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Main Authors: Liu, Yuyuan, Peng, Can, Yang, Yingyu, Yang, Qianye, Ouyang, Cheng, Noble, J. Alison
Format: Preprint
Published: 2026
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Online Access:https://arxiv.org/abs/2605.15997
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author Liu, Yuyuan
Peng, Can
Yang, Yingyu
Yang, Qianye
Ouyang, Cheng
Noble, J. Alison
author_facet Liu, Yuyuan
Peng, Can
Yang, Yingyu
Yang, Qianye
Ouyang, Cheng
Noble, J. Alison
contents Recent progress in deep learning has significantly advanced CT image analysis, particularly for segmentation tasks. However, these advances are largely confined to image-level pattern recognition, with most methods lacking explicit anatomical or contextual reasoning. Large vision-language models introduce linguistic context into image analysis, yet most approaches typically focus on a single task, which is insufficient for clinical workflow analysis that requires multiple fine-grained types of analysis, such as anatomy detection and segmentation. In this paper, we propose a unified autoregressive framework that integrates language-guided visual reasoning into CT interpretation. Our method introduces task-routing tokens that trigger detection and segmentation heads conditioned on the hidden states of a large vision-language model, enabling coherent generation of visual outputs (e.g., masks and bounding boxes) and textual reasonings. To progressively enhance localisation accuracy and semantic clarity, we further design a "closer-look" mechanism that allows the model to perform progressive coarse-to-fine visits to regions of interest under refined fields of view. To support model training and evaluation, we curated a new multimodal CT dataset containing pixel-wise masks, bounding boxes, spatial prompts, and structured descriptions for visual objects constructed through an AI-assisted annotation process with human verification. Experiments on public benchmarks demonstrate consistent improvements over the SoTA, achieving up to 1.0% Dice on BTCV and 1.7% Dice on MosMed+, while additionally providing appearance reasoning outputs. The code and dataset will be available.
format Preprint
id arxiv_https___arxiv_org_abs_2605_15997
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publishDate 2026
record_format arxiv
spellingShingle Segmentation, Detection and Explanation: A Unified Framework for CT Appearance Reasoning
Liu, Yuyuan
Peng, Can
Yang, Yingyu
Yang, Qianye
Ouyang, Cheng
Noble, J. Alison
Computer Vision and Pattern Recognition
Recent progress in deep learning has significantly advanced CT image analysis, particularly for segmentation tasks. However, these advances are largely confined to image-level pattern recognition, with most methods lacking explicit anatomical or contextual reasoning. Large vision-language models introduce linguistic context into image analysis, yet most approaches typically focus on a single task, which is insufficient for clinical workflow analysis that requires multiple fine-grained types of analysis, such as anatomy detection and segmentation. In this paper, we propose a unified autoregressive framework that integrates language-guided visual reasoning into CT interpretation. Our method introduces task-routing tokens that trigger detection and segmentation heads conditioned on the hidden states of a large vision-language model, enabling coherent generation of visual outputs (e.g., masks and bounding boxes) and textual reasonings. To progressively enhance localisation accuracy and semantic clarity, we further design a "closer-look" mechanism that allows the model to perform progressive coarse-to-fine visits to regions of interest under refined fields of view. To support model training and evaluation, we curated a new multimodal CT dataset containing pixel-wise masks, bounding boxes, spatial prompts, and structured descriptions for visual objects constructed through an AI-assisted annotation process with human verification. Experiments on public benchmarks demonstrate consistent improvements over the SoTA, achieving up to 1.0% Dice on BTCV and 1.7% Dice on MosMed+, while additionally providing appearance reasoning outputs. The code and dataset will be available.
title Segmentation, Detection and Explanation: A Unified Framework for CT Appearance Reasoning
topic Computer Vision and Pattern Recognition
url https://arxiv.org/abs/2605.15997