CT report generation (CTRG) requires models to summarize three-dimensional anatomical context and pathological findings from hundreds of axial slices. Existing methods typically learn a direct image-to-text mapping, providing limited mechanisms for modeling how CT evidence evolves across slices or how reports respond to controlled changes in latent lesion-related factors. We propose SliceWorld, a CT-specific world-state framework that treats an axial CT scan as an ordered sequence along the z-axis. SliceWorld encodes prefix CT evidence into factor-aware latent states containing anatomy, lesion, and uncertainty components, and projects these states into world tokens used for multi-step future-slice feature prediction, lesion-factor intervention, and LLM-based report generation. The model is first pretrained on CT slice sequences with predictive, factor-aware, and counterfactual objectives, and is then fine-tuned on paired CT-report data. Experiments on M3D-Cap and CT-RATE show that SliceWorld improves natural language generation metrics and clinically oriented automatic evaluation. Further analyses demonstrate multi-horizon future-slice prediction, measurable factor alignment, reduced-slice robustness, and selective lesion-sensitive report modulation. Code is available at https://github.com/synlp/SliceWorld.
Diffusion models have become a widely used framework for probabilistic time series forecasting, modeling the distribution of future values given an observed history. In time series forecasting, however, the future continues the observed history, creating an asymmetry the standard diffusion process leaves unaddressed, with slowly-varying content largely determined by the observed continuity while higher-frequency dynamics carry most of the residual uncertainty. Existing diffusion-based forecasters decouple this asymmetry through an external rule before generation, leaving the corruption trajectory blind to which parts of the target the history can already anchor. We propose DiffDiff, a diffusion framework that embeds this predictability asymmetry into the diffusion trajectory itself, so that a single end-to-end diffusion process becomes aware of which parts of the target the history can already anchor. DiffDiff makes the forward operator step-dependent so that the noisy intermediate state progressively shifts from the target itself toward its second-order differenced structure, while a conditioning pathway supplies the denoiser with both value-domain and differential history information balanced by a stage-adaptive gate at each diffusion step. The terminal distribution approaches a standard Gaussian, preserving compatibility with existing samplers. On seven benchmarks across four prediction horizons, DiffDiff outperforms six diffusion baselines, while our analyses show that its trajectory reallocates modeling effort according to history predictability and improves distributional fidelity.