# ORACLE-CT: Anatomy-Aware Support Pooling for CT Classification

arXiv: https://arxiv.org/abs/2606.05460 · HTML: https://mlsanity.com/paper/2606.05460/

## Key facts

- Cited by 1 papers in the map (data through 14 Oct 2026).
- Builds on 23 of its 40 references that are in the map.
- First posted on arXiv 3 Jun 2026.

## Builds on (most cited first, 23 of 23)

- [Attention Is All You Need](https://mlsanity.com/paper/1706.03762/) (2017)
- [Deep Residual Learning for Image Recognition](https://mlsanity.com/paper/1512.03385/) (2015)
- [Learning Transferable Visual Models From Natural Language Supervision](https://mlsanity.com/paper/2103.00020/) (2021)
- [An Image is Worth 16x16 Words: Transformers for Image Recognition at Scale](https://mlsanity.com/paper/2010.11929/) (2020)
- [Qwen3 Technical Report](https://mlsanity.com/paper/2505.09388/) (2025)
- [Neural Machine Translation by Jointly Learning to Align and Translate](https://mlsanity.com/paper/1409.0473/) (2014)
- [Quo Vadis, Action Recognition? A New Model and the Kinetics Dataset](https://mlsanity.com/paper/1705.07750/) (2017)
- [Non-local Neural Networks](https://mlsanity.com/paper/1711.07971/) (2017)
- [Show, Attend and Tell: Neural Image Caption Generation with Visual Attention](https://mlsanity.com/paper/1502.03044/) (2015)
- [Deep Sets](https://mlsanity.com/paper/1703.06114/) (2017)
- [Attention-based Deep Multiple Instance Learning](https://mlsanity.com/paper/1802.04712/) (2018)
- [Effective Approaches to Attention-based Neural Machine Translation](https://mlsanity.com/paper/1508.04025/) (2015)
- [TotalSegmentator: robust segmentation of 104 anatomical structures in CT images](https://mlsanity.com/paper/2208.05868/) (2022)
- [Network In Network](https://mlsanity.com/paper/1312.4400/) (2013)
- [Machine-Learning-Based Multiple Abnormality Prediction with Large-Scale Chest Computed Tomography Volumes](https://mlsanity.com/paper/2002.04752/) (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)
- [Pillar-0: A New Frontier for Radiology Foundation Models](https://mlsanity.com/paper/2511.17803/) (2025)
- [Comprehensive language-image pre-training for 3D medical image understanding](https://mlsanity.com/paper/2510.15042/) (2025)
- [Classification of Multiple Diseases on Body CT Scans using Weakly Supervised Deep Learning](https://mlsanity.com/paper/2008.01158/) (2020)
- [Unified Supervision For Vision-Language Modeling in 3D Computed Tomography](https://mlsanity.com/paper/2509.01554/) (2025)
- [Zero-Shot Multi-Disease Labeling of Chest, Abdomen, and Pelvis CT Reports Using Open-Weight Large Language Models: The Effect of Labeling Conventions](https://mlsanity.com/paper/2506.03259/) (2025)
- [GreenRFM: Learning a resource-efficient radiology vision-language foundation model via supervision-centric pre-training](https://mlsanity.com/paper/2603.06467/) (2026)

## Built on by (most cited first, 1 of 1)

- [OrganLens: Organ-Specific Representation Learning for CT Foundation Models](https://mlsanity.com/paper/2607.25164/) (2026)

## Abstract (arXiv)

Abdominal CT disease classification is challenging because each scan is a large 3D volume with many possible findings, while diagnostic evidence is often confined to specific organs or anatomical compartments. Most study-level classifiers aggregate encoder features using anatomy-agnostic pooling or attention, creating a mismatch between localized disease evidence and global evidence aggregation. We propose ORACLE--CT, an encoder-agnostic anatomy-aware aggregation framework that uses multi-organ segmentation to define label-specific anatomical supports and restrict attention pooling to relevant regions. The framework supports single-organ, multi-organ union, comparative, localized, and global support strategies. We evaluate ORACLE--CT with three encoder families: DINOv3, I3D--ResNet-121, and the radiology-native Pillar--0 encoder. Models are trained end-to-end on MERLIN and evaluated internally and under frozen external transfer to Duke--Abdomen and AMOS. Compared with global average pooling, support-masked pooling improved MERLIN macro-AUROC/AUPRC from 0.838/0.638 to 0.858/0.676 for DINOv3 and from 0.829/0.617 to 0.848/0.659 for I3D--ResNet-121. On harmonized 10-label external evaluation, DINOv3 improved on Duke--Abdomen from 0.802/0.628 to 0.835/0.683 and on AMOS from 0.742/0.313 to 0.762/0.350, with similar gains for I3D--ResNet-121. For Pillar--0, most gains came from learned attention, with smaller additional benefit from anatomical masking. ORACLE--CT improves discrimination and external robustness while preserving an auditable link between predictions and anatomical evidence.