledge. The CTCD framework successfully achieves this based on two significant findings: 1) Distilling knowledge from the smaller model to the larger model during co-training improves the performance of the larger model. 2) The enhanced performance of the larger model further boosts the performance of the smaller model. The CTCD framework shows promise as it can be combined with existing techniques like architecture design or data augmentation, replacing one-way KD methods, to achieve further performance improvement. Extensive ablation studies demonstrate the effectiveness of CTCD, and the small model distilled by CTCD outperforms the original larger model by a significant margin of 1.66 on the GLUE benchmark.

Connectionist Temporal Classification (CTC) is a widely used criterion for training supervised sequence-to-sequence (seq2seq) models. It enables learning the relations between input and output sequences, termed alignments, by marginalizing over perfect alignments (that yield the ground truth), at the expense of imperfect alignments. This binary differentiation of perfect and imperfect alignments falls short of capturing other essential alignment properties that hold significance in other real-world applications. Here we propose Align With Purpose, a general Plug-and-Play framework for enhancing a desired property in models trained with the CTC criterion. We do that by complementing the CTC with an additional loss term that prioritizes alignments according to a desired property. Our method does not require any intervention in the CTC loss function, enables easy optimization of a variety of properties, and allows differentiation between both perfect and imperfect alignments. We apply our framework in the domain of Automatic Speech Recognition (ASR) and show its generality in terms of property selection, architectural choice, and scale of training dataset (up to 280,000 hours). To demonstrate the effectiveness of our framework, we apply it to two unrelated properties: emission time and word error rate (WER). For the former, we report an improvement of up to 570ms in latency optimization with a minor reduction in WER, and for the latter, we report a relative improvement of 4.5% WER over the baseline models. To the best of our knowledge, these applications have never been demonstrated to work on a scale of data as large as ours. Notably, our method can be implemented using only a few lines of code, and can be extended to other alignment-free loss functions and to domains other than ASR.

Agentic (tool-using) language models are mainly trained on tool-call traces and agent trajectories during post-training. These data provide direct behavioral supervision, but producing them requires task environments, execution, and verification, making broad tool and task coverage expensive. Publicly available skills offer another source of training data: they encode reusable tool semantics and workflows but are typically used only as inference-time context. We introduce Skill Pre-Training (SPT), a mid-training method that applies causal language modeling to SkillCorpus, a collection of public multi-file skill packages, optionally mixed with general data. To preserve relations among files within each package, we also introduce Reference Insert, a reference-aware assembly strategy that places supporting files near their mentions in the primary instruction. Experiments across multiple model scales and post-training recipes show that SPT consistently improves agentic performance over mid-training on general or trajectory data, while largely preserving general performance. Data mixture experiments show additional benefits from combining skill data with general annealing corpora. These results indicate that skill packages are a valuable data source for pre-training agentic language models.

Most existing distillation methods ignore the flexible role of the temperature in the loss function and fix it as a hyper-parameter that can be decided by an inefficient grid search. In general, the temperature controls the discrepancy between two distributions and can faithfully determine the difficulty level of the distillation task. Keeping a constant temperature, i.e., a fixed level of task difficulty, is usually sub-optimal for a growing student during its progressive learning stages. In this paper, we propose a simple curriculum-based technique, termed Curriculum Temperature for Knowledge Distillation (CTKD), which controls the task difficulty level during the student's learning career through a dynamic and learnable temperature. Specifically, following an easy-to-hard curriculum, we gradually increase the distillation loss w.r.t. the temperature, leading to increased distillation difficulty in an adversarial manner. As an easy-to-use plug-in technique, CTKD can be seamlessly integrated into existing knowledge distillation frameworks and brings general improvements at a negligible additional computation cost. Extensive experiments on CIFAR-100, ImageNet-2012, and MS-COCO demonstrate the effectiveness of our method. Our code is available at https://github.com/zhengli97/CTKD.

Understanding radiologists' eye movement during Computed Tomography (CT) reading is crucial for developing effective interpretable computer-aided diagnosis systems. However, CT research in this area has been limited by the lack of publicly available eye-tracking datasets and the three-dimensional complexity of CT volumes. To address these challenges, we present the first publicly available eye gaze dataset on CT, called CT-ScanGaze. Then, we introduce CT-Searcher, a novel 3D scanpath predictor designed specifically to process CT volumes and generate radiologist-like 3D fixation sequences, overcoming the limitations of current scanpath predictors that only handle 2D inputs. Since deep learning models benefit from a pretraining step, we develop a pipeline that converts existing 2D gaze datasets into 3D gaze data to pretrain CT-Searcher. Through both qualitative and quantitative evaluations on CT-ScanGaze, we demonstrate the effectiveness of our approach and provide a comprehensive assessment framework for 3D scanpath prediction in medical imaging.

Self-supervised learning (SSL) has shown promise in learning representations of audio that are useful for automatic speech recognition (ASR). But, training SSL models like wav2vec~2.0 requires a two-stage pipeline. In this paper we demonstrate a single-stage training of ASR models that can utilize both unlabeled and labeled data. During training, we alternately minimize two losses: an unsupervised masked Contrastive Predictive Coding (CPC) loss and the supervised audio-to-text alignment loss Connectionist Temporal Classification (CTC). We show that this joint training method directly optimizes performance for the downstream ASR task using unsupervised data while achieving similar word error rates to wav2vec~2.0 on the Librispeech 100-hour dataset. Finally, we postulate that solving the contrastive task is a regularization for the supervised CTC loss.

We propose Guided-TTS, a high-quality text-to-speech (TTS) model that does not require any transcript of target speaker using classifier guidance. Guided-TTS combines an unconditional diffusion probabilistic model with a separately trained phoneme classifier for classifier guidance. Our unconditional diffusion model learns to generate speech without any context from untranscribed speech data. For TTS synthesis, we guide the generative process of the diffusion model with a phoneme classifier trained on a large-scale speech recognition dataset. We present a norm-based scaling method that reduces the pronunciation errors of classifier guidance in Guided-TTS. We show that Guided-TTS achieves a performance comparable to that of the state-of-the-art TTS model, Grad-TTS, without any transcript for LJSpeech. We further demonstrate that Guided-TTS performs well on diverse datasets including a long-form untranscribed dataset.

Large language models generate fluent texts and can follow natural language instructions to solve a wide range of tasks without task-specific training. Nevertheless, it is notoriously difficult to control their generation to satisfy the various constraints required by different applications. In this work, we present InstructCTG, a controlled text generation framework that incorporates different constraints by conditioning on natural language descriptions and demonstrations of the constraints. In particular, we first extract the underlying constraints of natural texts through a combination of off-the-shelf NLP tools and simple heuristics. We then verbalize the constraints into natural language instructions to form weakly supervised training data. By prepending natural language descriptions of the constraints and a few demonstrations, we fine-tune a pre-trained language model to incorporate various types of constraints. Compared to existing search-based or score-based methods, InstructCTG is more flexible to different constraint types and has a much smaller impact on the generation quality and speed because it does not modify the decoding procedure. Additionally, InstructCTG allows the model to adapt to new constraints without re-training through the use of few-shot task generalization and in-context learning abilities of instruction-tuned language models.

Generating synthetic Computed Tomography (CT) images from Cone Beam Computed Tomography (CBCT) is desirable for improving the image quality of CBCT. Existing synthetic CT (sCT) generation methods using Convolutional Neural Networks (CNN) and Transformers often face difficulties in effectively capturing both global and local features and contrasts for high-quality sCT generation. In this work, we propose a Global-Local Feature and Contrast learning (GLFC) framework for sCT generation. First, a Mamba-Enhanced UNet (MEUNet) is introduced by integrating Mamba blocks into the skip connections of a high-resolution UNet for effective global and local feature learning. Second, we propose a Multiple Contrast Loss (MCL) that calculates synthetic loss at different intensity windows to improve quality for both soft tissues and bone regions. Experiments on the SynthRAD2023 dataset demonstrate that GLFC improved the SSIM of sCT from 77.91% to 91.50% compared with the original CBCT, and significantly outperformed several existing methods for sCT generation. The code is available at https://github.com/HiLab-git/GLFC

Time accurate speech transcription is essential in critical appli- cations, such as medical conversation transcription, reading as- sessment, and atypical speech recognition. Encoder-decoder auto- matic speech recognition models, such as Whisper, do not produce word-level timestamps out-of-the-box for all languages. Existing approaches to word-level time stamp estimation either use an exter- nal CTC model capable of frame level phoneme/character prediction which is computationally expensive, or use the cross attention scores internal to the model which gives coarse time stamps. We consider timestamped speech transcription for Hindi in this paper. We pro- pose a CTC-based approach, in which we train a low-complexity character level CTC head directly on the Whisper encoder output, to address the complexity and granularity limitations of existing works. We evaluate the system using manually-annotated word-level times- tamps. Experiments show that the proposed internal-CTC based approach performs similar to using an external CTC model and better than the cross attention score-based approaches. Further, we study the usage of CTC-head output to detect and mitigate hallu- cinations in conversational speech. Our results show that a simple token length criterion derived from the CTC output can improve the transcription quality for short segments where hallucinations are more probable.

Objective: While recent advances in text-conditioned generative models have enabled the synthesis of realistic medical images, progress has been largely confined to 2D modalities such as chest X-rays. Extending text-to-image generation to volumetric Computed Tomography (CT) remains a significant challenge, due to its high dimensionality, anatomical complexity, and the absence of robust frameworks that align vision-language data in 3D medical imaging. Methods: We introduce a novel architecture for Text-to-CT generation that combines a latent diffusion model with a 3D contrastive vision-language pretraining scheme. Our approach leverages a dual-encoder CLIP-style model trained on paired CT volumes and radiology reports to establish a shared embedding space, which serves as the conditioning input for generation. CT volumes are compressed into a low-dimensional latent space via a pretrained volumetric VAE, enabling efficient 3D denoising diffusion without requiring external super-resolution stages. Results: We evaluate our method on the CT-RATE dataset and conduct a comprehensive assessment of image fidelity, clinical relevance, and semantic alignment. Our model achieves competitive performance across all tasks, significantly outperforming prior baselines for text-to-CT generation. Moreover, we demonstrate that CT scans synthesized by our framework can effectively augment real data, improving downstream diagnostic performance. Conclusion: Our results show that modality-specific vision-language alignment is a key component for high-quality 3D medical image generation. By integrating contrastive pretraining and volumetric diffusion, our method offers a scalable and controllable solution for synthesizing clinically meaningful CT volumes from text, paving the way for new applications in data augmentation, medical education, and automated clinical simulation.

Training-free guided generation is a widely used and powerful technique that allows the end user to exert further control over the generative process of flow/diffusion models. Generally speaking, two families of techniques have emerged for solving this problem for gradient-based guidance: namely, posterior guidance (i.e., guidance via projecting the current sample to the target distribution via the target prediction model) and end-to-end guidance (i.e., guidance by performing backpropagation throughout the entire ODE solve). In this work, we show that these two seemingly separate families can actually be unified by looking at posterior guidance as a greedy strategy of end-to-end guidance. We explore the theoretical connections between these two families and provide an in-depth theoretical of these two techniques relative to the continuous ideal gradients. Motivated by this analysis we then show a method for interpolating between these two families enabling a trade-off between compute and accuracy of the guidance gradients. We then validate this work on several inverse image problems and property-guided molecular generation.

Recent progress in vision-language modeling for 3D medical imaging has been fueled by large-scale computed tomography (CT) corpora with paired free-text reports, stronger architectures, and powerful pretrained models. This has enabled applications such as automated report generation and text-conditioned 3D image synthesis. Yet, current approaches struggle with high-resolution, long-sequence volumes: contrastive pretraining often yields vision encoders that are misaligned with clinical language, and slice-wise tokenization blurs fine anatomy, reducing diagnostic performance on downstream tasks. We introduce BTB3D (Better Tokens for Better 3D), a causal convolutional encoder-decoder that unifies 2D and 3D training and inference while producing compact, frequency-aware volumetric tokens. A three-stage training curriculum enables (i) local reconstruction, (ii) overlapping-window tiling, and (iii) long-context decoder refinement, during which the model learns from short slice excerpts yet generalizes to scans exceeding 300 slices without additional memory overhead. BTB3D sets a new state-of-the-art on two key tasks: it improves BLEU scores and increases clinical F1 by 40% over CT2Rep, CT-CHAT, and Merlin for report generation; and it reduces FID by 75% and halves FVD compared to GenerateCT and MedSyn for text-to-CT synthesis, producing anatomically consistent 512*512*241 volumes. These results confirm that precise three-dimensional tokenization, rather than larger language backbones alone, is essential for scalable vision-language modeling in 3D medical imaging. The codebase is available at: https://github.com/ibrahimethemhamamci/BTB3D

Consistency Training (CT) has recently emerged as a promising alternative to diffusion models, achieving competitive performance in image generation tasks. However, non-distillation consistency training often suffers from high variance and instability, and analyzing and improving its training dynamics is an active area of research. In this work, we propose a novel CT training approach based on the Flow Matching framework. Our main contribution is a trained noise-coupling scheme inspired by the architecture of Variational Autoencoders (VAE). By training a data-dependent noise emission model implemented as an encoder architecture, our method can indirectly learn the geometry of the noise-to-data mapping, which is instead fixed by the choice of the forward process in classical CT. Empirical results across diverse image datasets show significant generative improvements, with our model outperforming baselines and achieving the state-of-the-art (SoTA) non-distillation CT FID on CIFAR-10, and attaining FID on par with SoTA on ImageNet at 64 times 64 resolution in 2-step generation. Our code is available at https://github.com/sony/vct .

