Fetal brain biometry provides a quantitative basis for assessing prenatal growth and identifying congenital brain abnormalities. However, comprehensive assessment remains limited by labor-intensive manual measurements and automated models that lose accuracy across imaging sequences and institutions. We introduce BioTTA, an anatomically guided test-time adaptation framework that measures 11 fetal brain biometrics from reconstructed three-dimensional magnetic resonance images. BioTTA adapts pretrained models to individual unlabeled volumes using geometric consistency and atlas priors, without access to source images. In a retrospective study across five centers in China and Switzerland, BioTTA improved measurement accuracy across three out-of-distribution datasets and two network architectures. It reduced mean absolute measurement errors by 46-82% relative to the corresponding models without adaptation, achieving errors similar to those of supervised fine-tuning. Its measurements were mapped onto normative growth trajectories derived from expert annotations, enabling gestational-age-specific assessment through a web-based reporting platform. Across four disease cohorts, the platform achieved 82.1-95.0% accuracy in binary detection of ventriculomegaly or cerebellar abnormalities, with performance similar to that of a senior radiologist. BioTTA provides a practical foundation for standardized fetal brain biometry across heterogeneous imaging settings, supporting scalable prenatal growth assessment and quantitative evaluation of brain abnormalities.
Understanding the progress of an activity requires tracking how the objects involved change over time. Object state readout provides this information by describing a target object's states and transitions across video frames. Although multimodal large language models (MLLMs) generate detailed visual descriptions, these descriptions may leave the attributes needed to distinguish successive states insufficiently specified. In this paper, we propose look-ahead state readout (LASER), an anticipation-guided agent for object state readout that uses possible next-step changes to determine which attributes to inspect in the present. Given temporally ordered frames and a target object, LASER converts anticipated changes into targeted visual questions and inspects the current frame to establish attribute values. It then checks state readouts and forecasts against independent observations of subsequent frames, refining a state record used to generate the final description. Reusable textual observation skills guide this process and are refined by tracing discrepancies with reference captions to the responsible instructions. Candidate revisions are selected on separate videos based on improved caption quality without increased contradictions with reference facts. Model parameters remain frozen throughout adaptation and inference, and the revised skills remain fixed during evaluation. Experiment results and further analysis on OSCaR and PLM RCap show consistent improvements of LASER over strong baselines and existing approaches, which demonstrates the effectiveness of our approach.
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.