{"ID":3084697,"CreatedAt":"2026-06-05T06:46:15.197025399Z","UpdatedAt":"2026-06-06T20:54:36.964885582Z","DeletedAt":null,"paper_url":"https://arxiv.org/abs/2606.05460","arxiv_id":"2606.05460","title":"ORACLE-CT: Anatomy-Aware Support Pooling for CT Classification","abstract":"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.","short_abstract":"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...","url_abs":"https://arxiv.org/abs/2606.05460","url_pdf":"https://arxiv.org/pdf/2606.05460v1","authors":"[\"Lavsen Dahal\",\"Yubraj Bhandari\",\"Geoffrey Rubin\",\"Joseph Y. Lo\"]","published":"2026-06-03T21:37:05Z","proceeding":"cs.CV","tasks":"[\"cs.CV\"]","methods":"[\"Generative Adversarial Network\"]","has_code":false}