We present a new algorithm, Cross-Episodic Curriculum (CEC), to boost the learning efficiency and generalization of Transformer agents. Central to CEC is the placement of cross-episodic experiences into a Transformer's context, which forms the basis of a curriculum. By sequentially structuring online learning trials and mixed-quality demonstrations, CEC constructs curricula that encapsulate learning progression and proficiency increase across episodes. Such synergy combined with the potent pattern recognition capabilities of Transformer models delivers a powerful cross-episodic attention mechanism. The effectiveness of CEC is demonstrated under two representative scenarios: one involving multi-task reinforcement learning with discrete control, such as in DeepMind Lab, where the curriculum captures the learning progression in both individual and progressively complex settings; and the other involving imitation learning with mixed-quality data for continuous control, as seen in RoboMimic, where the curriculum captures the improvement in demonstrators' expertise. In all instances, policies resulting from CEC exhibit superior performance and strong generalization. Code is open-sourced at https://cec-agent.github.io/ to facilitate research on Transformer agent learning.

Model-based reconstruction employing the time separation technique (TST) was found to improve dynamic perfusion imaging of the liver using C-arm cone-beam computed tomography (CBCT). To apply TST using prior knowledge extracted from CT perfusion data, the liver should be accurately segmented from the CT scans. Reconstructions of primary and model-based CBCT data need to be segmented for proper visualisation and interpretation of perfusion maps. This research proposes Turbolift learning, which trains a modified version of the multi-scale Attention UNet on different liver segmentation tasks serially, following the order of the trainings CT, CBCT, CBCT TST - making the previous trainings act as pre-training stages for the subsequent ones - addressing the problem of limited number of datasets for training. For the final task of liver segmentation from CBCT TST, the proposed method achieved an overall Dice scores of 0.874pm0.031 and 0.905pm0.007 in 6-fold and 4-fold cross-validation experiments, respectively - securing statistically significant improvements over the model, which was trained only for that task. Experiments revealed that Turbolift not only improves the overall performance of the model but also makes it robust against artefacts originating from the embolisation materials and truncation artefacts. Additionally, in-depth analyses confirmed the order of the segmentation tasks. This paper shows the potential of segmenting the liver from CT, CBCT, and CBCT TST, learning from the available limited training data, which can possibly be used in the future for the visualisation and evaluation of the perfusion maps for the treatment evaluation of liver diseases.

Non-autoregressive automatic speech recognition (ASR) modeling has received increasing attention recently because of its fast decoding speed and superior performance. Among representatives, methods based on the connectionist temporal classification (CTC) are still a dominating stream. However, the theoretically inherent flaw, the assumption of independence between tokens, creates a performance barrier for the school of works. To mitigate the challenge, we propose a context-aware knowledge transferring strategy, consisting of a knowledge transferring module and a context-aware training strategy, for CTC-based ASR. The former is designed to distill linguistic information from a pre-trained language model, and the latter is framed to modulate the limitations caused by the conditional independence assumption. As a result, a knowledge-injected context-aware CTC-based ASR built upon the wav2vec2.0 is presented in this paper. A series of experiments on the AISHELL-1 and AISHELL-2 datasets demonstrate the effectiveness of the proposed method.

Effective long-context modeling is not merely about retaining more of the past, but about preserving the information that may prove relevant later. Test-time training (TTT) is an appealing approach that performs online parameter updates for long-context modeling, yet existing TTT methods only optimize either reconstruction or online adaptation objectives without considering the future utility of retained information. In this work, we propose Test-Time Context Distillation (TTCD), a TTT framework that introduces a self-supervised objective for allocating limited memory capacity for future use. Specifically, TTCD uses a long-window teacher to supervise the fast weights of a short-window student, where the hidden-state discrepancy between them offers a dense, self-supervised signal guiding the model to memorize the contextual information crucial for future token predictions. We focus on an in-place variant: In-Place TTCD (IP-TTCD), which uses the existing MLP parameters as the fast weights. Experiments on long-context language modeling tasks show IP-TTCD consistently outperforms DeltaNet, Gated DeltaNet, sliding-window attention, and TTT when pre-trained from scratch. Furthermore, IP-TTCD allows pre-trained transformer models to adapt their parameters during inference through continual pre-training, gaining long-context capabilities with only a lightweight architectural augmentation. Our results position TTCD as a step toward architectural continual learning.

Continual post-training (CPT) is a popular and effective technique for adapting foundation models like multimodal large language models to specific and ever-evolving downstream tasks. While existing research has primarily concentrated on methods like data replay, model expansion, or parameter regularization, the fundamental role of the learning paradigm within CPT remains largely unexplored. This paper presents a comparative analysis of two core post-training paradigms: supervised fine-tuning (SFT) and reinforcement fine-tuning (RFT), investigating their respective impacts on knowledge retention during CPT. Our experiments are conducted on a benchmark comprising seven diverse multimodal tasks, utilizing Qwen2.5-VL-7B-Instruct as the base model for continual post-training. The investigation yields two significant findings: (1) When continuously learning on downstream tasks, SFT leads to catastrophic forgetting of previously learned tasks. In contrast, RFT inherently preserves prior knowledge and achieve performance comparable to multi-task training. (2) RFT successfully protects and even enhances the model's general knowledge on standard benchmarks (e.g., MMMU and MMLU-Pro). Conversely, SFT degrades general model capabilities severely. Further analysis shows that explicit mechanisms, such as KL penalty and chain-of-thought reasoning, are not the primary factors. Instead, we find that the implicit regularization inherent to RFT is a key factor in mitigating forgetting. Finally, we propose a rollout-based instance filtering algorithm to improve the stability and efficiency of RFT. Our comprehensive study demonstrates the superiority of RFT as a robust paradigm for continual post-training.

Connectionist temporal classification (CTC) naturally supports offline and streaming speech recognition with utterance-level supervision, but conventional implementations materialize frame-by-vocabulary activations in memory, making CTC training with native LLM vocabularies prohibitively memory-intensive. A key observation is that every valid CTC alignment uses only target tokens and blank, and their union across a batch typically forms a small subset of the full vocabulary. We introduce Pruned CTC, which restricts alignment computation to this subset while retaining full-vocabulary normalization. We prove that this vocabulary reduction is exactly equivalent to full-vocabulary CTC in loss and gradients. Head-and-loss activation memory no longer scales linearly with vocabulary size. We further apply finite-beam alignment pruning. Building on Pruned CTC, we develop LLM-CTC, which adapts pretrained LLMs for non-autoregressive ASR while retaining causal attention and native vocabularies, and extend it to bounded-history streaming, avoiding chunk-level speech--text alignments. Experiments show that, with Zipformer-M encoder and 180K vocabulary, Pruned CTC reduces full-step memory by 5.1times with only 17% step-time overhead. Across three corpora, it matches standard CTC accuracy. On GigaSpeech, across six Qwen3 model sizes from 0.6B to 32B, LLM-CTC remains within 7% relative WER of LLM-CE with 7 to 10times faster recognition; when fine-tuning Qwen3-ASR for bounded-history streaming, LLM-CTC remains within 3% relative WER of matched offline models on the test set. Together, these results establish Pruned CTC as a scalable sequence objective for native-vocabulary LLM ASR across offline and streaming settings.

Medical report generation has achieved remarkable advancements yet has still been faced with several challenges. First, the inherent imbalance in the distribution of normal and abnormal cases may lead models to exhibit a biased focus on normal samples, resulting in unreliable diagnoses. Second, the frequent occurrence of common template sentences in the reports may overwhelm the critical abnormal information. Moreover, existing works focus on 2D chest X-rays, leaving CT report generation underexplored due to the high-dimensional nature of CT images and the limited availability of CT-report pairs. Recently, LLM has shown a great ability to generate reliable answers with appropriate prompts, which shed light on addressing the aforementioned challenges. In this paper, we propose Dia-LLaMA, a framework to adapt the LLaMA2-7B for CT report generation by incorporating diagnostic information as guidance prompts. Considering the high dimension of CT, we leverage a pre-trained ViT3D with perceiver to extract the visual information. To tailor the LLM for report generation and emphasize abnormality, we extract additional diagnostic information by referring to a disease prototype memory bank, which is updated during training to capture common disease representations. Furthermore, we introduce disease-aware attention to enable the model to adjust attention for different diseases. Experiments on the chest CT dataset demonstrated that our proposed method outperformed previous methods and achieved state-of-the-art on both clinical efficacy performance and natural language generation metrics. The code will be made publically available.

Automated segmentation of liver lesions on non-contrast computed tomography (NCCT) is clinically important but fundamentally challenging, particularly in low-resource settings across Africa and Asia where contrast agents are frequently unavailable. Progress has been limited by the absence of annotated NCCT benchmarks. Here we describe the TriALS challenge for automated liver lesion segmentation under contrast-limited conditions, supported by a multi-centre dataset of 150 cases with four-phase CT acquisitions (600 volumes) from Egyptian and Chinese institutions. Algorithms were evaluated on 70 cases from three institutions, including an independent external cohort. The top-performing method achieved a mean venous-phase Dice of 0.754, consistent with human-level performance, yet dropped to 0.57 on NCCT. On external validation, the leading method outperformed off-the-shelf models by up to 28% in Dice on NCCT. Algorithm performance was most strongly predicted by training data scale and pre-training strategy. A cross-year comparison exposed a persistent perceptual barrier on NCCT that scaling pre-training alone cannot overcome. Data, annotations, and code are available at https://github.com/xmed-lab/TriALS.

We demonstrate that architectures which traditionally are considered to be ill-suited for a task can be trained using inductive biases from another architecture. Networks are considered untrainable when they overfit, underfit, or converge to poor results even when tuning their hyperparameters. For example, plain fully connected networks overfit on object recognition while deep convolutional networks without residual connections underfit. The traditional answer is to change the architecture to impose some inductive bias, although what that bias is remains unknown. We introduce guidance, where a guide network guides a target network using a neural distance function. The target is optimized to perform well and to match its internal representations, layer-by-layer, to those of the guide; the guide is unchanged. If the guide is trained, this transfers over part of the architectural prior and knowledge of the guide to the target. If the guide is untrained, this transfers over only part of the architectural prior of the guide. In this manner, we can investigate what kinds of priors different architectures place on untrainable networks such as fully connected networks. We demonstrate that this method overcomes the immediate overfitting of fully connected networks on vision tasks, makes plain CNNs competitive to ResNets, closes much of the gap between plain vanilla RNNs and Transformers, and can even help Transformers learn tasks which RNNs can perform more easily. We also discover evidence that better initializations of fully connected networks likely exist to avoid overfitting. Our method provides a mathematical tool to investigate priors and architectures, and in the long term, may demystify the dark art of architecture creation, even perhaps turning architectures into a continuous optimizable parameter of the network.

Connectionist Temporal Classification (CTC) suffers from the latency problem when applied to streaming models. We argue that in CTC lattice, the alignments that can access more future context are preferred during training, thereby leading to higher symbol delay. In this work we propose the delay-penalized CTC which is augmented with latency penalty regularization. We devise a flexible and efficient implementation based on the differentiable Finite State Transducer (FST). Specifically, by attaching a binary attribute to CTC topology, we can locate the frames that firstly emit non-blank tokens on the resulting CTC lattice, and add the frame offsets to the log-probabilities. Experimental results demonstrate the effectiveness of our proposed delay-penalized CTC, which is able to balance the delay-accuracy trade-off. Furthermore, combining the delay-penalized transducer enables the CTC model to achieve better performance and lower latency. Our work is open-sourced and publicly available https://github.com/k2-fsa/k2.

