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We developed RADAR, a generalist vision-language model trained on more than 400,000 contrast-enhanced abdominal computed tomography (CT) examinations and 15 million anatomy-wise image-text pairs, learning directly from clinical reports without manual annotation. Throughout internal and external evaluations across multiple centers and varied clinical scenarios, RADAR achieved high diagnostic performance and robust generalization for 18 anatomical structures and 146 imaging findings. In a reader study, RADAR assistance increased the diagnostic sensitivity of 26 radiologists by ~10%. 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