# TotalFM: An Organ-Separated 3D-CT Foundation Model Leveraging Large-Scale Routine Clinical Radiology Data

arXiv: https://arxiv.org/abs/2601.00260 · HTML: https://mlsanity.com/paper/2601.00260/

## Key facts

- Cited by 4 papers in the map (data through 14 Oct 2026).
- Builds on 21 of its 28 references that are in the map.
- First posted on arXiv 1 Jan 2026.

## Builds on (most cited first, 21 of 21)

- [Learning Transferable Visual Models From Natural Language Supervision](https://mlsanity.com/paper/2103.00020/) (2021)
- [LLaMA: Open and Efficient Foundation Language Models](https://mlsanity.com/paper/2302.13971/) (2023)
- [A Simple Framework for Contrastive Learning of Visual Representations](https://mlsanity.com/paper/2002.05709/) (2020)
- [Representation Learning with Contrastive Predictive Coding](https://mlsanity.com/paper/1807.03748/) (2018)
- [Masked Autoencoders Are Scalable Vision Learners](https://mlsanity.com/paper/2111.06377/) (2021)
- [BLIP-2: Bootstrapping Language-Image Pre-training with Frozen Image Encoders and Large Language Models](https://mlsanity.com/paper/2301.12597/) (2023)
- [Sigmoid Loss for Language Image Pre-Training](https://mlsanity.com/paper/2303.15343/) (2023)
- [Supervised Contrastive Learning](https://mlsanity.com/paper/2004.11362/) (2020)
- [gpt-oss-120b & gpt-oss-20b Model Card](https://mlsanity.com/paper/2508.10925/) (2025)
- [VideoMAE: Masked Autoencoders are Data-Efficient Learners for Self-Supervised Video Pre-Training](https://mlsanity.com/paper/2203.12602/) (2022)
- [LLaVA-Med: Training a Large Language-and-Vision Assistant for Biomedicine in One Day](https://mlsanity.com/paper/2306.00890/) (2023)
- [TotalSegmentator: robust segmentation of 104 anatomical structures in CT images](https://mlsanity.com/paper/2208.05868/) (2022)
- [InternVideo2: Scaling Foundation Models for Multimodal Video Understanding](https://mlsanity.com/paper/2403.15377/) (2024)
- [Learning to Exploit Temporal Structure for Biomedical Vision-Language Processing](https://mlsanity.com/paper/2301.04558/) (2023)
- [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)
- [Self Pre-training with Masked Autoencoders for Medical Image Classification and Segmentation](https://mlsanity.com/paper/2203.05573/) (2022)
- [Large-Vocabulary Segmentation for Medical Images with Text Prompts](https://mlsanity.com/paper/2312.17183/) (2023)
- [Pillar-0: A New Frontier for Radiology Foundation Models](https://mlsanity.com/paper/2511.17803/) (2025)
- [Visual Grounding of Whole Radiology Reports for 3D CT Images](https://mlsanity.com/paper/2312.04794/) (2023)
- [FALCON: False-Negative Aware Learning of Contrastive Negatives in Vision-Language Alignment](https://mlsanity.com/paper/2505.11192/) (2025)

## Built on by (most cited first, 4 of 4)

- [Jolia: Concept-Level Vision-Language Alignment for 3D CT Contrastive Learning](https://mlsanity.com/paper/2606.24570/) (2026)
- [EasyLens: A Training-Free Plug-and-Play Subtle-Lesion Representation Amplifier for Medical Vision-Language Models](https://mlsanity.com/paper/2606.06379/) (2026)
- [A Multi-Center Benchmark for Abdominal Disease Diagnosis and Report Generation from Non-Contrast CT](https://mlsanity.com/paper/2606.16991/) (2026)
- [OrganLens: Organ-Specific Representation Learning for CT Foundation Models](https://mlsanity.com/paper/2607.25164/) (2026)

## Abstract (arXiv)

While foundation models in radiology are expected to be applied to various clinical tasks, computational cost constraints remain a major challenge when training on 3D-CT volumetric data. In this study, we propose TotalFM, a radiological foundation model that efficiently learns the correspondence between 3D-CT images and linguistic expressions based on the concept of organ separation, utilizing a large-scale dataset of 140,000 series. By automating the creation of organ volume and finding-sentence pairs through segmentation techniques and Large Language Model (LLM)-based radiology report processing, and by combining self-supervised pre-training via VideoMAE with contrastive learning using volume-text pairs, we aimed to balance computational efficiency and representation capability. In zero-shot organ-wise lesion classification tasks, the proposed model achieved higher F1 scores in 83% (5/6) of organs compared to CT-CLIP and 64% (9/14) of organs compared to Merlin. These results suggest that the proposed model exhibits high generalization performance in a clinical evaluation setting using actual radiology report sentences. Furthermore, in zero-shot finding-wise lesion classification tasks, our model achieved a higher AUROC in 83% (25/30) of finding categories compared to Merlin. We also confirmed performance comparable to existing Vision-Language Models (VLMs) in radiology report generation tasks. Our results demonstrate that the organ-separated learning framework can serve as a realistic and effective design guideline for the practical implementation of 3D-CT foundation models. The source code and pretrained models are publicly available at https://github.com/jichi-labo/TotalFM.