Research in Curriculum Learning has shown better performance on the task by optimizing the sequence of the training data. Recent works have focused on using complex reinforcement learning techniques to find the optimal data ordering strategy to maximize learning for a given network. In this paper, we present a simple yet efficient technique based on continuous optimization trained with auto-encoding procedure. We call this new approach Training Sequence Optimization (TSO). With a usual encoder-decoder setup we try to learn the latent space continuous representation of the training strategy and a predictor network is used on the continuous representation to predict the accuracy of the strategy on the fixed network architecture. The performance predictor and encoder enable us to perform gradient-based optimization by gradually moving towards the latent space representation of training data ordering with potentially better accuracy. We show an empirical gain of 2AP with our generated optimal curriculum strategy over the random strategy using the CIFAR-100 and CIFAR-10 datasets and have better boosts than the existing state-of-the-art CL algorithms.

Guided sampling is a vital approach for applying diffusion models in real-world tasks that embeds human-defined guidance during the sampling procedure. This paper considers a general setting where the guidance is defined by an (unnormalized) energy function. The main challenge for this setting is that the intermediate guidance during the diffusion sampling procedure, which is jointly defined by the sampling distribution and the energy function, is unknown and is hard to estimate. To address this challenge, we propose an exact formulation of the intermediate guidance as well as a novel training objective named contrastive energy prediction (CEP) to learn the exact guidance. Our method is guaranteed to converge to the exact guidance under unlimited model capacity and data samples, while previous methods can not. We demonstrate the effectiveness of our method by applying it to offline reinforcement learning (RL). Extensive experiments on D4RL benchmarks demonstrate that our method outperforms existing state-of-the-art algorithms. We also provide some examples of applying CEP for image synthesis to demonstrate the scalability of CEP on high-dimensional data.

Classifier-Free Guidance (CFG) has been a default technique in various visual generative models, yet it requires inference from both conditional and unconditional models during sampling. We propose to build visual models that are free from guided sampling. The resulting algorithm, Guidance-Free Training (GFT), matches the performance of CFG while reducing sampling to a single model, halving the computational cost. Unlike previous distillation-based approaches that rely on pretrained CFG networks, GFT enables training directly from scratch. GFT is simple to implement. It retains the same maximum likelihood objective as CFG and differs mainly in the parameterization of conditional models. Implementing GFT requires only minimal modifications to existing codebases, as most design choices and hyperparameters are directly inherited from CFG. Our extensive experiments across five distinct visual models demonstrate the effectiveness and versatility of GFT. Across domains of diffusion, autoregressive, and masked-prediction modeling, GFT consistently achieves comparable or even lower FID scores, with similar diversity-fidelity trade-offs compared with CFG baselines, all while being guidance-free. Code will be available at https://github.com/thu-ml/GFT.

Continual Test-Time Adaptation (CTTA) aims to adapt the source model to continually changing unlabeled target domains without access to the source data. Existing methods mainly focus on model-based adaptation in a self-training manner, such as predicting pseudo labels for new domain datasets. Since pseudo labels are noisy and unreliable, these methods suffer from catastrophic forgetting and error accumulation when dealing with dynamic data distributions. Motivated by the prompt learning in NLP, in this paper, we propose to learn an image-level visual domain prompt for target domains while having the source model parameters frozen. During testing, the changing target datasets can be adapted to the source model by reformulating the input data with the learned visual prompts. Specifically, we devise two types of prompts, i.e., domains-specific prompts and domains-agnostic prompts, to extract current domain knowledge and maintain the domain-shared knowledge in the continual adaptation. Furthermore, we design a homeostasis-based prompt adaptation strategy to suppress domain-sensitive parameters in domain-invariant prompts to learn domain-shared knowledge more effectively. This transition from the model-dependent paradigm to the model-free one enables us to bypass the catastrophic forgetting and error accumulation problems. Experiments show that our proposed method achieves significant performance gains over state-of-the-art methods on four widely-used benchmarks, including CIFAR-10C, CIFAR-100C, ImageNet-C, and VLCS datasets.

Supervised synthetic CT generation from CBCT requires registered training pairs, yet perfect registration between separately acquired scans remains unattainable. This registration bias propagates into trained models and corrupts standard evaluation metrics. This may suggest that superior benchmark performance indicates better reproduction of registration artifacts rather than anatomical fidelity. We propose physics-based CBCT simulation to provide geometrically aligned training pairs by construction, combined with evaluation using geometric alignment metrics against input CBCT rather than biased ground truth. On two independent pelvic datasets, models trained on synthetic data achieved superior geometric alignment (Normalized Mutual Information: 0.31 vs 0.22) despite lower conventional intensity scores. Intensity metrics showed inverted correlations with clinical assessment for deformably registered data, while Normalized Mutual Information consistently predicted observer preference across registration methodologies (rho = 0.31, p < 0.001). Clinical observers preferred synthetic-trained outputs in 87% of cases, demonstrating that geometric fidelity, not intensity agreement with biased ground truth, aligns with clinical requirements.

There are substantial instructional videos on the Internet, which provide us tutorials for completing various tasks. Existing instructional video datasets only focus on specific steps at the video level, lacking experiential guidelines at the task level, which can lead to beginners struggling to learn new tasks due to the lack of relevant experience. Moreover, the specific steps without guidelines are trivial and unsystematic, making it difficult to provide a clear tutorial. To address these problems, we present the GUIDE (Guideline-Guided) dataset, which contains 3.5K videos of 560 instructional tasks in 8 domains related to our daily life. Specifically, we annotate each instructional task with a guideline, representing a common pattern shared by all task-related videos. On this basis, we annotate systematic specific steps, including their associated guideline steps, specific step descriptions and timestamps. Our proposed benchmark consists of three sub-tasks to evaluate comprehension ability of models: (1) Step Captioning: models have to generate captions for specific steps from videos. (2) Guideline Summarization: models have to mine the common pattern in task-related videos and summarize a guideline from them. (3) Guideline-Guided Captioning: models have to generate captions for specific steps under the guide of guideline. We evaluate plenty of foundation models with GUIDE and perform in-depth analysis. Given the diversity and practicality of GUIDE, we believe that it can be used as a better benchmark for instructional video comprehension.

We propose CoT-Self-Instruct, a synthetic data generation method that instructs LLMs to first reason and plan via Chain-of-Thought (CoT) based on the given seed tasks, and then to generate a new synthetic prompt of similar quality and complexity for use in LLM training, followed by filtering for high-quality data with automatic metrics. In verifiable reasoning, our synthetic data significantly outperforms existing training datasets, such as s1k and OpenMathReasoning, across MATH500, AMC23, AIME24 and GPQA-Diamond. For non-verifiable instruction-following tasks, our method surpasses the performance of human or standard self-instruct prompts on both AlpacaEval 2.0 and Arena-Hard.

Computed Tomography (CT) is one of the most popular modalities for medical imaging. By far, CT images have contributed to the largest publicly available datasets for volumetric medical segmentation tasks, covering full-body anatomical structures. Large amounts of full-body CT images provide the opportunity to pre-train powerful models, e.g., STU-Net pre-trained in a supervised fashion, to segment numerous anatomical structures. However, it remains unclear in which conditions these pre-trained models can be transferred to various downstream medical segmentation tasks, particularly segmenting the other modalities and diverse targets. To address this problem, a large-scale benchmark for comprehensive evaluation is crucial for finding these conditions. Thus, we collected 87 public datasets varying in modality, target, and sample size to evaluate the transfer ability of full-body CT pre-trained models. We then employed a representative model, STU-Net with multiple model scales, to conduct transfer learning across modalities and targets. Our experimental results show that (1) there may be a bottleneck effect concerning the dataset size in fine-tuning, with more improvement on both small- and large-scale datasets than medium-size ones. (2) Models pre-trained on full-body CT demonstrate effective modality transfer, adapting well to other modalities such as MRI. (3) Pre-training on the full-body CT not only supports strong performance in structure detection but also shows efficacy in lesion detection, showcasing adaptability across target tasks. We hope that this large-scale open evaluation of transfer learning can direct future research in volumetric medical image segmentation.

This paper introduces an innovative methodology for producing high-quality 3D lung CT images guided by textual information. While diffusion-based generative models are increasingly used in medical imaging, current state-of-the-art approaches are limited to low-resolution outputs and underutilize radiology reports' abundant information. The radiology reports can enhance the generation process by providing additional guidance and offering fine-grained control over the synthesis of images. Nevertheless, expanding text-guided generation to high-resolution 3D images poses significant memory and anatomical detail-preserving challenges. Addressing the memory issue, we introduce a hierarchical scheme that uses a modified UNet architecture. We start by synthesizing low-resolution images conditioned on the text, serving as a foundation for subsequent generators for complete volumetric data. To ensure the anatomical plausibility of the generated samples, we provide further guidance by generating vascular, airway, and lobular segmentation masks in conjunction with the CT images. The model demonstrates the capability to use textual input and segmentation tasks to generate synthesized images. The results of comparative assessments indicate that our approach exhibits superior performance compared to the most advanced models based on GAN and diffusion techniques, especially in accurately retaining crucial anatomical features such as fissure lines, airways, and vascular structures. This innovation introduces novel possibilities. This study focuses on two main objectives: (1) the development of a method for creating images based on textual prompts and anatomical components, and (2) the capability to generate new images conditioning on anatomical elements. The advancements in image generation can be applied to enhance numerous downstream tasks.

Classifier-free guidance (CFG) typically applies a shared scale to all latent tokens, although their velocity predictions evolve differently during sampling. We introduce Trajectory-Adaptive Classifier-Free Guidance (TrajCFG), a training-free method for flow-matching models that adapts token-wise guidance using historical changes in guided velocity direction. TrajCFG maps this feedback to bounded scales, assigning stronger guidance to larger directional changes and weaker guidance to more consistent directions. It combines adjacent-step and interval-normalized longer-span feedback, reusing standard CFG predictions without additional model evaluations. Controlled diagnostics and ablations examine the roles of directional feedback, token-wise allocation, and history-span fusion. Experiments on text-to-video, image-to-video, text-to-audio-video, text-to-image, and image-to-3D generation show improvements over base samplers across multiple backbones. For text-to-video generation, TrajCFG improves VBench Total scores by 0.30-0.75 points over the strongest evaluated baseline on each of three backbones. These results support historical directional feedback as a broadly applicable signal for fine-grained guidance allocation. The project page is available at https://jyliu-98.github.io/trajcfg-project-page/.

Neural Transducer and connectionist temporal classification (CTC) are popular end-to-end automatic speech recognition systems. Due to their frame-synchronous design, blank symbols are introduced to address the length mismatch between acoustic frames and output tokens, which might bring redundant computation. Previous studies managed to accelerate the training and inference of neural Transducers by discarding frames based on the blank symbols predicted by a co-trained CTC. However, there is no guarantee that the co-trained CTC can maximize the ratio of blank symbols. This paper proposes two novel regularization methods to explicitly encourage more blanks by constraining the self-loop of non-blank symbols in the CTC. It is interesting to find that the frame reduction ratio of the neural Transducer can approach the theoretical boundary. Experiments on LibriSpeech corpus show that our proposed method accelerates the inference of neural Transducer by 4 times without sacrificing performance. Our work is open-sourced and publicly available https://github.com/k2-fsa/icefall.

Recent advancements in Large Language Models (LLMs) such as GPT4 have displayed exceptional multi-modal capabilities in following open-ended instructions given images. However, the performance of these models heavily relies on design choices such as network structures, training data, and training strategies, and these choices have not been extensively discussed in the literature, making it difficult to quantify progress in this field. To address this issue, this paper presents a systematic and comprehensive study, quantitatively and qualitatively, on training such models. We implement over 20 variants with controlled settings. Concretely, for network structures, we compare different LLM backbones and model designs. For training data, we investigate the impact of data and sampling strategies. For instructions, we explore the influence of diversified prompts on the instruction-following ability of the trained models. For benchmarks, we contribute the first, to our best knowledge, comprehensive evaluation set including both image and video tasks through crowd-sourcing. Based on our findings, we present Lynx, which performs the most accurate multi-modal understanding while keeping the best multi-modal generation ability compared to existing open-sourced GPT4-style models.

Deep neural networks are highly performant, but might base their decision on spurious or background features that co-occur with certain classes, which can hurt generalization. To mitigate this issue, the usage of 'model guidance' has gained popularity recently: for this, models are guided to be "right for the right reasons" by regularizing the models' explanations to highlight the right features. Experimental validation of these approaches has thus far however been limited to relatively simple and / or synthetic datasets. To gain a better understanding of which model-guiding approaches actually transfer to more challenging real-world datasets, in this work we conduct an in-depth evaluation across various loss functions, attribution methods, models, and 'guidance depths' on the PASCAL VOC 2007 and MS COCO 2014 datasets, and show that model guidance can sometimes even improve model performance. In this context, we further propose a novel energy loss, show its effectiveness in directing the model to focus on object features. We also show that these gains can be achieved even with a small fraction (e.g. 1%) of bounding box annotations, highlighting the cost effectiveness of this approach. Lastly, we show that this approach can also improve generalization under distribution shifts. Code will be made available.

