Daily Papers

Despite the progress in medical image segmentation, most existing methods remain task-specific and lack interactivity. Although recent text-prompt-based segmentation approaches enhance user-driven and reasoning-based segmentation, they remain confined to single-round dialogues and fail to perform multi-round reasoning. In this work, we introduce Multi-Round Entity-Level Medical Reasoning Segmentation (MEMR-Seg), a new task that requires generating segmentation masks through multi-round queries with entity-level reasoning. To support this task, we construct MR-MedSeg, a large-scale dataset of 177K multi-round medical segmentation dialogues, featuring entity-based reasoning across rounds. Furthermore, we propose MediRound, an effective baseline model designed for multi-round medical reasoning segmentation. To mitigate the inherent error propagation in the chain-like pipeline of multi-round segmentation, we introduce a lightweight yet effective Judgment & Correction Mechanism during model inference. Experimental results demonstrate that our method effectively addresses the MEMR-Seg task and outperforms conventional medical referring segmentation methods.

This paper investigates the fundamental discontinuity between the latest two Segment Anything Models: SAM2 and SAM3. We explain why the expertise in prompt-based segmentation of SAM2 does not transfer to the multimodal concept-driven paradigm of SAM3. SAM2 operates through spatial prompts points, boxes, and masks yielding purely geometric and temporal segmentation. In contrast, SAM3 introduces a unified vision-language architecture capable of open-vocabulary reasoning, semantic grounding, contrastive alignment, and exemplar-based concept understanding. We structure this analysis through five core components: (1) a Conceptual Break Between Prompt-Based and Concept-Based Segmentation, contrasting spatial prompt semantics of SAM2 with multimodal fusion and text-conditioned mask generation of SAM3; (2) Architectural Divergence, detailing pure vision-temporal design of SAM2 versus integration of vision-language encoders, geometry and exemplar encoders, fusion modules, DETR-style decoders, object queries, and ambiguity-handling via Mixture-of-Experts in SAM3; (3) Dataset and Annotation Differences, contrasting SA-V video masks with multimodal concept-annotated corpora of SAM3; (4) Training and Hyperparameter Distinctions, showing why SAM2 optimization knowledge does not apply to SAM3; and (5) Evaluation, Metrics, and Failure Modes, outlining the transition from geometric IoU metrics to semantic, open-vocabulary evaluation. Together, these analyses establish SAM3 as a new class of segmentation foundation model and chart future directions for the emerging concept-driven segmentation era.

Medical imaging is crucial for diagnosing a patient's health condition, and accurate segmentation of these images is essential for isolating regions of interest to ensure precise diagnosis and treatment planning. Existing methods primarily rely on bounding boxes or point-based prompts, while few have explored text-related prompts, despite clinicians often describing their observations and instructions in natural language. To address this gap, we first propose a RAG-based free-form text prompt generator, that leverages the domain corpus to generate diverse and realistic descriptions. Then, we introduce FLanS, a novel medical image segmentation model that handles various free-form text prompts, including professional anatomy-informed queries, anatomy-agnostic position-driven queries, and anatomy-agnostic size-driven queries. Additionally, our model also incorporates a symmetry-aware canonicalization module to ensure consistent, accurate segmentations across varying scan orientations and reduce confusion between the anatomical position of an organ and its appearance in the scan. FLanS is trained on a large-scale dataset of over 100k medical images from 7 public datasets. Comprehensive experiments demonstrate the model's superior language understanding and segmentation precision, along with a deep comprehension of the relationship between them, outperforming SOTA baselines on both in-domain and out-of-domain datasets.

Pancreatic cancer carries a poor prognosis and relies on endoscopic ultrasound (EUS) for targeted biopsy and radiotherapy. However, the speckle noise, low contrast, and unintuitive appearance of EUS make segmentation of pancreatic tumors with fully supervised deep learning (DL) models both error-prone and dependent on large, expert-curated annotation datasets. To address these challenges, we present TextSAM-EUS, a novel, lightweight, text-driven adaptation of the Segment Anything Model (SAM) that requires no manual geometric prompts at inference. Our approach leverages text prompt learning (context optimization) through the BiomedCLIP text encoder in conjunction with a LoRA-based adaptation of SAM's architecture to enable automatic pancreatic tumor segmentation in EUS, tuning only 0.86% of the total parameters. On the public Endoscopic Ultrasound Database of the Pancreas, TextSAM-EUS with automatic prompts attains 82.69% Dice and 85.28% normalized surface distance (NSD), and with manual geometric prompts reaches 83.10% Dice and 85.70% NSD, outperforming both existing state-of-the-art (SOTA) supervised DL models and foundation models (e.g., SAM and its variants). As the first attempt to incorporate prompt learning in SAM-based medical image segmentation, TextSAM-EUS offers a practical option for efficient and robust automatic EUS segmentation. Code is available at https://github.com/HealthX-Lab/TextSAM-EUS .

