ARC-CT: Anatomy-Routed Contrastive Vision-Language Learning for 3D Chest CT

Contrastive vision-language learning uses paired chest CT volumes and radiology reports to learn abnormality classifiers without manually annotated labels. However, two characteristics of chest CT challenge conventional global contrastive learning. First, many critical abnormalities are small or anatomically localized, and pooling an en- tire volume into a single embedding may dilute their visual evidence. Second, the standard contrastive objective treats every other scan in a batch as a negative. Because many chest CTs share abnormalities, this objective incorrectly pushes co-positive pairs apart. We propose Anatomy-Routed Contrastive Learning for 3D Chest CT (ARC-CT), a region-aware framework that addresses these limitations using only la- bels extracted from reports by an LLM, with no manual annotations or bounding boxes. ARC-CT combines three components: (1) an Anato- myQFormer localizing evidence via queries constrained by automatically generated organ masks; (2) a label-Jaccard soft InfoNCE objective in- tegrating the standard one-hot target with the label-set overlap of each pair, which reduces false-negative penalties between studies that share clinical findings; and (3) an organ-level alignment loss connecting mask- pooled visual features to organ-specific report text extracted offline with a large language model. ARC-CT achieves a 0.86 mask-free macro AUC across 18 abnormalities using a compact 3D ResNet-18 backbone. Over- all, ARC-CT outperforms both comparable efficient baselines and sev- eral larger transformer models. Our code and weights are available at https://github.com/arc-ct/arc-ct.

Understand Before Detect: Vision--Language Learning for Omni-Domain Infrared Small Target Detection

Omni-domain infrared small target (IRST) detection is crucial for infrared surveillance, yet remains challenging due to heterogeneous imaging domains and inconsistent target characteristics. Previous deep learning-based methods have been developed for visual-only paradigms and achieved promising performance on domain-specific tasks. However, existing methods follow the task-specific supervised learning paradigm. This paradigm simplifies the full-scene infrared observations to sparse target supervision, discarding the semantics that remain invariant across heterogeneous domains. Consequently, detection performance suffers substantially under domain shifts. To handle this issue, we introduce \textbf{``understand before detect''}, a paradigm that formulates omni-domain IRST detection as an understanding-driven process, where holistic infrared target understanding precedes precise detection. Building on this paradigm, we propose \textbf{JinSight}, which first develops holistic IRST understanding through language supervision and then transfers the learned cross-domain representations to precise small-target detection. By grounding infrared representations in language semantics, JinSight enables a single model to generalize across heterogeneous infrared domains. We then introduce Latent Semantic Interaction (LSI), which exchanges language-aligned global semantics with fine-grained spatial features in a compact low-rank space. To address the lack of multimodal omni-domain IRST benchmarks, we build \textbf{OmniIRST-VL}, the first large-scale, highly diverse vision--language dataset for omni-domain IRST detection. It comprises over 39k annotations across six complementary instruction tasks covering both scene-level understanding and target-centric reasoning.

Semantically Calibrated Evidence Composition for CT Vision-Language Learning

Learning transferable representations from CT-report pairs requires combining whole-volume context with anatomy-specific evidence. Existing methods typically emphasize either global CT-report alignment or fine-grained anatomy-level correspondence. Global alignment preserves broad study context but leaves the contribution of localized evidence implicit, whereas anatomy-level alignment explicitly grounds local findings but does not specify how independently represented evidence should interact, acquire study-level meaning, and contribute to a global CT representation. To address this gap, we propose SCOPE (Semantic Calibration Of comPosed Evidence), a framework for semantically calibrated evidence composition in CT vision-language learning. Under organ-specific report supervision, mask-guided queries with fixed anatomical identities extract context-aware organ evidence from shared, uncropped volumetric features, while an unrestricted global query retains access to whole-volume context. The global query then drives Local-Global Coupling to compose the organ evidence into a unified evidence representation. The composed evidence is subsequently calibrated using the diagnostic summary, providing study-level semantic supervision beyond local organ descriptions, and is finally integrated as a controlled residual into a context-preserving whole-volume representation aligned with the complete report. This progressive pathway connects localized evidence with study-level semantics without reducing the CT representation to a predefined set of organs. On CT-RATE and RadChestCT, SCOPE achieves macro AUCs of 85.0 and 72.2, respectively, outperforming the previous SOTA by 7.2 and 4.2, while also yielding substantial gains in linear probing and cross-modal retrieval. These results demonstrate the effectiveness of semantically calibrated evidence composition.