We propose self-speculative decoding for speech-aware LLMs by using the CTC encoder as a draft model to accelerate auto-regressive (AR) inference and improve ASR accuracy. Our three-step procedure works as follows: (1) if the frame entropies of the CTC output distributions are below a threshold, the greedy CTC hypothesis is accepted as final; (2) otherwise, the CTC hypothesis is verified in a single LLM forward pass using a relaxed acceptance criterion based on token likelihoods; (3) if verification fails, AR decoding resumes from the accepted CTC prefix. Experiments on nine corpora and five languages show that this approach can simultaneously accelerate decoding and reduce WER. On the HuggingFace Open ASR benchmark with a 1B parameter LLM and 440M parameter CTC encoder, we achieve a record 5.58% WER and improve the inverse real time factor by a factor of 4.4 with only a 12% relative WER increase over AR search. Code and model weights are publicly available under a permissive license.

Classifier-free guidance is a key component for enhancing the performance of conditional generative models across diverse tasks. While it has previously demonstrated remarkable improvements for the sample quality, it has only been exclusively employed for diffusion models. In this paper, we integrate classifier-free guidance into Flow Matching (FM) models, an alternative simulation-free approach that trains Continuous Normalizing Flows (CNFs) based on regressing vector fields. We explore the usage of Guided Flows for a variety of downstream applications. We show that Guided Flows significantly improves the sample quality in conditional image generation and zero-shot text-to-speech synthesis, boasting state-of-the-art performance. Notably, we are the first to apply flow models for plan generation in the offline reinforcement learning setting, showcasing a 10x speedup in computation compared to diffusion models while maintaining comparable performance.

Large-language-model (LLM)-based text-to-speech (TTS) systems can generate natural speech, but most are not designed for low-latency dual-streaming synthesis. High-quality dual-streaming TTS depends on accurate text--speech alignment and well-designed training sequences that balance synthesis quality and latency. Prior work often relies on GMM-HMM based forced-alignment toolkits (e.g., MFA), which are pipeline-heavy and less flexible than neural aligners; fixed-ratio interleaving of text and speech tokens struggles to capture text--speech alignment regularities. We propose CTC-TTS, which replaces MFA with a CTC based aligner and introduces a bi-word based interleaving strategy. Two variants are designed: CTC-TTS-L (token concatenation along the sequence length) for higher quality and CTC-TTS-F (embedding stacking along the feature dimension) for lower latency. Experiments show that CTC-TTS outperforms fixed-ratio interleaving and MFA-based baselines on streaming synthesis and zero-shot tasks. Speech samples are available at https://ctctts.github.io/.

Quantification of real-time informal feedback delivered by an experienced surgeon to a trainee during surgery is important for skill improvements in surgical training. Such feedback in the live operating room is inherently multimodal, consisting of verbal conversations (e.g., questions and answers) as well as non-verbal elements (e.g., through visual cues like pointing to anatomic elements). In this work, we leverage a clinically-validated five-category classification of surgical feedback: "Anatomic", "Technical", "Procedural", "Praise" and "Visual Aid". We then develop a multi-label machine learning model to classify these five categories of surgical feedback from inputs of text, audio, and video modalities. The ultimate goal of our work is to help automate the annotation of real-time contextual surgical feedback at scale. Our automated classification of surgical feedback achieves AUCs ranging from 71.5 to 77.6 with the fusion improving performance by 3.1%. We also show that high-quality manual transcriptions of feedback audio from experts improve AUCs to between 76.5 and 96.2, which demonstrates a clear path toward future improvements. Empirically, we find that the Staged training strategy, with first pre-training each modality separately and then training them jointly, is more effective than training different modalities altogether. We also present intuitive findings on the importance of modalities for different feedback categories. This work offers an important first look at the feasibility of automated classification of real-world live surgical feedback based on text, audio, and video modalities.

Multimodal large language models (MLLMs) have achieved significant success in the general field of image processing. Their emerging task generalization and freeform conversational capabilities can greatly facilitate medical diagnostic assistance, helping patients better understand their conditions and enhancing doctor-patient trust. Computed Tomography (CT) is a non-invasive imaging technique used to capture the internal mechanisms of a patient's condition and is widely utilized. However, in past research, the complex textural features of this imaging data have made accurate interpretation by algorithms challenging, impeding the performance of general LLMs in diagnostic assistance. To address this, we developed OrthoDoc, a MLLM designed for CT diagnostics. OrthoDoc is trained on 120,000 CT images and diagnostic reports and includes a Retrieval-Augmented Generation (RAG) module capable of effectively mitigating model hallucinations. This module is informed by extensive medical literature, textbooks, and explanatory data. Thus, OrthoDoc not only processes complex CT images but also stores, understands, and reasons over medical knowledge and language. In extensive experiments, OrthoDoc outperforms commercial models led by GPT-4, demonstrating superior diagnostic capabilities and accuracy. Specifically, OrthoDoc significantly surpasses existing models in the diagnosis of common orthopedic conditions such as fractures, arthritis, and tumors. Additionally, OrthoDoc exhibits robust generalization and stability when handling rare and complex cases.

Text to image latent diffusion models have recently advanced medical image synthesis, but applications to 3D CT generation remain limited. Existing approaches rely on simplified prompts, neglecting the rich semantic detail in full radiology reports, which reduces text image alignment and clinical fidelity. We propose Report2CT, a radiology report conditional latent diffusion framework for synthesizing 3D chest CT volumes directly from free text radiology reports, incorporating both findings and impression sections using multiple text encoder. Report2CT integrates three pretrained medical text encoders (BiomedVLP CXR BERT, MedEmbed, and ClinicalBERT) to capture nuanced clinical context. Radiology reports and voxel spacing information condition a 3D latent diffusion model trained on 20000 CT volumes from the CT RATE dataset. Model performance was evaluated using Frechet Inception Distance (FID) for real synthetic distributional similarity and CLIP based metrics for semantic alignment, with additional qualitative and quantitative comparisons against GenerateCT model. Report2CT generated anatomically consistent CT volumes with excellent visual quality and text image alignment. Multi encoder conditioning improved CLIP scores, indicating stronger preservation of fine grained clinical details in the free text radiology reports. Classifier free guidance further enhanced alignment with only a minor trade off in FID. We ranked first in the VLM3D Challenge at MICCAI 2025 on Text Conditional CT Generation and achieved state of the art performance across all evaluation metrics. By leveraging complete radiology reports and multi encoder text conditioning, Report2CT advances 3D CT synthesis, producing clinically faithful and high quality synthetic data.

Purpose : To develop and evaluate CAPTOR, a deep-learning vision-language foundation model for oncologic chest-abdomen-pelvis (CAP) CT interpretation. Materials & Methods : CAPTOR (Chest-Abdomen-Pelvis foundaTion model for Oncologic Radiology) is a contrastive vision-language model, trained using a pretraining strategy for oncologic CAP CT (in single- or multiple-series acquisitions), on a multicenter retrospective dataset from North America, Europe and Asia, predominantly from tumor lesion examinations. CAPTOR was compared with state-of-the-art CT foundation models on three downstream tasks: disease detection, survival prediction using TumorImagingBench and image retrieval. Classification and retrieval were both evaluated on held-out internal and public test sets, stratified by anatomical coverage and indication. Bootstrap resampling was used to estimate confidence intervals, and pairwise comparisons were performed using permutation tests. Results : CAPTOR was trained and tested on 25,512 and 10,794 CT-report pairs respectively. TumorImagingBench datasets comprised between 134 and 421 studies each. CAPTOR outperformed all baseline models, on the classification task, on the CAP subset (AUC 0.767, 95%CI: 0.734-0.793, vs. 0.695, 95%CI: 0.645-0.736 for the next-best, p<0.001) and oncologic subset (AUC 0.784, 95%CI: 0.759-0.805, vs. 0.734, 95%CI: 0.703-0.767 p<0.001), ranked first on three of the four oncologic prognostic benchmarks, and achieved superior retrieval performance on CAP and oncologic subsets. Conclusion : A foundation model trained on oncology-enriched CAP CT data outperformed relevant state-of-the-art models in its target clinical context, underscoring the importance of clinically aligned pretraining. We release our preprocessing, training and inference code : https://github.com/Guerbet-AI/CAPTOR and model weights : https://huggingface.co/Guerbet-AI/CAPTOR

Continual pre-training (CPT) has been an important approach for adapting language models to specific domains or tasks. To make the CPT approach more traceable, this paper presents a technical report for continually pre-training Llama-3 (8B), which significantly enhances the Chinese language ability and scientific reasoning ability of the backbone model. To enhance the new abilities while retaining the original abilities, we design specific data mixture and curriculum strategies by utilizing existing datasets and synthesizing high-quality datasets. Specifically, we synthesize multidisciplinary scientific question and answer (QA) pairs based on related web pages, and subsequently incorporate these synthetic data to improve the scientific reasoning ability of Llama-3. We refer to the model after CPT as Llama-3-SynE (Synthetic data Enhanced Llama-3). We also present the tuning experiments with a relatively small model -- TinyLlama, and employ the derived findings to train the backbone model. Extensive experiments on a number of evaluation benchmarks show that our approach can largely improve the performance of the backbone models, including both the general abilities (+8.81 on C-Eval and +6.31 on CMMLU) and the scientific reasoning abilities (+12.00 on MATH and +4.13 on SciEval), without hurting the original capacities. Our model, data, and codes are available at https://github.com/RUC-GSAI/Llama-3-SynE.

Generative modelling of entire CT volumes conditioned on clinical reports has the potential to accelerate research through data augmentation, privacy-preserving synthesis and reducing regulator-constraints on patient data while preserving diagnostic signals. With the recent release of CT-RATE, a large-scale collection of 3D CT volumes paired with their respective clinical reports, training large text-conditioned CT volume generation models has become achievable. In this work, we introduce CTFlow, a 0.5B latent flow matching transformer model, conditioned on clinical reports. We leverage the A-VAE from FLUX to define our latent space, and rely on the CT-Clip text encoder to encode the clinical reports. To generate consistent whole CT volumes while keeping the memory constraints tractable, we rely on a custom autoregressive approach, where the model predicts the first sequence of slices of the volume from text-only, and then relies on the previously generated sequence of slices and the text, to predict the following sequence. We evaluate our results against state-of-the-art generative CT model, and demonstrate the superiority of our approach in terms of temporal coherence, image diversity and text-image alignment, with FID, FVD, IS scores and CLIP score.

Guidance in conditional diffusion generation is of great importance for sample quality and controllability. However, existing guidance schemes are to be desired. On one hand, mainstream methods such as classifier guidance and classifier-free guidance both require extra training with labeled data, which is time-consuming and unable to adapt to new conditions. On the other hand, training-free methods such as universal guidance, though more flexible, have yet to demonstrate comparable performance. In this work, through a comprehensive investigation into the design space, we show that it is possible to achieve significant performance improvements over existing guidance schemes by leveraging off-the-shelf classifiers in a training-free fashion, enjoying the best of both worlds. Employing calibration as a general guideline, we propose several pre-conditioning techniques to better exploit pretrained off-the-shelf classifiers for guiding diffusion generation. Extensive experiments on ImageNet validate our proposed method, showing that state-of-the-art diffusion models (DDPM, EDM, DiT) can be further improved (up to 20%) using off-the-shelf classifiers with barely any extra computational cost. With the proliferation of publicly available pretrained classifiers, our proposed approach has great potential and can be readily scaled up to text-to-image generation tasks. The code is available at https://github.com/AlexMaOLS/EluCD/tree/main.

We participated in the SynthRAD2025 challenge (Tasks 1 and 2) with a unified pipeline for synthetic CT (sCT) generation from MRI and CBCT, implemented using the KonfAI framework. Our model is a 2.5D U-Net++ with a ResNet-34 encoder, trained jointly across anatomical regions and fine-tuned per region. The loss function combined pixel-wise L1 loss with IMPACT-Synth, a perceptual loss derived from SAM and TotalSegmentator to enhance structural fidelity. Training was performed using AdamW (initial learning rate = 0.001, halved every 25k steps) on patch-based, normalized, body-masked inputs (320x320 for MRI, 256x256 for CBCT), with random flipping as the only augmentation. No post-processing was applied. Final predictions leveraged test-time augmentation and five-fold ensembling. The best model was selected based on validation MAE. Two registration strategies were evaluated: (i) Elastix with mutual information, consistent with the challenge pipeline, and (ii) IMPACT, a feature-based similarity metric leveraging pretrained segmentation networks. On the local test sets, IMPACT-based registration achieved more accurate and anatomically consistent alignments than mutual-information-based registration, resulting in improved sCT synthesis with lower MAE and more realistic anatomical structures. On the public validation set, however, models trained with Elastix-aligned data achieved higher scores, reflecting a registration bias favoring alignment strategies consistent with the evaluation pipeline. This highlights how registration errors can propagate into supervised learning, influencing both training and evaluation, and potentially inflating performance metrics at the expense of anatomical fidelity. By promoting anatomically consistent alignment, IMPACT helps mitigate this bias and supports the development of more robust and generalizable sCT synthesis models.

