Structure Observation Driven Image-Text Contrastive Learning for Computed Tomography Report Generation

Computed Tomography Report Generation (CTRG) aims to automate the clinical radiology reporting process, thereby reducing the workload of report writing and facilitating patient care. While deep learning approaches have achieved remarkable advances in X-ray report generation, their effectiveness may be limited in CTRG due to larger data volumes of CT images and more intricate details required to describe them. This work introduces a novel two-stage (structure- and report-learning) framework tailored for CTRG featuring effective structure-wise image-text contrasting. In the first stage, a set of learnable structure-specific visual queries observe corresponding structures in a CT image. The resulting observation tokens are contrasted with structure-specific textual features extracted from the accompanying radiology report with a structure-wise image-text contrastive loss. In addition, text-text similarity-based soft pseudo targets are proposed to mitigate the impact of false negatives, i.e., semantically identical image structures and texts from non-paired images and reports. Thus, the model learns structure-level semantic correspondences between CT images and reports. Further, a dynamic, diversity-enhanced negative queue is proposed to guide the network in learning to discriminate various abnormalities. In the second stage, the visual structure queries are frozen and used to select the critical image patch embeddings depicting each anatomical structure, minimizing distractions from irrelevant areas while reducing memory consumption. Also, a text decoder is added and trained for report generation.Our extensive experiments on two public datasets demonstrate that our framework establishes new state-of-the-art performance for CTRG in clinical efficiency, and its components are effective.

FDP: A Frequency-Decomposition Preprocessing Pipeline for Unsupervised Anomaly Detection in Brain MRI

Due to the diversity of brain anatomy and the scarcity of annotated data, supervised anomaly detection for brain MRI remains challenging, driving the development of unsupervised anomaly detection (UAD) approaches. Current UAD methods typically utilize artificially generated noise perturbations on healthy MRIs to train generative models for normal anatomy reconstruction, enabling anomaly detection via residual mapping. However, such simulated anomalies lack the biophysical fidelity and morphological complexity characteristic of true clinical lesions. To advance UAD in brain MRI, we conduct the first systematic frequency-domain analysis of pathological signatures, revealing two key properties: (1) anomalies exhibit unique frequency patterns distinguishable from normal anatomy, and (2) low-frequency signals maintain consistent representations across healthy scans. These insights motivate our Frequency-Decomposition Preprocessing (FDP) framework, the first UAD method to leverage frequency-domain reconstruction for simultaneous pathology suppression and anatomical preservation. FDP can integrate seamlessly with existing anomaly simulation techniques, consistently enhancing detection performance across diverse architectures while maintaining diagnostic fidelity. Experimental results demonstrate that FDP consistently improves anomaly detection performance when integrated with existing methods. Notably, FDP achieves a 17.63% increase in DICE score with LDM while maintaining robust improvements across multiple baselines. The code is available at https://github.com/ls1rius/MRI_FDP.