Astra: a generalizable report generation foundation model for 3D computed tomography

CT interpretation requires radiologists to review hundreds of volumetric slices per examination, making reporting time-consuming and highly 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 prone to noisy textual supervision, thereby limiting model generalizability. Here we present Astra, a generalizable CT report generation foundation model trained on 90,678 thoracoabdominal CT-report pairs (CTRgDB) with 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. Evaluating on CTRgDB and six external cohorts, Astra achieves state-of-the-art performance with a 44.1% average improvement in fine-grained diagnostic metrics (P<0.001). In real-world clinical workflows, Astra assistance accelerates chest report drafting by 29.6% and improves abdominal report completeness by 11.3% (P<0.001). Furthermore, Astra also 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.

A physics-informed foundation model for quantitative diffusion MRI

Understanding the human brain requires access to its microscopic tissue architecture. Diffusion magnetic resonance imaging (MRI) provides the only noninvasive window into whole-brain microstructure in vivo, yet reliable quantitative mapping remains confined to specialized research settings requiring dense sampling and optimized acquisition protocols. To address this gap, we present a physics-informed generative microstructure network (PIGMENT) that learns a universal generative prior of human brain microstructure and adapts it zero-shot to each participant's measured data to recover subject-specific maps. Trained on 11375 scans spanning multiple sites, vendors, and field strengths, PIGMENT enabled reliable quantitative mapping for tensor, kurtosis, and NODDI models across external datasets from five independent centers. It remains effective where conventional fitting becomes unreliable, recovering meaningful maps from extremely sparse acquisitions while supporting downstream tractography and structural connectivity mapping. PIGMENT estimates demonstrated strong biological validity, preserving submillimeter cortical microarchitectural patterns and early-childhood white matter developmental trajectories from 10-fold accelerated scans. Furthermore, PIGMENT enables reliable quantitative tensor mapping on cost-efficient low-field systems and the extraction of tumor-related biomarkers using ultra-fast clinical protocols. Together, these results establish PIGMENT as a physics-informed foundation model that extends quantitative diffusion MRI into regimes traditionally too sparse, heterogeneous, or clinically constrained for reliable analysis.

Exploring the Potential of Encoder-free Architectures in 3D LMMs

Encoder-free architectures have been preliminarily explored in the 2D visual domain, yet it remains an open question whether they can be effectively applied to 3D understanding scenarios. In this paper, we present the first comprehensive investigation into the potential of encoder-free architectures to overcome the challenges of encoder-based 3D Large Multimodal Models (LMMs). These challenges include the failure to adapt to varying point cloud resolutions and the point features from the encoder not meeting the semantic needs of Large Language Models (LLMs). We identify key aspects for 3D LMMs to remove the encoder and enable the LLM to assume the role of the 3D encoder: 1) We propose the LLM-embedded Semantic Encoding strategy in the pre-training stage, exploring the effects of various point cloud self-supervised losses. And we present the Hybrid Semantic Loss to extract high-level semantics. 2) We introduce the Hierarchical Geometry Aggregation strategy in the instruction tuning stage. This incorporates inductive bias into the LLM early layers to focus on the local details of the point clouds. To the end, we present the first Encoder-free 3D LMM, ENEL. Our 7B model rivals the current state-of-the-art model, ShapeLLM-13B, achieving 55.0%, 50.92%, and 42.7% on the classification, captioning, and VQA tasks, respectively. Our results demonstrate that the encoder-free architecture is highly promising for replacing encoder-based architectures in the field of 3D understanding. The code is released at https://github.com/Ivan-Tang-3D/ENEL

LLM-RG4: Flexible and Factual Radiology Report Generation across Diverse Input Contexts

Drafting radiology reports is a complex task requiring flexibility, where radiologists tail content to available information and particular clinical demands. However, most current radiology report generation (RRG) models are constrained to a fixed task paradigm, such as predicting the full ``finding'' section from a single image, inherently involving a mismatch between inputs and outputs. The trained models lack the flexibility for diverse inputs and could generate harmful, input-agnostic hallucinations. To bridge the gap between current RRG models and the clinical demands in practice, we first develop a data generation pipeline to create a new MIMIC-RG4 dataset, which considers four common radiology report drafting scenarios and has perfectly corresponded input and output. Secondly, we propose a novel large language model (LLM) based RRG framework, namely LLM-RG4, which utilizes LLM's flexible instruction-following capabilities and extensive general knowledge. We further develop an adaptive token fusion module that offers flexibility to handle diverse scenarios with different input combinations, while minimizing the additional computational burden associated with increased input volumes. Besides, we propose a token-level loss weighting strategy to direct the model's attention towards positive and uncertain descriptions. Experimental results demonstrate that LLM-RG4 achieves state-of-the-art performance in both clinical efficiency and natural language generation on the MIMIC-RG4 and MIMIC-CXR datasets. We quantitatively demonstrate that our model has minimal input-agnostic hallucinations, whereas current open-source models commonly suffer from this problem.