# SelfCue: Making a 3D CT Report Generator Say What It Already Knows

arXiv: https://arxiv.org/abs/2609.31788 · HTML: https://mlsanity.com/paper/2609.31788/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 36 of its 49 references that are in the map.
- First posted on arXiv 25 Sep 2026.

## Builds on (most cited first, 30 of 36)

- [LoRA: Low-Rank Adaptation of Large Language Models](https://mlsanity.com/paper/2106.09685/) (2021)
- [Distilling the Knowledge in a Neural Network](https://mlsanity.com/paper/1503.02531/) (2015)
- [Visual Instruction Tuning](https://mlsanity.com/paper/2304.08485/) (2023)
- [Efficient Memory Management for Large Language Model Serving with PagedAttention](https://mlsanity.com/paper/2309.06180/) (2023)
- [Inference-Time Intervention: Eliciting Truthful Answers from a Language Model](https://mlsanity.com/paper/2306.03341/) (2023)
- [Sequence-Level Knowledge Distillation](https://mlsanity.com/paper/1606.07947/) (2016)
- [Discovering Latent Knowledge in Language Models Without Supervision](https://mlsanity.com/paper/2212.03827/) (2022)
- [On Distillation of Guided Diffusion Models](https://mlsanity.com/paper/2210.03142/) (2022)
- [Mitigating Object Hallucinations in Large Vision-Language Models through Visual Contrastive Decoding](https://mlsanity.com/paper/2311.16922/) (2023)
- [Contrastive Decoding: Open-ended Text Generation as Optimization](https://mlsanity.com/paper/2210.15097/) (2022)
- [Trusting Your Evidence: Hallucinate Less with Context-aware Decoding](https://mlsanity.com/paper/2305.14739/) (2023)
- [LLMs Know More Than They Show: On the Intrinsic Representation of LLM Hallucinations](https://mlsanity.com/paper/2410.02707/) (2024)
- [Generalist Foundation Models from a Multimodal Dataset for 3D Computed Tomography](https://mlsanity.com/paper/2403.17834/) (2024)
- [Learning by Distilling Context](https://mlsanity.com/paper/2209.15189/) (2022)
- [GREEN: Generative Radiology Report Evaluation and Error Notation](https://mlsanity.com/paper/2405.03595/) (2024)
- [CT2Rep: Automated Radiology Report Generation for 3D Medical Imaging](https://mlsanity.com/paper/2403.06801/) (2024)
- [PromptMRG: Diagnosis-Driven Prompts for Medical Report Generation](https://mlsanity.com/paper/2308.12604/) (2023)
- [Stay on topic with Classifier-Free Guidance](https://mlsanity.com/paper/2306.17806/) (2023)
- [Knowledge Distillation as Semiparametric Inference](https://mlsanity.com/paper/2104.09732/) (2021)
- [Better Tokens for Better 3D: Advancing Vision-Language Modeling in 3D Medical Imaging](https://mlsanity.com/paper/2510.20639/) (2025)
- [Toward Guidance-Free AR Visual Generation via Condition Contrastive Alignment](https://mlsanity.com/paper/2410.09347/) (2024)
- [Boosting Vision Semantic Density with Anatomy Normality Modeling for Medical Vision-language Pre-training](https://mlsanity.com/paper/2508.03742/) (2025)
- [CT-AGRG: Automated Abnormality-Guided Report Generation from 3D Chest CT Volumes](https://mlsanity.com/paper/2408.11965/) (2024)
- [OmniCT: Towards a Unified Slice-Volume LVLM for Comprehensive CT Analysis](https://mlsanity.com/paper/2602.16110/) (2026)
- [RadAgent: A tool-using AI agent for stepwise interpretation of chest computed tomography](https://mlsanity.com/paper/2604.15231/) (2026)
- [CCD: Mitigating Hallucinations in Radiology MLLMs via Clinical Contrastive Decoding](https://mlsanity.com/paper/2509.23379/) (2025)
- [MEPNet: Medical Entity-balanced Prompting Network for Brain CT Report Generation](https://mlsanity.com/paper/2503.17784/) (2025)
- [Beyond the Embedding Bottleneck: Adaptive Retrieval-Augmented 3D CT Report Generation](https://mlsanity.com/paper/2603.15822/) (2026)
- [CWCD: Category-Wise Contrastive Decoding for Structured Medical Report Generation](https://mlsanity.com/paper/2604.10410/) (2026)
- [Generating Reports or Repeating Templates? Measuring and Mitigating Template Collapse in 3D CT Report Generation](https://mlsanity.com/paper/2605.30984/) (2026)

## Abstract (arXiv)

Progress in 3D CT report generation is usually sought in increasingly sophisticated architectures and larger pools of training data. We find instead that a 3D CT report generator already holds what its report leaves out, and loses it when the hidden state becomes tokens. Over the 18 CT-RATE abnormalities, this hidden-to-report surfacing gap is reflected by a drop in macro AUROC from 0.848 in the hidden states to 0.739 in the generated report. We propose SelfCue based on contrastive decoding. It promotes what the hidden state already supports and suppresses what it does not. It raises clinical efficacy F1 to 0.481 and the LLM-judged GREEN score to 0.510. Distilling that behaviour into the weights gives SelfCue-KD, a student that keeps most of the gain, needs nothing extra at inference, and drops into any pipeline already serving the baseline. Code is available at https://github.com/renjie-liang/SelfCue-CT.