Beyond the Embedding Bottleneck: Adaptive Retrieval-Augmented 3D CT Report Generation

Automated radiology report generation from 3D CT volumes often suffers from incomplete pathology coverage. We provide empirical evidence that this limitation stems from a representational bottleneck: contrastive 3D CT embeddings encode discriminative pathology signals, yet exhibit severe dimensional concentration, with as few as 2 effective dimensions out of 512. Corroborating this, scaling the language model yields no measurable improvement, suggesting that the bottleneck lies in the visual representation rather than the generator. This bottleneck limits both generation and retrieval; naive static retrieval fails to improve clinical efficacy and can even degrade performance. We propose \textbf{AdaRAG-CT}, an adaptive augmentation framework that compensates for this visual bottleneck by introducing supplementary textual information through controlled retrieval and selectively integrating it during generation. On the CT-RATE benchmark, AdaRAG-CT achieves state-of-the-art clinical efficacy, improving Clinical F1 from 0.420 (CT-Agent) to 0.480 (+6 points); ablation studies confirm that both the retrieval and generation components contribute to the improvement. Code is available at https://github.com/renjie-liang/Adaptive-RAG-for-3DCT-Report-Generation.

Enhancing Renal Tumor Malignancy Prediction: Deep Learning with Automatic 3D CT Organ Focused Attention

Accurate prediction of malignancy in renal tumors is crucial for informing clinical decisions and optimizing treatment strategies. However, existing imaging modalities lack the necessary accuracy to reliably predict malignancy before surgical intervention. While deep learning has shown promise in malignancy prediction using 3D CT images, traditional approaches often rely on manual segmentation to isolate the tumor region and reduce noise, which enhances predictive performance. Manual segmentation, however, is labor-intensive, costly, and dependent on expert knowledge. In this study, a deep learning framework was developed utilizing an Organ Focused Attention (OFA) loss function to modify the attention of image patches so that organ patches attend only to other organ patches. Hence, no segmentation of 3D renal CT images is required at deployment time for malignancy prediction. The proposed framework achieved an AUC of 0.685 and an F1-score of 0.872 on a private dataset from the UF Integrated Data Repository (IDR), and an AUC of 0.760 and an F1-score of 0.852 on the publicly available KiTS21 dataset. These results surpass the performance of conventional models that rely on segmentation-based cropping for noise reduction, demonstrating the frameworks ability to enhance predictive accuracy without explicit segmentation input. The findings suggest that this approach offers a more efficient and reliable method for malignancy prediction, thereby enhancing clinical decision-making in renal cancer diagnosis.

DTC: A Deformable Transposed Convolution Module for Medical Image Segmentation

In medical image segmentation, particularly in UNet-like architectures, upsampling is primarily used to transform smaller feature maps into larger ones, enabling feature fusion between encoder and decoder features and supporting multi-scale prediction. Conventional upsampling methods, such as transposed convolution and linear interpolation, operate on fixed positions: transposed convolution applies kernel elements to predetermined pixel or voxel locations, while linear interpolation assigns values based on fixed coordinates in the original feature map. These fixed-position approaches may fail to capture structural information beyond predefined sampling positions and can lead to artifacts or loss of detail. Inspired by deformable convolutions, we propose a novel upsampling method, Deformable Transposed Convolution (DTC), which learns dynamic coordinates (i.e., sampling positions) to generate high-resolution feature maps for both 2D and 3D medical image segmentation tasks. Experiments on 3D (e.g., BTCV15) and 2D datasets (e.g., ISIC18, BUSI) demonstrate that DTC can be effectively integrated into existing medical image segmentation models, consistently improving the decoder's feature reconstruction and detail recovery capability.