OmniCT: Towards a Unified Slice-Volume LVLM for Comprehensive CT Analysis

Computed Tomography (CT) is one of the most widely used and diagnostically information-dense imaging modalities, covering critical organs such as the heart, lungs, liver, and colon. Clinical interpretation relies on both slice-driven local features (e.g., sub-centimeter nodules, lesion boundaries) and volume-driven spatial representations (e.g., tumor infiltration, inter-organ anatomical relations). However, existing Large Vision-Language Models (LVLMs) remain fragmented in CT slice versus volumetric understanding: slice-driven LVLMs show strong generalization but lack cross-slice spatial consistency, while volume-driven LVLMs explicitly capture volumetric semantics but suffer from coarse granularity and poor compatibility with slice inputs. The absence of a unified modeling paradigm constitutes a major bottleneck for the clinical translation of medical LVLMs. We present OmniCT, a powerful unified slice-volume LVLM for CT scenarios, which makes three contributions: (i) Spatial Consistency Enhancement (SCE): volumetric slice composition combined with tri-axial positional embedding that introduces volumetric consistency, and an MoE hybrid projection enables efficient slice-volume adaptation; (ii) Organ-level Semantic Enhancement (OSE): segmentation and ROI localization explicitly align anatomical regions, emphasizing lesion- and organ-level semantics; (iii) MedEval-CT: the largest slice-volume CT dataset and hybrid benchmark integrates comprehensive metrics for unified evaluation. OmniCT consistently outperforms existing methods with a substantial margin across diverse clinical tasks and satisfies both micro-level detail sensitivity and macro-level spatial reasoning. More importantly, it establishes a new paradigm for cross-modal medical imaging understanding.

CtrlCoT: Dual-Granularity Chain-of-Thought Compression for Controllable Reasoning

Chain-of-thought (CoT) prompting improves LLM reasoning but incurs high latency and memory cost due to verbose traces, motivating CoT compression with preserved correctness. Existing methods either shorten CoTs at the semantic level, which is often conservative, or prune tokens aggressively, which can miss task-critical cues and degrade accuracy. Moreover, combining the two is non-trivial due to sequential dependency, task-agnostic pruning, and distribution mismatch. We propose \textbf{CtrlCoT}, a dual-granularity CoT compression framework that harmonizes semantic abstraction and token-level pruning through three components: Hierarchical Reasoning Abstraction produces CoTs at multiple semantic granularities; Logic-Preserving Distillation trains a logic-aware pruner to retain indispensable reasoning cues (e.g., numbers and operators) across pruning ratios; and Distribution-Alignment Generation aligns compressed traces with fluent inference-time reasoning styles to avoid fragmentation. On MATH-500 with Qwen2.5-7B-Instruct, CtrlCoT uses 30.7\% fewer tokens while achieving 7.6 percentage points higher than the strongest baseline, demonstrating more efficient and reliable reasoning. Our code will be publicly available at https://github.com/fanzhenxuan/Ctrl-CoT.