# Resolution Meets Reduction: Efficient Visual Context for 3D Radiology Report Generation

arXiv: https://arxiv.org/abs/2608.08713 · HTML: https://mlsanity.com/paper/2608.08713/

## Key facts

- Cited by 1 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 41 of its 51 references that are in the map.
- First posted on arXiv 9 Aug 2026.

## Placed in

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

## Builds on (most cited first, 30 of 41)

- [Learning Transferable Visual Models From Natural Language Supervision](https://mlsanity.com/paper/2103.00020/) (2021)
- [LoRA: Low-Rank Adaptation of Large Language Models](https://mlsanity.com/paper/2106.09685/) (2021)
- [A Simple Framework for Contrastive Learning of Visual Representations](https://mlsanity.com/paper/2002.05709/) (2020)
- [Qwen3 Technical Report](https://mlsanity.com/paper/2505.09388/) (2025)
- [DINOv2: Learning Robust Visual Features without Supervision](https://mlsanity.com/paper/2304.07193/) (2023)
- [Visual Instruction Tuning](https://mlsanity.com/paper/2304.08485/) (2023)
- [Masked Autoencoders Are Scalable Vision Learners](https://mlsanity.com/paper/2111.06377/) (2021)
- [Flamingo: a Visual Language Model for Few-Shot Learning](https://mlsanity.com/paper/2204.14198/) (2022)
- [Qwen3-VL Technical Report](https://mlsanity.com/paper/2511.21631/) (2025)
- [Gemma 3 Technical Report](https://mlsanity.com/paper/2503.19786/) (2025)
- [Microsoft COCO Captions: Data Collection and Evaluation Server](https://mlsanity.com/paper/1504.00325/) (2015)
- [gpt-oss-120b & gpt-oss-20b Model Card](https://mlsanity.com/paper/2508.10925/) (2025)
- [TotalSegmentator: robust segmentation of 104 anatomical structures in CT images](https://mlsanity.com/paper/2208.05868/) (2022)
- [Smarter, Better, Faster, Longer: A Modern Bidirectional Encoder for Fast, Memory Efficient, and Long Context Finetuning and Inference](https://mlsanity.com/paper/2412.13663/) (2024)
- [Phi-4-Mini Technical Report: Compact yet Powerful Multimodal Language Models via Mixture-of-LoRAs](https://mlsanity.com/paper/2503.01743/) (2025)
- [AMOS: A Large-Scale Abdominal Multi-Organ Benchmark for Versatile Medical Image Segmentation](https://mlsanity.com/paper/2206.08023/) (2022)
- [Generalist Foundation Models from a Multimodal Dataset for 3D Computed Tomography](https://mlsanity.com/paper/2403.17834/) (2024)
- [TokenPacker: Efficient Visual Projector for Multimodal LLM](https://mlsanity.com/paper/2407.02392/) (2024)
- [M3D: Advancing 3D Medical Image Analysis with Multi-Modal Large Language Models](https://mlsanity.com/paper/2404.00578/) (2024)
- [MAIRA-2: Grounded Radiology Report Generation](https://mlsanity.com/paper/2406.04449/) (2024)
- [GREEN: Generative Radiology Report Evaluation and Error Notation](https://mlsanity.com/paper/2405.03595/) (2024)
- [Merlin: A Computed Tomography Vision-Language Foundation Model and Dataset](https://mlsanity.com/paper/2406.06512/) (2024)
- [SegVol: Universal and Interactive Volumetric Medical Image Segmentation](https://mlsanity.com/paper/2311.13385/) (2023)
- [Vision Foundation Models for Computed Tomography](https://mlsanity.com/paper/2501.09001/) (2025)
- [MedGemma 1.5 Technical Report](https://mlsanity.com/paper/2604.05081/) (2026)
- [Large Language Model with Region-guided Referring and Grounding for CT Report Generation](https://mlsanity.com/paper/2411.15539/) (2024)
- [An OpenMind for 3D medical vision self-supervised learning](https://mlsanity.com/paper/2412.17041/) (2024)
- [Primus: Enforcing Attention Usage for 3D Medical Image Segmentation](https://mlsanity.com/paper/2503.01835/) (2025)
- [Comprehensive language-image pre-training for 3D medical image understanding](https://mlsanity.com/paper/2510.15042/) (2025)
- [CT-Agent: A Multimodal-LLM Agent for 3D CT Radiology Question Answering](https://mlsanity.com/paper/2505.16229/) (2025)

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

- [NV-Reason-CT: 3D Visual Language Model for CT Analysis](https://mlsanity.com/paper/2609.27511/) (2026)

## Abstract (arXiv)

Vision-language models offer a promising path toward automating radiology report generation, but applying them to full 3D CT volumes poses substantial computational challenges. Modern foundation vision encoders (VEs) can produce tens of thousands of vision tokens per scan, making the visual sequence passed to the large language model (LLM) a primary computational bottleneck. Vision-to-language projectors can compress this sequence to reduce computation, but may discard clinically relevant detail; conversely, effective compression can accommodate higher-resolution inputs while keeping the downstream token count fixed. How this vision-token budget should be allocated across input field of view, spatial resolution, and vision-to-language projection therefore remains an open design question. We systematically evaluate four heterogeneous VEs (CNN- and ViT-based), five token-reducing projectors at up to 64x compression alongside a non-reducing MLP projector baseline, and five instruction-tuned LLMs (1.7B--4B) on two large-scale CT report datasets (CT-RATE and Merlin). At matched LLM token budgets, anatomy-guided region of interest cropping is the most consistent strategy, improving clinical macro F1 in 19 of 20 settings by +3.7 points on average for the 3D ViT Primus encoder and +1.1 for the slice-based 2D ViT Curia encoder. Increasing input resolution further is strongly projector-dependent: the PerceiverResampler, paired with higher-resolution Curia features, yields the strongest configuration in the resolution study on both datasets. Our best configurations achieve state-of-the-art clinical macro F1 on the test sets, reaching 49.5 on CT-RATE and 49.0 on Merlin. Code and models will be published upon publication.