Lesion Detection in CT with Frozen Self-Distilled Features: SALT, a Spatially Adaptive Label-Guided Temperature

Self-supervised pretraining objectives are spatially uniform: the teacher temperature and the per-patch loss weight are identical everywhere in the image, so a lesion a few patches wide contributes no more to the training signal than the surrounding parenchyma. Prior work biases the views toward annotated regions, which changes what the model sees but adds no pressure on the objective. We instead condition the targets of self-distillation, a method we call SALT (Spatially Adaptive Label-guided Temperature). Weak, box-derived labels, available only during pretraining, define a compact region on the encoder's patch grid, inside which the teacher's softmax temperature is sharpened and the masked-patch loss is up-weighted. The objectives, the masking policy and the centering statistics are otherwise unchanged, and at every downstream use the encoder is a plain feature extractor with no labels and no conditioning. We evaluate by freezing the encoder and training only a lightweight multi-depth CenterNet-style head, detecting lesions in 3D on four CT cohorts, and we isolate the mechanism against a backbone identical in architecture, pretraining data, schedule and label-guided cropping but with no target conditioning. We report patch-level separability, 3D detection stratified by cohort and by lesion size, box quality, and a detector-free probe in which a single frozen patch embedding re-identifies a lesion in a follow-up scan without registration, masks or fine-tuning. Because the conditioning is expressed through a spatial indicator rather than through label semantics, the formulation admits any weak spatial annotation; we instantiate and validate it for lesions.

DALE-CT: Depth-Aware Foundation Models for Computed Tomography

Recent breakthroughs in self-supervised learning (SSL), such as the Latent-Euclidean Joint-Embedding Predictive Architecture (LeJEPA), alongside successes in integrating visual encoders with language models, have driven the demand for adaptable, high-capacity vision encoders in Computed Tomography (CT). In this work, we explore 2D slice-based architectures as a flexible alternative to native 3D models for processing volumetric CT data. Using the CT-RATE dataset, we trained DALE-CT (Depth-Aware Latent-Euclidean Computed Tomography), a 2D model family built entirely from scratch using LeJEPA, and compared its performance against a continually pre-trained DINOv2 baseline. To enhance representation quality, we developed a novel 3D depth-aware pre-training strategy anchored by dense auxiliary supervision from both automated anatomical masks and human-annotated abnormalities. Under linear probe evaluation with Multiple Instance Learning (MIL) for multi-abnormality detection, the frozen backbone of this dual-supervised model (DALE-CT-2S) achieves a Macro AUROC of 0.833. This performance demonstrates near-parity with state-of-the-art 3D vision-language models, achieved entirely from scratch with significantly less data and no textual supervision. To ensure reproducibility, all training code, evaluation scripts, and model weights have been made publicly available.

A Framework for Cross-Domain Generalization in Coronary Artery Calcium Scoring Across Gated and Non-Gated Computed Tomography

Coronary artery calcium (CAC) scoring is a key predictor of cardiovascular risk, but it relies on ECG-gated CT scans, restricting its use to specialized cardiac imaging settings. We introduce an automated framework for CAC detection and lesion-specific Agatston scoring that operates across both gated and non-gated CT scans. At its core is CARD-ViT, a self-supervised Vision Transformer trained exclusively on gated CT data using DINO. Without any non-gated training data, our framework achieves 0.707 accuracy and a Cohen's kappa of 0.528 on the Stanford non-gated dataset, matching models trained directly on non-gated scans. On gated test sets, the framework achieves 0.910 accuracy with Cohen's kappa scores of 0.871 and 0.874 across independent datasets, demonstrating robust risk stratification. These results demonstrate the feasibility of cross-domain CAC scoring from gated to non-gated domains, supporting scalable cardiovascular screening in routine chest imaging without additional scans or annotations.

Toward an AI Reasoning-Enabled System for Patient-Clinical Trial Matching

Screening patients for clinical trial eligibility remains a manual, time-consuming, and resource-intensive process. We present a secure, scalable proof-of-concept system for Artificial Intelligence (AI)-augmented patient-trial matching that addresses key implementation challenges: integrating heterogeneous electronic health record (EHR) data, facilitating expert review, and maintaining rigorous security standards. Leveraging open-source, reasoning-enabled large language models (LLMs), the system moves beyond binary classification to generate structured eligibility assessments with interpretable reasoning chains that support human-in-the-loop review. This decision support tool represents eligibility as a dynamic state rather than a fixed determination, identifying matches when available and offering actionable recommendations that could render a patient eligible in the future. The system aims to reduce coordinator burden, intelligently broaden the set of trials considered for each patient and guarantee comprehensive auditability of all AI-generated outputs.