Recent advances in Large Vision-Language Models (LVLMs) have shown strong potential for multi-modal radiological reasoning, particularly in tasks like diagnostic visual question answering (VQA) and radiology report generation. However, most existing approaches for 3D CT analysis largely rely on static, single-pass inference. In practice, clinical interpretation is a dynamic, tool-mediated workflow where radiologists iteratively review slices and use measurement, radiomics, and segmentation tools to refine findings. To bridge this gap, we propose CT-Flow, an agentic framework designed for interoperable volumetric interpretation. By leveraging the Model Context Protocol (MCP), CT-Flow shifts from closed-box inference to an open, tool-aware paradigm. We curate CT-FlowBench, the first large-scale instruction-tuning benchmark tailored for 3D CT tool-use and multi-step reasoning. Built upon this, CT-Flow functions as a clinical orchestrator capable of decomposing complex natural language queries into automated tool-use sequences. Experimental evaluations on CT-FlowBench and standard 3D VQA datasets demonstrate that CT-Flow achieves state-of-the-art performance, surpassing baseline models by 41% in diagnostic accuracy and achieving a 95% success rate in autonomous tool invocation. This work provides a scalable foundation for integrating autonomous, agentic intelligence into real-world clinical radiology.

Classifier-Free Guidance (CFG) is a critical technique for enhancing the sample quality of visual generative models. However, in autoregressive (AR) multi-modal generation, CFG introduces design inconsistencies between language and visual content, contradicting the design philosophy of unifying different modalities for visual AR. Motivated by language model alignment methods, we propose Condition Contrastive Alignment (CCA) to facilitate guidance-free AR visual generation with high performance and analyze its theoretical connection with guided sampling methods. Unlike guidance methods that alter the sampling process to achieve the ideal sampling distribution, CCA directly fine-tunes pretrained models to fit the same distribution target. Experimental results show that CCA can significantly enhance the guidance-free performance of all tested models with just one epoch of fine-tuning (sim 1\% of pretraining epochs) on the pretraining dataset, on par with guided sampling methods. This largely removes the need for guided sampling in AR visual generation and cuts the sampling cost by half. Moreover, by adjusting training parameters, CCA can achieve trade-offs between sample diversity and fidelity similar to CFG. This experimentally confirms the strong theoretical connection between language-targeted alignment and visual-targeted guidance methods, unifying two previously independent research fields. Code and model weights: https://github.com/thu-ml/CCA.

Recent text-to-motion models have improved motion quality and instruction following, yet many-step denoising and large model components make deployment slow and memory-intensive. We present Terminal-Amplification-Controlled Distillation (TACD), an on-policy approach for training efficient motion generators from text prompts and pretrained teachers, without real-motion training data. Building on segmented on-policy flow distillation, we supervise clean-motion predictions along student-generated trajectories. We identify a failure mode in which velocity matching on a fixed supervision grid repeatedly overweights errors near the denoising endpoint, degrading few-step generation. TACD ties the latest teacher query to the student's step size, bounding the effective loss weights in clean-motion space without changing inference. Experiments on HumanML3D and KIT-ML demonstrate improved few-step generation, including a 58% reduction in eight-step HY-Motion student FID relative to distillation without this bound. For diffusion teachers, the endpoint-matching form of TACD yields four-step students with lower FID and matched or improved text-motion retrieval relative to their 50-step teachers on HumanML3D. On HY-Motion and Kimodo, eight-step students with compact components achieve 7.7-11.9x end-to-end speedups and reduce peak GPU memory by 3.8-6.7x relative to their teachers. Project page: https://vkgo.github.io/TACD/

Instruction generation is a vital and multidisciplinary research area with broad applications. Existing instruction generation models are limited to generating instructions in a single style from a particular dataset, and the style and content of generated instructions cannot be controlled. Moreover, most existing instruction generation methods also disregard the spatial modeling of the navigation environment. Leveraging the capabilities of Large Language Models (LLMs), we propose C-Instructor, which utilizes the chain-of-thought-style prompt for style-controllable and content-controllable instruction generation. Firstly, we propose a Chain of Thought with Landmarks (CoTL) mechanism, which guides the LLM to identify key landmarks and then generate complete instructions. CoTL renders generated instructions more accessible to follow and offers greater controllability over the manipulation of landmark objects. Furthermore, we present a Spatial Topology Modeling Task to facilitate the understanding of the spatial structure of the environment. Finally, we introduce a Style-Mixed Training policy, harnessing the prior knowledge of LLMs to enable style control for instruction generation based on different prompts within a single model instance. Extensive experiments demonstrate that instructions generated by C-Instructor outperform those generated by previous methods in text metrics, navigation guidance evaluation, and user studies.

Recent end-to-end Automatic Speech Recognition (ASR) systems demonstrated the ability to outperform conventional hybrid DNN/ HMM ASR. Aside from architectural improvements in those systems, those models grew in terms of depth, parameters and model capacity. However, these models also require more training data to achieve comparable performance. In this work, we combine freely available corpora for German speech recognition, including yet unlabeled speech data, to a big dataset of over 1700h of speech data. For data preparation, we propose a two-stage approach that uses an ASR model pre-trained with Connectionist Temporal Classification (CTC) to boot-strap more training data from unsegmented or unlabeled training data. Utterances are then extracted from label probabilities obtained from the network trained with CTC to determine segment alignments. With this training data, we trained a hybrid CTC/attention Transformer model that achieves 12.8% WER on the Tuda-DE test set, surpassing the previous baseline of 14.4% of conventional hybrid DNN/HMM ASR.

The rapid increase in the number of Computed Tomography (CT) scan examinations has created an urgent need for automated tools, such as organ segmentation, anomaly classification, and report generation, to assist radiologists with their growing workload. Multi-label classification of Three-Dimensional (3D) CT scans is a challenging task due to the volumetric nature of the data and the variety of anomalies to be detected. Existing deep learning methods based on Convolutional Neural Networks (CNNs) struggle to capture long-range dependencies effectively, while Vision Transformers require extensive pre-training, posing challenges for practical use. Additionally, these existing methods do not explicitly model the radiologist's navigational behavior while scrolling through CT scan slices, which requires both global context understanding and local detail awareness. In this study, we present CT-Scroll, a novel global-local attention model specifically designed to emulate the scrolling behavior of radiologists during the analysis of 3D CT scans. Our approach is evaluated on two public datasets, demonstrating its efficacy through comprehensive experiments and an ablation study that highlights the contribution of each model component.

Data scarcity and the modality gap between the speech and text modalities are two major obstacles of end-to-end Speech Translation (ST) systems, thus hindering their performance. Prior work has attempted to mitigate these challenges by leveraging external MT data and optimizing distance metrics that bring closer the speech-text representations. However, achieving competitive results typically requires some ST data. For this reason, we introduce ZeroSwot, a method for zero-shot ST that bridges the modality gap without any paired ST data. Leveraging a novel CTC compression and Optimal Transport, we train a speech encoder using only ASR data, to align with the representation space of a massively multilingual MT model. The speech encoder seamlessly integrates with the MT model at inference, enabling direct translation from speech to text, across all languages supported by the MT model. Our experiments show that we can effectively close the modality gap without ST data, while our results on MuST-C and CoVoST demonstrate our method's superiority over not only previous zero-shot models, but also supervised ones, achieving state-of-the-art results.

We propose continuous adversarial flow models, a type of continuous-time flow model trained with an adversarial objective. Unlike flow matching, which uses a fixed mean-squared-error criterion, our approach introduces a learned discriminator to guide training. This change in objective induces a different generalized distribution, which empirically produces samples that are better aligned with the target data distribution. Our method is primarily proposed for post-training existing flow-matching models, although it can also train models from scratch. On the ImageNet 256px generation task, our post-training substantially improves the guidance-free FID of latent-space SiT from 8.26 to 3.63 and of pixel-space JiT from 7.17 to 3.57. It also improves guided generation, reducing FID from 2.06 to 1.53 for SiT and from 1.86 to 1.80 for JiT. We further evaluate our approach on text-to-image generation, where it achieves improved results on both the GenEval and DPG benchmarks.

Recent AIGC systems possess the capability to generate digital multimedia content based on human language instructions, such as text, image and video. However, when it comes to speech, existing methods related to human instruction-to-speech generation exhibit two limitations. Firstly, they require the division of inputs into content prompt (transcript) and description prompt (style and speaker), instead of directly supporting human instruction. This division is less natural in form and does not align with other AIGC models. Secondly, the practice of utilizing an independent description prompt to model speech style, without considering the transcript content, restricts the ability to control speech at a fine-grained level. To address these limitations, we propose VoxInstruct, a novel unified multilingual codec language modeling framework that extends traditional text-to-speech tasks into a general human instruction-to-speech task. Our approach enhances the expressiveness of human instruction-guided speech generation and aligns the speech generation paradigm with other modalities. To enable the model to automatically extract the content of synthesized speech from raw text instructions, we introduce speech semantic tokens as an intermediate representation for instruction-to-content guidance. We also incorporate multiple Classifier-Free Guidance (CFG) strategies into our codec language model, which strengthens the generated speech following human instructions. Furthermore, our model architecture and training strategies allow for the simultaneous support of combining speech prompt and descriptive human instruction for expressive speech synthesis, which is a first-of-its-kind attempt. Codes, models and demos are at: https://github.com/thuhcsi/VoxInstruct.

We propose a new end-to-end neural acoustic model for automatic speech recognition. The model is composed of multiple blocks with residual connections between them. Each block consists of one or more modules with 1D time-channel separable convolutional layers, batch normalization, and ReLU layers. It is trained with CTC loss. The proposed network achieves near state-of-the-art accuracy on LibriSpeech and Wall Street Journal, while having fewer parameters than all competing models. We also demonstrate that this model can be effectively fine-tuned on new datasets.

Purpose: Medical imaging has become increasingly important in diagnosing and treating oncological patients, particularly in radiotherapy. Recent advances in synthetic computed tomography (sCT) generation have increased interest in public challenges to provide data and evaluation metrics for comparing different approaches openly. This paper describes a dataset of brain and pelvis computed tomography (CT) images with rigidly registered CBCT and MRI images to facilitate the development and evaluation of sCT generation for radiotherapy planning. Acquisition and validation methods: The dataset consists of CT, CBCT, and MRI of 540 brains and 540 pelvic radiotherapy patients from three Dutch university medical centers. Subjects' ages ranged from 3 to 93 years, with a mean age of 60. Various scanner models and acquisition settings were used across patients from the three data-providing centers. Details are available in CSV files provided with the datasets. Data format and usage notes: The data is available on Zenodo (https://doi.org/10.5281/zenodo.7260705) under the SynthRAD2023 collection. The images for each subject are available in nifti format. Potential applications: This dataset will enable the evaluation and development of image synthesis algorithms for radiotherapy purposes on a realistic multi-center dataset with varying acquisition protocols. Synthetic CT generation has numerous applications in radiation therapy, including diagnosis, treatment planning, treatment monitoring, and surgical planning.

Large language models offer broad capabilities, but adapting them to evolving domains, tools, and requirements often entails repeated post-training. Autonomous systems automate parts of this process by proposing updates, training candidates, and using evaluation feedback to select subsequent proposals. As evidence accumulates, a central problem emerges: which past update evidence remains actionable after subsequent training has changed the parent model? An update's effect depends on its parent, data, and training stage. Treating past success as context-free permission can waste compute. If the resulting child is promoted, it can also degrade the subsequent training trajectory. We formulate this problem as conditional experience transfer and introduce Boundary-Calibrated Intervention Transfer (BCIT), a method that authorizes experience reuse before weight-changing training. BCIT binds an observed effect to its source context, checks applicability conditions, vetoes candidates with named hard conflicts, and obtains current-state evidence through a bounded training trial when needed. Fully trained candidates still face a shared adoption rule, and only observed events extend memory. On one 4B model adapted across finance reasoning, text-to-SQL, and function calling, candidate updates exhibit heterogeneous target and retention effects across the evaluated contexts. Under matched candidates, evidence, and compute, BCIT authorizes fewer harmful updates and attains higher equal-budget final-model quality than the evaluated alternatives. These results support treating experience authorization as a distinct problem in autonomous post-training.

