# SCALE-VLP: Soft-Weighted Contrastive Volumetric Vision-Language Pre-training with Spatial-Knowledge Semantics

arXiv: https://arxiv.org/abs/2511.02996 · HTML: https://mlsanity.com/paper/2511.02996/

## Key facts

- Cited by 2 papers in the map (data through 14 Oct 2026).
- Placed in Medical vision-language models, one of 16 directions in Multimodal LLMs / vision-language models.
- Builds on 11 of its 37 references that are in the map.
- First posted on arXiv 4 Nov 2025.

## Placed in

- Multimodal LLMs / vision-language models / [Medical vision-language models](https://mlsanity.com/mllm/medical-vision-language-models/)

## Builds on (most cited first, 11 of 11)

- [Publicly Available Clinical BERT Embeddings](https://mlsanity.com/paper/1904.03323/) (2019)
- [BioMistral: A Collection of Open-Source Pretrained Large Language Models for Medical Domains](https://mlsanity.com/paper/2402.10373/) (2024)
- [MEDITRON-70B: Scaling Medical Pretraining for Large Language Models](https://mlsanity.com/paper/2311.16079/) (2023)
- [HuatuoGPT-o1, Towards Medical Complex Reasoning with LLMs](https://mlsanity.com/paper/2412.18925/) (2024)
- [Generalist Foundation Models from a Multimodal Dataset for 3D Computed Tomography](https://mlsanity.com/paper/2403.17834/) (2024)
- [M3D: Advancing 3D Medical Image Analysis with Multi-Modal Large Language Models](https://mlsanity.com/paper/2404.00578/) (2024)
- [Show, Describe and Conclude: On Exploiting the Structure Information of Chest X-Ray Reports](https://mlsanity.com/paper/2004.12274/) (2020)
- [Large-scale and Fine-grained Vision-language Pre-training for Enhanced CT Image Understanding](https://mlsanity.com/paper/2501.14548/) (2025)
- [CT-GLIP: 3D Grounded Language-Image Pretraining with CT Scans and Radiology Reports for Full-Body Scenarios](https://mlsanity.com/paper/2404.15272/) (2024)
- [How Well Do Supervised 3D Models Transfer to Medical Imaging Tasks?](https://mlsanity.com/paper/2501.11253/) (2025)
- [T3D: Advancing 3D Medical Vision-Language Pre-training by Learning Multi-View Visual Consistency](https://mlsanity.com/paper/2312.01529/) (2023)

## Built on by (most cited first, 2 of 2)

- [Curriculum-Driven 3D CT Report Generation via Language-Free Visual Grafting and Zone-Constrained Compression](https://mlsanity.com/paper/2603.23308/) (2026)
- [Volumetric Radiology AI in the Era of Multimodal Large Language Models](https://mlsanity.com/paper/2608.20549/) (2026)

## Abstract (arXiv)

Vision-language models (VLMs) have demonstrated strong cross-modal capabilities, yet most work remains limited to 2D data and assumes binary supervision (i.e., positive vs. negative pairs), overlooking the continuous and structured dependencies present in volumetric data such as CT. Existing approaches often treat volumetric scans as independent 2D slices, compromising spatial coherence and underutilizing rich clinical semantics. We propose SCALE-VLP, a soft-weighted contrastive vision-language pre-training framework that integrates (i) volumetric spatial semantics to preserve anatomical structure and (ii) domain-aware, knowledge-infused semantics (e.g., radiological ontologies) to guide alignment. This yields structurally consistent and semantically grounded representations under limited supervision, demonstrating strong cross-task transferability (retrieval, report generation, and classification), and cross-domain generalizability with consistent gains without further fine-tuning. In particular, compared to the previous state of the art, SCALE-VLP achieves up to 4.3x higher top-1 CT-report retrieval, improves abnormality classification by 10 points, and reaches ROUGE-L 0.44 and BERT-F1 0.89 for report generation. Further, in zero-shot evaluation on an out-of-domain external dataset, we observe consistent gains, indicating the cross-task and cross-domain generalization ability of SCALE-VLP.