Sep 14, 2026 · cs.CVJ/K move · Enter open · S save
Yang Xing, Jiong Wu, Savas Ozdemir, Yang Zhou+10
1J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL, USA · Department of Radiology, University of Florida, Jacksonville, FL, USA · Department of Applied Mathematics & Statistics, Stony Brook University, Stony Brook, NY, USA · Department of Radiology, University of California, San Francisco, San Francisco, CA, USA · 7Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
Accurate PSMA PET/CT interpretation is central to prostate cancer management, yet existing PET/CT AI models typically address isolated tasks. We propose a unified PSMA PET/CT vision-language model for report generation, visual question answering, and lesion segmentation. The framework adopts an LLaVA-style architecture, comprising a PET/CT vision encoder, an MLP-Mixer projection module, a LoRA-tuned large language model, and a 3D segmentation branch. Training followed a four-stage strategy: vision encoder pretraining, projection-layer alignment, VLM fine-tuning, and final multitask tuning. Language tasks used 5,747 PSMA PET/CT datasets with paired reports, while segmentation used the PSMA subset of AutoPET. The model outperformed PET2REP and a CT-based baseline across standard report-generation metrics, improved performance across VQA question types, and achieved higher Dice and lesion-level overlap F1 than SegAnyPET and nnUNet. These results support the feasibility of a unified framework for structured, interactive, interpretable PSMA PET/CT analysis with voxel-level grounding within a single multitask model architecture.