This paper proposes a method to relax the conditional independence assumption of connectionist temporal classification (CTC)-based automatic speech recognition (ASR) models. We train a CTC-based ASR model with auxiliary CTC losses in intermediate layers in addition to the original CTC loss in the last layer. During both training and inference, each generated prediction in the intermediate layers is summed to the input of the next layer to condition the prediction of the last layer on those intermediate predictions. Our method is easy to implement and retains the merits of CTC-based ASR: a simple model architecture and fast decoding speed. We conduct experiments on three different ASR corpora. Our proposed method improves a standard CTC model significantly (e.g., more than 20 % relative word error rate reduction on the WSJ corpus) with a little computational overhead. Moreover, for the TEDLIUM2 corpus and the AISHELL-1 corpus, it achieves a comparable performance to a strong autoregressive model with beam search, but the decoding speed is at least 30 times faster.

Experiment trackers show how training is progressing, but changing a live run still usually requires trainer-specific code. We present Interactive Training 2, an open-source control plane for steering training through a shared protocol. Training applications declare which settings and actions they expose, humans and automated controllers submit requests through the same interface, and the training loop validates and applies them at safe control points. A customized Aim workspace combines live metrics and controls with a chronological record of requests and outcomes. We demonstrate the system across five NLP and reinforcement-learning workflows. The released code and traces provide a reusable foundation for auditable human- and agent-guided training.

In ophthalmic surgery, developing an AI system capable of interpreting surgical videos and predicting subsequent operations requires numerous ophthalmic surgical videos with high-quality annotations, which are difficult to collect due to privacy concerns and labor consumption. Text-guided video generation (T2V) emerges as a promising solution to overcome this issue by generating ophthalmic surgical videos based on surgeon instructions. In this paper, we present Ophora, a pioneering model that can generate ophthalmic surgical videos following natural language instructions. To construct Ophora, we first propose a Comprehensive Data Curation pipeline to convert narrative ophthalmic surgical videos into a large-scale, high-quality dataset comprising over 160K video-instruction pairs, Ophora-160K. Then, we propose a Progressive Video-Instruction Tuning scheme to transfer rich spatial-temporal knowledge from a T2V model pre-trained on natural video-text datasets for privacy-preserved ophthalmic surgical video generation based on Ophora-160K. Experiments on video quality evaluation via quantitative analysis and ophthalmologist feedback demonstrate that Ophora can generate realistic and reliable ophthalmic surgical videos based on surgeon instructions. We also validate the capability of Ophora for empowering downstream tasks of ophthalmic surgical workflow understanding. Code is available at https://github.com/mar-cry/Ophora.

Conventional Computed Tomography (CT) methods require large numbers of noise-free projections for accurate density reconstructions, limiting their applicability to the more complex class of Cone Beam Geometry CT (CBCT) reconstruction. Recently, deep learning methods have been proposed to overcome these limitations, with methods based on neural fields (NF) showing strong performance, by approximating the reconstructed density through a continuous-in-space coordinate based neural network. Our focus is on improving such methods, however, unlike previous work, which requires training an NF from scratch for each new set of projections, we instead propose to leverage anatomical consistencies over different scans by training a single conditional NF on a dataset of projections. We propose a novel conditioning method where local modulations are modeled per patient as a field over the input domain through a Neural Modulation Field (NMF). The resulting Conditional Cone Beam Neural Tomography (CondCBNT) shows improved performance for both high and low numbers of available projections on noise-free and noisy data.

Test-time training (TTT) methods explicitly update the weights of a model to adapt to the specific test instance, and they have found success in a variety of settings, including most recently language modeling and reasoning. To demystify this success, we investigate a gradient-based TTT algorithm for in-context learning, where we train a transformer model on the in-context demonstrations provided in the test prompt. Specifically, we provide a comprehensive theoretical characterization of linear transformers when the update rule is a single gradient step. Our theory (i) delineates the role of alignment between pretraining distribution and target task, (ii) demystifies how TTT can alleviate distribution shift, and (iii) quantifies the sample complexity of TTT including how it can significantly reduce the eventual sample size required for in-context learning. As our empirical contribution, we study the benefits of TTT for TabPFN, a tabular foundation model. In line with our theory, we demonstrate that TTT significantly reduces the required sample size for tabular classification (3 to 5 times fewer) unlocking substantial inference efficiency with a negligible training cost.

While Large Language Models (LLMs) acquire vast knowledge during pre-training, they often lack domain-specific, new, or niche information. Continual pre-training (CPT) attempts to address this gap but suffers from catastrophic forgetting and inefficiencies in low-data regimes. We introduce Knowledge-Instruct, a novel approach to efficiently inject knowledge from limited corpora through pure instruction-tuning. By generating information-dense synthetic instruction data, it effectively integrates new knowledge while preserving general reasoning and instruction-following abilities. Knowledge-Instruct demonstrates superior factual memorization, minimizes catastrophic forgetting, and remains scalable by leveraging synthetic data from relatively small language models. Additionally, it enhances contextual understanding, including complex multi-hop reasoning, facilitating integration with retrieval systems. We validate its effectiveness across diverse benchmarks, including Companies, a new dataset that we release to measure knowledge injection capabilities.

Large language models (LLMs) have demonstrated exceptional capabilities when trained within executable runtime environments, notably excelling at software engineering tasks through verified feedback loops. Yet, scalable and generalizable execution-grounded environments remain scarce, limiting progress in training more capable ML agents. We introduce CTF-Dojo, the first large-scale executable runtime tailored for training LLMs with verifiable feedback, featuring 658 fully functional Capture-The-Flag (CTF)-style challenges containerized in Docker with guaranteed reproducibility. To enable rapid scaling without manual intervention, we develop CTF-Forge, an automated pipeline that transforms publicly available artifacts into ready-to-use execution environments in minutes, eliminating weeks of expert configuration traditionally required. We trained LLM-based agents on just 486 high-quality, execution-verified trajectories from CTF-Dojo, achieving up to 11.6% absolute gains over strong baselines across three competitive benchmarks: InterCode-CTF, NYU CTF Bench, and Cybench. Our best-performing 32B model reaches 31.9% Pass@1, establishing a new open-weight state-of-the-art that rivals frontier models like DeepSeek-V3-0324 and Gemini-2.5-Flash. By framing CTF-style tasks as a benchmark for executable-agent learning, CTF-Dojo demonstrates that execution-grounded training signals are not only effective but pivotal in advancing high-performance ML agents without dependence on costly proprietary systems.

Masked diffusion language models (MDLMs) generate text by unmasking tokens in parallel and have recently emerged as alternatives to autoregressive language models. They can be viewed as parallel decoders trained with a position-wise cross-entropy (CE) loss, the same setup as non-autoregressive translation (NAT). In NAT, CE-trained parallel decoders have been argued to be sensitive to small positional shifts, since CE penalizes them harshly. We ask whether CE-trained MDLMs are similarly sensitive to such shifts under iterative decoding. To probe this, we apply a controlled intervention that introduces them during decoding. On LLaDA-8B-Instruct with Arena-Hard, displacing as little as 1% of generated tokens by one position substantially reduces win rates against the unintervened model, showing that MDLMs are sensitive to such small shifts under iterative parallel decoding. Motivated by this, we adapt connectionist temporal classification (CTC), an alignment-flexible objective known to mitigate it there, to MDLM supervised fine-tuning. By relaxing the strict position-wise match that CE imposes, CTC gives the loss room to absorb small positional shifts; concretely, we modified CTC objective to use a special <slack> token that absorbs positional uncertainty between target tokens and output positions, and a updated collapse map that preserves target surface forms. Across four open-ended generation benchmarks, the resulting model consistently improves over both the original model and a matched cross-entropy-trained baseline, with statistically significant gains on all four. These results identify training-side alignment flexibility as a useful design dimension for MDLM SFT, complementary to the inference-time approaches explored in prior work.

Text-conditioned generative models for volumetric medical imaging provide semantic control but lack explicit anatomical guidance, often resulting in outputs that are spatially ambiguous or anatomically inconsistent. In contrast, structure-driven methods ensure strong anatomical consistency but typically assume access to ground-truth annotations, which are unavailable when the target image is to be synthesized. We propose a retrieval-augmented approach for Text-to-CT generation that integrates semantic and anatomical information under a realistic inference setting. Given a radiology report, our method retrieves a semantically related clinical case using a 3D vision-language encoder and leverages its associated anatomical annotation as a structural proxy. This proxy is injected into a text-conditioned latent diffusion model via a ControlNet branch, providing coarse anatomical guidance while maintaining semantic flexibility. Experiments on the CT-RATE dataset show that retrieval-augmented generation improves image fidelity and clinical consistency compared to text-only baselines, while additionally enabling explicit spatial controllability, a capability inherently absent in such approaches. Further analysis highlights the importance of retrieval quality, with semantically aligned proxies yielding consistent gains across all evaluation axes. This work introduces a principled and scalable mechanism to bridge semantic conditioning and anatomical plausibility in volumetric medical image synthesis. Code will be released.

Agentic robotics systems combine planners with robot harnesses to perform complex manipulation tasks. Recent work improves these systems through better harnesses and external memory, but relies on powerful closed-source models as planners and does not improve the planners' own capabilities. In contrast, coding agents have improved substantially by post-training the model itself. We therefore investigate whether post-training can also improve robot planners. However, applying it across robot harnesses requires accommodating different execution mechanisms, including VLA skill invocation and control-code generation. To this end, we introduce AgenticRoboRL, a framework for post-training robot planners across different harnesses. The training recipe combines supervised fine-tuning with multi-turn reinforcement learning. To accommodate different execution mechanisms, harness-specific adapters connect recorded planner interactions with task outcomes, enabling a common RL training pipeline while keeping execution components fixed. On LIBERO-PRO, AgenticRoboRL raises the success rate of a 9B-parameter planner from 18.1% to 71.0% without external memory, approaching the 72.1% achieved by Codex (GPT-5.5) with external memory. These results demonstrate post-training as an effective approach for improving robot planners. We will release the framework and trained planner checkpoints.

Prompt-based methods, which encode medical priors through descriptive text, have been only minimally explored for CT Image Quality Assessment (IQA). While such prompts can embed prior knowledge about diagnostic quality, they often introduce bias by reflecting idealized definitions that may not hold under real-world degradations such as noise, motion artifacts, or scanner variability. To address this, we propose the Context-Aware Prompt-guided Image Quality Assessment (CAP-IQA) framework, which integrates text-level priors with instance-level context prompts and applies causal debiasing to separate idealized knowledge from factual, image-specific degradations. Our framework combines a CNN-based visual encoder with a domain-specific text encoder to assess diagnostic visibility, anatomical clarity, and noise perception in abdominal CT images. The model leverages radiology-style prompts and context-aware fusion to align semantic and perceptual representations. On the 2023 LDCTIQA challenge benchmark, CAP-IQA achieves an overall correlation score of 2.8590 (sum of PLCC, SROCC, and KROCC), surpassing the top-ranked leaderboard team (2.7427) by 4.24%. Moreover, our comprehensive ablation experiments confirm that prompt-guided fusion and the simplified encoder-only design jointly enhance feature alignment and interpretability. Furthermore, evaluation on an in-house dataset of 91,514 pediatric CT images demonstrates the true generalizability of CAP-IQA in assessing perceptual fidelity in a different patient population.

The recently introduced Controlled Text Reduction (CTR) task isolates the text generation step within typical summarization-style tasks. It does so by challenging models to generate coherent text conforming to pre-selected content within the input text (``highlights''). This framing enables increased modularity in summarization-like tasks, allowing to couple a single CTR model with various content-selection setups and modules. However, there are currently no reliable CTR models, while the performance of the existing baseline for the task is mediocre, falling short of practical utility. Here, we address this gap by introducing a high-quality, open-source CTR model that tackles two prior key limitations: inadequate enforcement of the content-preservation constraint, and suboptimal silver training data. Addressing these, we amplify the content-preservation constraint in both training, via RL, and inference, via a controlled decoding strategy. Further, we substantially improve the silver training data quality via GPT-4 distillation. Overall, pairing the distilled dataset with the highlight-adherence strategies yields marked gains over the current baseline, of up to 30 ROUGE-L points, providing a reliable CTR model for downstream use.

Spoken communication plays a central role in clinical workflows. In radiology, for example, most reports are created through dictation. Yet, nearly all medical AI systems rely exclusively on written text. In this work, we address this gap by exploring the feasibility of learning visual-language representations directly from spoken radiology reports. Specifically, we synthesize a large-scale dataset (Speech-RATE) of spoken radiology reports and train SpeechCT-CLIP, a contrastive model that aligns speech and 3D CT volumes in a shared representation space. While naive speech-based models underperform compared to text-trained counterparts, we show that knowledge distillation from a pretrained text-image CLIP model effectively transfers semantic alignment capabilities from text to speech, substantially narrowing this gap. Experiments demonstrate improved zero-shot classification F1 from 0.623 to 0.705, recovering 88% of the performance difference, and strong retrieval results without requiring text at inference. These findings highlight speech as a practical alternative to text in multimodal pretraining and open the door to voice-driven diagnostic support tools in clinical practice.

Connectionist temporal classification (CTC) models are known to have peaky output distributions. Such behavior is not a problem for automatic speech recognition (ASR), but it can cause inaccurate forced alignments (FA), especially at finer granularity, e.g., phoneme level. This paper aims at alleviating the peaky behavior for CTC and improve its suitability for forced alignment generation, by leveraging label priors, so that the scores of alignment paths containing fewer blanks are boosted and maximized during training. As a result, our CTC model produces less peaky posteriors and is able to more accurately predict the offset of the tokens besides their onset. It outperforms the standard CTC model and a heuristics-based approach for obtaining CTC's token offset timestamps by 12-40% in phoneme and word boundary errors (PBE and WBE) measured on the Buckeye and TIMIT data. Compared with the most widely used FA toolkit Montreal Forced Aligner (MFA), our method performs similarly on PBE/WBE on Buckeye, yet falls behind MFA on TIMIT. Nevertheless, our method has a much simpler training pipeline and better runtime efficiency. Our training recipe and pretrained model are released in TorchAudio.

Purpose: This study aims to explore training strategies to improve convolutional neural network-based image-to-image deformable registration for abdominal imaging. Methods: Different training strategies, loss functions, and transfer learning schemes were considered. Furthermore, an augmentation layer which generates artificial training image pairs on-the-fly was proposed, in addition to a loss layer that enables dynamic loss weighting. Results: Guiding registration using segmentations in the training step proved beneficial for deep-learning-based image registration. Finetuning the pretrained model from the brain MRI dataset to the abdominal CT dataset further improved performance on the latter application, removing the need for a large dataset to yield satisfactory performance. Dynamic loss weighting also marginally improved performance, all without impacting inference runtime. Conclusion: Using simple concepts, we improved the performance of a commonly used deep image registration architecture, VoxelMorph. In future work, our framework, DDMR, should be validated on different datasets to further assess its value.

There is substantial interest in developing artificial intelligence systems to support radiologists across tasks ranging from segmentation to report generation. Existing computed tomography (CT) foundation models have largely focused on building generalist vision-language systems capable of tasks such as question answering and report generation. However, training reliable vision-language systems requires paired image-text data at a scale that remains unavailable in CT. Moreover, adapting the underlying visual representations to downstream tasks typically requires partial or full backbone fine-tuning, a computationally demanding process inaccessible to many research groups. Instead, foundation models should prioritise learning robust visual representations that enable efficient transfer to new tasks with minimal labelled data and without backbone fine-tuning. We present VoxelFM, a 3D CT foundation model trained with self-distillation using the DINO framework, which learns semantically rich features without language supervision. We evaluated VoxelFM across seven categories of clinically relevant downstream tasks using frozen backbone representations with lightweight probes: classification, regression, survival analysis, instance retrieval, localisation, segmentation, and report generation. VoxelFM matched or outperformed four existing CT foundation models across all task categories. Despite receiving no language supervision during pre-training, VoxelFM surpassed models explicitly trained with language-alignment objectives, including on report generation. Our results indicate that current CT foundation models perform significantly better as feature extractors for lightweight probes rather than as vision encoders for vision-language models. Model weights and training code are publicly available.

Recent work on applying large language models (LMs) achieves impressive performance in many NLP applications. Adapting or posttraining an LM using an unlabeled domain corpus can produce even better performance for end-tasks in the domain. This paper proposes the problem of continually extending an LM by incrementally post-train the LM with a sequence of unlabeled domain corpora to expand its knowledge without forgetting its previous skills. The goal is to improve the few-shot end-task learning in these domains. The resulting system is called CPT (Continual PostTraining), which to our knowledge, is the first continual post-training system. Experimental results verify its effectiveness.

Sparse-view Computed Tomography (CT) reconstructs images from a limited number of X-ray projections to reduce radiation and scanning time, which is an ill-posed inverse problem. Existing methods achieve high-fidelity reconstructions but overfit to a fixed acquisition setup, failing to generalize well across sampling rates. For example, convolutional neural networks (CNNs) use the same kernels across resolutions, leading to artifacts when data resolution changes. This is a critical limitation in clinical practice, where acquisition sampling settings vary across organs and diagnostic protocols. We propose Computed Tomography neural Operator (CTO), the first neural operator (NO) framework for CT reconstruction. CTO extends learning from fixed discretized grids to continuous function space, enabling a single model to generalize across measurement sampling rates without retraining. We also propose new NO architectural designs for CT: (i) a dual-domain NO architecture in both sinogram and image spaces, capturing complementary spatial-frequency information, and (ii) rotation-equivariant DIScrete-COntinuous convolutions (DISCO) that exploit the rotational structure inherent in tomographic acquisition. Empirically, CTO outperforms CNNs (> 3.4dB PSNR gain) and other baselines in multi-resolution settings across multiple CT datasets. Compared to state-of-the-art diffusion methods, CTO has 500x faster inference with an average 3dB gain. CTO further demonstrates strong out-of-distribution robustness, maintaining gains under cross-dataset transfer and noisy sinogram conditions. Ablation studies also validate each design choice. CTO establishes neural operators as a principled and practical paradigm for flexible, discretization-agnostic CT reconstruction. Our code is available at https://github.com/neuraloperator/sparse_ct.

Recent efforts have extended textual LLMs to the speech domain. Yet, a key challenge remains, which is balancing speech understanding and generation while avoiding catastrophic forgetting when integrating acoustically rich codec-based representations into models originally trained on text. In this work, we propose a novel approach that leverages continual pre-training (CPT) on a pre-trained textual LLM to create a codec-based speech language model. This strategy mitigates the modality gap between text and speech, preserving the linguistic reasoning of the original model while enabling high-fidelity speech synthesis. We validate our approach with extensive experiments across multiple tasks, including automatic speech recognition, text-to-speech, speech-to-text translation, and speech-to-speech translation (S2ST), demonstrating that our model achieves superior TTS performance and, notably, the first end-to-end S2ST system based on neural codecs.

Photon-counting CT (PCCT) provides superior image quality with higher spatial resolution and lower noise compared to conventional energy-integrating CT (EICT), but its limited clinical availability restricts large-scale research and clinical deployment. To bridge this gap, we propose SUMI, a simulated degradation-to-enhancement method that learns to reverse realistic acquisition artifacts in low-quality EICT by leveraging high-quality PCCT as reference. Our central insight is to explicitly model realistic acquisition degradations, transforming PCCT into clinically plausible lower-quality counterparts and learning to invert this process. The simulated degradations were validated for clinical realism by board-certified radiologists, enabling faithful supervision without requiring paired acquisitions at scale. As outcomes of this technical contribution, we: (1) train a latent diffusion model on 1,046 PCCTs, using an autoencoder first pre-trained on both these PCCTs and 405,379 EICTs from 145 hospitals to extract general CT latent features that we release for reuse in other generative medical imaging tasks; (2) construct a large-scale dataset of over 17,316 publicly available EICTs enhanced to PCCT-like quality, with radiologist-validated voxel-wise annotations of airway trees, arteries, veins, lungs, and lobes; and (3) demonstrate substantial improvements: across external data, SUMI outperforms state-of-the-art image translation methods by 15% in SSIM and 20% in PSNR, improves radiologist-rated clinical utility in reader studies, and enhances downstream top-ranking lesion detection performance, increasing sensitivity by up to 15% and F1 score by up to 10%. Our results suggest that emerging imaging advances can be systematically distilled into routine EICT using limited high-quality scans as reference.

Vision-language models (VLMs) pretrained on large-scale image-text pairs demonstrate strong image-level understanding, but are primarily optimized for global alignment and do not explicitly encode fine-grained anatomical structure, limiting their suitability for spatially precise tasks such as segmentation. We introduce CheXanatomy, a framework that integrates explicit anatomical knowledge into a pretrained VLM through autoregressive token-space supervision. Instead of adding task-specific decoder heads, the model is trained to generate anatomical segmentation masks via next-token prediction. To enable scalable supervision, we synthesize realistic chest radiographs from CT volumes and forward-project CT segmentation labels to obtain anatomically consistent 2D masks. We evaluate the approach on synthetic and real chest radiographs against a U-Net baseline, including ablations on model scale, input resolution, and vision encoder fine-tuning. Autoregressive anatomical supervision achieves performance comparable to specialized convolutional models in-distribution and demonstrates improved geometric robustness under domain shift to real CXR data. In addition, anatomy-pretrained models exhibit improved sample efficiency when adapting to novel localization tasks under limited supervision. Larger models and higher input image resolution improve performance, while vision encoder fine-tuning has limited effect. These results show that embedding anatomical structure directly into the generative objective promotes spatially grounded representations and supports anatomy-aware medical vision-language modeling.

End-to-end (E2E) automatic speech recognition (ASR) systems have revolutionized the field by integrating all components into a single neural network, with attention-based encoder-decoder models achieving state-of-the-art performance. However, their autoregressive decoding process limits inference speed, making them unsuitable for real-time applications. In contrast, CTC-based models offer faster, non-autoregressive decoding but struggle to model linguistic dependencies effectively. Addressing this challenge, we propose a novel auxiliary loss framework called Language-Aware Intermediate Loss (LAIL) to enhance CTC-based ASR using the linguistic knowledge of large language models (LLMs). By attaching connector layers to intermediate encoder layers, LAIL maps outputs to the embedding space of an LLM and computes a causal language modeling loss during training. This approach enhances linguistic modeling while preserving the computational efficiency of CTC decoding. Using the Conformer architecture and various LLaMA models, we demonstrate significant improvements in Word Error Rate (WER) on the LibriSpeech, TEDLIUM2, and WSJ corpora, achieving state-of-the-art performance for CTC-based ASR with minimal computational overhead.

Purpose: To develop and evaluate TotalSynth, a reusable pretrained framework for whole-body synthetic CT (sCT) generation from MRI and cone-beam CT (CBCT) images. Materials and Methods: In this retrospective technical study, the dataset was assembled between 2020 and 2026 from SynthRAD challenge data, four prostate cohorts, and BIC-MAC. After registration quality control, 1450 of 1800 public challenge pairs were retained; 350 were excluded for insufficient registration quality or major source/CT mismatch. The corpus also included 84 additional prostate MRI/CT and 60 external BIC-MAC MRI/CT cases. Three 5-fold model families were evaluated with image-domain, anatomy-aware, registration-based, and uncertainty metrics. Age and sex were not consistently available across public datasets. Results: The released MRI-to-CT model achieved an overall MAE of 67.49 HU, SSIM of 0.920, and PSNR of 29.28 dB. The CBCT-to-CT model achieved an overall MAE of 53.55 HU, SSIM of 0.939, and PSNR of 32.09 dB. The unified model maintained similar performance on MRI inputs (MAE, 67.68 HU) and CBCT inputs (MAE, 54.22 HU). On external BIC-MAC data, MRI-to-CT MAE was 100.91 HU without fine-tuning and 62.21 HU after fine-tuning. Conclusion: TotalSynth provides reusable MRI- and CBCT-based CT synthesis models with broad anatomical coverage, while external evaluation highlights the need for local validation and optional fine-tuning under domain shift.

Large Multimodal Models (LMMs) exhibit remarkable multi-tasking ability by learning mixed instruction datasets. However, novel tasks would be encountered sequentially in dynamic world, which urges for equipping LMMs with multimodal continual instruction learning (MCIT) ability especially for diverse and challenging generative tasks. Existing MCIT methods do not fully exploit the unique attribute of LMMs and often gain performance at the expense of efficiency. In this paper, we propose a novel prompt learning framework for MCIT to effectively alleviate forgetting of previous knowledge while managing computational complexity with natural image-text supervision. Concretely, we learn prompts for each task and exploit efficient prompt fusion for knowledge transfer and prompt selection for complexity management with dual-modality guidance. Extensive experiments demonstrate that our approach achieves substantial +14.26% performance gain on MCIT benchmarks with remarkable times 1.42 inference speed free from growing computation. Code is available at https://github.com/AuroraZengfh/ModalPrompt.

Small Language Models (SLMs) enable cost-effective, on-device and latency-sensitive AI applications, yet their deployment in Traditional Chinese (TC) remains hindered by token-level instability - models unpredictably emit non-TC characters or code-switch into other languages. We address this practical reliability gap by creating PureTC-1B, a three-stage stabilization pipeline for Llama-3.2-1B-Instruct (an open-weight, instruction-tuned model released by Meta) using parameter-efficient LoRA adapters. Our method combines Continual Pre-Training (CPT) on TC-centric corpora, Supervised Fine-Tuning (SFT) with instruction data, and Direct Preference Optimization (DPO) using TC-adherence preferences to improve monolingual robustness without full-model retraining. On a benchmark designed to simulate real-world usage, PureTC-1B achieves a 51.3% relative reduction (micro-average) in non-TC output tokens versus the base model. On a Named Entity Translation (NET) task, PureTC-1B further reduces incorrect-language tokens by 77.2% relative to Llama-3B and 57.2% relative to Qwen-1.5B, indicating that robust TC adherence is attainable even at the 1B scale. The pipeline is reproducible, adapter-only, and hardware-friendly, offering practitioners a practical recipe to enhance language stability for TC and potentially other non-English languages.

Purpose: A profound education of novice surgeons is crucial to ensure that surgical interventions are effective and safe. One important aspect is the teaching of technical skills for minimally invasive or robot-assisted procedures. This includes the objective and preferably automatic assessment of surgical skill. Recent studies presented good results for automatic, objective skill evaluation by collecting and analyzing motion data such as trajectories of surgical instruments. However, obtaining the motion data generally requires additional equipment for instrument tracking or the availability of a robotic surgery system to capture kinematic data. In contrast, we investigate a method for automatic, objective skill assessment that requires video data only. This has the advantage that video can be collected effortlessly during minimally invasive and robot-assisted training scenarios. Methods: Our method builds on recent advances in deep learning-based video classification. Specifically, we propose to use an inflated 3D ConvNet to classify snippets, i.e., stacks of a few consecutive frames, extracted from surgical video. The network is extended into a Temporal Segment Network during training. Results: We evaluate the method on the publicly available JIGSAWS dataset, which consists of recordings of basic robot-assisted surgery tasks performed on a dry lab bench-top model. Our approach achieves high skill classification accuracies ranging from 95.1% to 100.0%. Conclusions: Our results demonstrate the feasibility of deep learning-based assessment of technical skill from surgical video. Notably, the 3D ConvNet is able to learn meaningful patterns directly from the data, alleviating the need for manual feature engineering. Further evaluation will require more annotated data for training and testing.

Classifier-free guidance (CFG) is a key technique for improving conditional generation in diffusion models, enabling more accurate control while enhancing sample quality. It is natural to extend this technique to video diffusion, which generates video conditioned on a variable number of context frames, collectively referred to as history. However, we find two key challenges to guiding with variable-length history: architectures that only support fixed-size conditioning, and the empirical observation that CFG-style history dropout performs poorly. To address this, we propose the Diffusion Forcing Transformer (DFoT), a video diffusion architecture and theoretically grounded training objective that jointly enable conditioning on a flexible number of history frames. We then introduce History Guidance, a family of guidance methods uniquely enabled by DFoT. We show that its simplest form, vanilla history guidance, already significantly improves video generation quality and temporal consistency. A more advanced method, history guidance across time and frequency further enhances motion dynamics, enables compositional generalization to out-of-distribution history, and can stably roll out extremely long videos. Website: https://boyuan.space/history-guidance

Recently, both closed-source LLMs and open-source communities have made significant strides, outperforming humans in various general domains. However, their performance in specific professional domains such as medicine, especially within the open-source community, remains suboptimal due to the complexity of medical knowledge. In this paper, we propose CareBot, a bilingual medical LLM, which leverages a comprehensive approach integrating continuous pre-training (CPT), supervised fine-tuning (SFT), and reinforcement learning with human feedback (RLHF). Our novel two-stage CPT method, comprising Stable CPT and Boost CPT, effectively bridges the gap between general and domain-specific data, facilitating a smooth transition from pre-training to fine-tuning and enhancing domain knowledge progressively. We also introduce DataRater, a model designed to assess data quality during CPT, ensuring that the training data is both accurate and relevant. For SFT, we develope a large and diverse bilingual dataset, along with ConFilter, a metric to enhance multi-turn dialogue quality, which is crucial to improving the model's ability to handle more complex dialogues. The combination of high-quality data sources and innovative techniques significantly improves CareBot's performance across a range of medical applications. Our rigorous evaluations on Chinese and English benchmarks confirm CareBot's effectiveness in medical consultation and education. These advancements not only address current limitations in medical LLMs but also set a new standard for developing effective and reliable open-source models in the medical domain. We will open-source the datasets and models later, contributing valuable resources to the research community.

Purpose: Automating tasks such as lung tumor localization and segmentation in radiological images can free valuable time for radiologists and other clinical personnel. Convolutional neural networks may be suited for such tasks, but require substantial amounts of labeled data to train. Obtaining labeled data is a challenge, especially in the medical domain. Methods: This paper investigates the use of a teacher-student design to utilize datasets with different types of supervision to train an automatic model performing pulmonary tumor segmentation on computed tomography images. The framework consists of two models: the student that performs end-to-end automatic tumor segmentation and the teacher that supplies the student additional pseudo-annotated data during training. Results: Using only a small proportion of semantically labeled data and a large number of bounding box annotated data, we achieved competitive performance using a teacher-student design. Models trained on larger amounts of semantic annotations did not perform better than those trained on teacher-annotated data. Conclusions: Our results demonstrate the potential of utilizing teacher-student designs to reduce the annotation load, as less supervised annotation schemes may be performed, without any real degradation in segmentation accuracy.

Large Language Models prompting, such as using in-context demonstrations, is a mainstream technique for invoking LLMs to perform high-performance and solid complex reasoning (e.g., mathematical reasoning, commonsense reasoning), and has the potential for further human-machine collaborative scientific findings. However, current LLMs are delicate and elusive in prompt words and styles. And there is an unseen gap between LLM understanding and human-written prompts. This paper introduces Alignedcot, an LLM-acquainted prompting technique that includes proficient ``native-speaking'' in in-context learning for the LLMs. Specifically, it achieves consistent and correct step-wise prompts in zero-shot scenarios by progressively probing, refining, and formatting the LLM chain of thoughts so that free from handcrafted few-shot demonstrations while maintaining the prompt quality. We conduct experiments on mathematical reasoning and commonsense reasoning. We find that LLMs with Alignedcot perform significantly superior to them with human-crafted demonstrations. We further apply Alignedcot for rewriting the GSM8K training set, resulting in a GSM8K-Align dataset. We observe its benefits for retrieval augmented generation. The code and data can be found at https://github.com/yangzhch6/AlignedCoT.

Multilingual pretrained models nominally support Nepali, yet no controlled benchmark has compared them under a single fine-tuning protocol. We fine-tune six pretrained models (XLSR-53, IndicWav2Vec, MMS-1B, Whisper-Medium, Whisper-Large-v3-Turbo, and Conformer-Hi) spanning CTC self-supervised, autoregressive encoder-decoder, and hybrid Conformer-CTC architectures, on the OpenSLR SLR54 Nepali corpus (~165 hours) using identical preprocessing, splits, optimizer, and family-matched learning-rate schedules. We evaluate Word Error Rate (WER), Character Error Rate (CER), and Real-Time Factor (RTF) on three independent test sets (OpenSLR, FLEURS, Common Voice). Whisper-Large-v3-Turbo (14.76% WER) and IndicWav2Vec (14.89% WER) tie at the top despite a 9x parameter gap and 40x pretraining-data gap, providing direct empirical evidence that language-family proximity in pretraining can substitute for raw scale for in-domain Nepali. CTC decoders run up to 29x faster than autoregressive Whisper at the same accuracy, flipping the practical deployment preference toward CTC under any latency budget. Massively multilingual pretraining (MMS-1B) yields the smallest out-of-domain degradation on FLEURS (+12.55 pp), indicating that scale buys robustness rather than peak in-domain accuracy. The resulting benchmark provides the first standardized, multi-model, efficiency-aware reference numbers for Nepali ASR.

Radiation therapy plays a crucial role in cancer treatment, necessitating precise delivery of radiation to tumors while sparing healthy tissues over multiple days. Computed tomography (CT) is integral for treatment planning, offering electron density data crucial for accurate dose calculations. However, accurately representing patient anatomy is challenging, especially in adaptive radiotherapy, where CT is not acquired daily. Magnetic resonance imaging (MRI) provides superior soft-tissue contrast. Still, it lacks electron density information while cone beam CT (CBCT) lacks direct electron density calibration and is mainly used for patient positioning. Adopting MRI-only or CBCT-based adaptive radiotherapy eliminates the need for CT planning but presents challenges. Synthetic CT (sCT) generation techniques aim to address these challenges by using image synthesis to bridge the gap between MRI, CBCT, and CT. The SynthRAD2023 challenge was organized to compare synthetic CT generation methods using multi-center ground truth data from 1080 patients, divided into two tasks: 1) MRI-to-CT and 2) CBCT-to-CT. The evaluation included image similarity and dose-based metrics from proton and photon plans. The challenge attracted significant participation, with 617 registrations and 22/17 valid submissions for tasks 1/2. Top-performing teams achieved high structural similarity indices (>0.87/0.90) and gamma pass rates for photon (>98.1%/99.0%) and proton (>99.0%/97.3%) plans. However, no significant correlation was found between image similarity metrics and dose accuracy, emphasizing the need for dose evaluation when assessing the clinical applicability of sCT. SynthRAD2023 facilitated the investigation and benchmarking of sCT generation techniques, providing insights for developing MRI-only and CBCT-based adaptive radiotherapy.

Interpreting computed tomography (CT) requires review of hundreds of volumetric slices and remains time-intensive and expertise-dependent. Automated CT report generation offers a promising route to improving clinical efficiency, yet the field still lacks a generalizable CT report generation foundation model that supports multi-region reporting and remains robust across external real-world cohorts. Intrinsic inconsistencies in reporting style and diagnostic terminology across cohorts make naive joint training difficult. Here we present Astra, a generalizable CT report generation foundation model developed on 90,678 thoracoabdominal CT-report pairs collected from five sites worldwide (CTRgDB), comprising 353,671 abnormalities spanning eight organ systems. By harmonizing report style and further refining diagnostic consistency via reinforcement learning, Astra achieves style-consistent and diagnostically accurate report generation across diverse anatomical regions and institutions. Evaluated on CTRgDB and six external cohorts, Astra achieves state-of-the-art performance with a 38.4% average improvement in fine-grained diagnostic metrics (P<0.001). Deployed at external clinical sites without any site-specific fine-tuning, Astra accelerated chest report drafting by 29.6% and improved abdominal report completeness by 11.3% among junior and mid-level radiologists (P<0.001). Furthermore, Astra demonstrates broad utility as a foundation for CT AI development, improving downstream diagnostic performance and scaling vision-language pretrain through high-quality report synthesis. Overall, Astra serves as a broadly accessible clinical assistant and a pivotal infrastructure for the next generation of AI-powered healthcare. The code for Astra is publicly available at https://github.com/zh-Wang-Med/Astra.

Automatic radiology report generation is a promising application of multimodal deep learning, aiming to reduce reporting workload and improve consistency. However, current state-of-the-art (SOTA) systems - such as Multimodal AI for Radiology Applications (MAIRA-2) and Medical Pathways Language Model-Multimodal (MedPaLM-M) - depend on large-scale multimodal training, clinical metadata, and multiple imaging views, making them resource-intensive and inaccessible for most settings. We introduce a compact image-to-text architecture that generates the Findings section of chest X-ray reports from a single frontal image. The model combines a frozen Self-Distillation with No Labels v3 (DINOv3) Vision Transformer (ViT) encoder with a Generative Pre-trained Transformer 2 (GPT-2) decoder enhanced by layer-wise anatomical attention. This mechanism integrates lung and heart segmentation masks through hierarchical Gaussian smoothing, biasing attention toward clinically relevant regions without adding trainable parameters. Evaluated on the official Medical Information Mart for Intensive Care-Chest X-ray (MIMIC-CXR) dataset using Chest Radiograph Expert (CheXpert) and Radiology Graph (RadGraph) metrics, our approach achieved substantial gains: CheXpert Macro-F1 for five key pathologies increased by 168% (0.083 -> 0.238) and Micro-F1 by 146% (0.137 -> 0.337), while broader performance across 14 observations improved by 86% (0.170 -> 0.316). Structural coherence also improved, with RadGraph F1 rising by 9.7%. Despite its small size and purely image-conditioned design, the model demonstrates that decoder-level anatomical guidance improves spatial grounding and enhances coherence in clinically relevant regions. The source code is publicly available at: https://github.com/devMuniz02/UDEM-CXR-Reporting-Thesis-2025.