Recent advancements in prompt-based medical image segmentation have enabled clinicians to identify tumors using simple input like bounding boxes or text prompts. However, existing methods face challenges when doctors need to interact through natural language or when position reasoning is required - understanding spatial relationships between anatomical structures and pathologies. We present PRS-Med, a framework that integrates vision-language models with segmentation capabilities to generate both accurate segmentation masks and corresponding spatial reasoning outputs. Additionally, we introduce the MMRS dataset (Multimodal Medical in Positional Reasoning Segmentation), which provides diverse, spatially-grounded question-answer pairs to address the lack of position reasoning data in medical imaging. PRS-Med demonstrates superior performance across six imaging modalities (CT, MRI, X-ray, ultrasound, endoscopy, RGB), significantly outperforming state-of-the-art methods in both segmentation accuracy and position reasoning. Our approach enables intuitive doctor-system interaction through natural language, facilitating more efficient diagnoses. Our dataset pipeline, model, and codebase will be released to foster further research in spatially-aware multimodal reasoning for medical applications.

Image segmentation is usually addressed by training a model for a fixed set of object classes. Incorporating additional classes or more complex queries later is expensive as it requires re-training the model on a dataset that encompasses these expressions. Here we propose a system that can generate image segmentations based on arbitrary prompts at test time. A prompt can be either a text or an image. This approach enables us to create a unified model (trained once) for three common segmentation tasks, which come with distinct challenges: referring expression segmentation, zero-shot segmentation and one-shot segmentation. We build upon the CLIP model as a backbone which we extend with a transformer-based decoder that enables dense prediction. After training on an extended version of the PhraseCut dataset, our system generates a binary segmentation map for an image based on a free-text prompt or on an additional image expressing the query. We analyze different variants of the latter image-based prompts in detail. This novel hybrid input allows for dynamic adaptation not only to the three segmentation tasks mentioned above, but to any binary segmentation task where a text or image query can be formulated. Finally, we find our system to adapt well to generalized queries involving affordances or properties. Code is available at https://eckerlab.org/code/clipseg.

Segment Anything Model (SAM) has attracted widespread attention for its superior interactive segmentation capabilities with visual prompts while lacking further exploration of text prompts. In this paper, we empirically investigate what text prompt encoders (e.g., CLIP or LLM) are good for adapting SAM for referring expression segmentation and introduce the Early Vision-language Fusion-based SAM (EVF-SAM). EVF-SAM is a simple yet effective referring segmentation method which exploits multimodal prompts (i.e., image and text) and comprises a pre-trained vision-language model to generate referring prompts and a SAM model for segmentation. Surprisingly, we observe that: (1) multimodal prompts and (2) vision-language models with early fusion (e.g., BEIT-3) are beneficial for prompting SAM for accurate referring segmentation. Our experiments show that the proposed EVF-SAM based on BEIT-3 can obtain state-of-the-art performance on RefCOCO/+/g for referring expression segmentation and demonstrate the superiority of prompting SAM with early vision-language fusion. In addition, the proposed EVF-SAM with 1.32B parameters achieves remarkably higher performance while reducing nearly 82% of parameters compared to previous SAM methods based on large multimodal models.

Multimodal Large Language Models (MLLMs) achieve remarkable performance for fine-grained pixel-level understanding tasks. However, all the works rely heavily on extra components, such as vision encoder (CLIP), segmentation experts, leading to high system complexity and limiting model scaling. In this work, our goal is to explore a highly simplified MLLM without introducing extra components. Our work is motivated by the recent works on Single trAnsformer as a unified vIsion-Language Model (SAIL) design, where these works jointly learn vision tokens and text tokens in transformers. We present Pixel-SAIL, a single transformer for pixel-wise MLLM tasks. In particular, we present three technical improvements on the plain baseline. First, we design a learnable upsampling module to refine visual token features. Secondly, we propose a novel visual prompt injection strategy to enable the single transformer to understand visual prompt inputs and benefit from the early fusion of visual prompt embeddings and vision tokens. Thirdly, we introduce a vision expert distillation strategy to efficiently enhance the single transformer's fine-grained feature extraction capability. In addition, we have collected a comprehensive pixel understanding benchmark (PerBench), using a manual check. It includes three tasks: detailed object description, visual prompt-based question answering, and visual-text referring segmentation. Extensive experiments on four referring segmentation benchmarks, one visual prompt benchmark, and our PerBench show that our Pixel-SAIL achieves comparable or even better results with a much simpler pipeline. Code and model will be released at https://github.com/magic-research/Sa2VA.

Recent advances in generative modeling with diffusion processes (DPs) enabled breakthroughs in image synthesis. Despite impressive image quality, these models have various prompt compliance problems, including low recall in generating multiple objects, difficulty in generating text in images, and meeting constraints like object locations and pose. For fine-grained editing and manipulation, they also require fine-grained semantic or instance maps that are tedious to produce manually. While prompt compliance can be enhanced by addition of loss functions at inference, this is time consuming and does not scale to complex scenes. To overcome these limitations, this work introduces a new family of Factor Graph Diffusion Models (FG-DMs) that models the joint distribution of images and conditioning variables, such as semantic, sketch, depth or normal maps via a factor graph decomposition. This joint structure has several advantages, including support for efficient sampling based prompt compliance schemes, which produce images of high object recall, semi-automated fine-grained editing, text-based editing of conditions with noise inversion, explainability at intermediate levels, ability to produce labeled datasets for the training of downstream models such as segmentation or depth, training with missing data, and continual learning where new conditioning variables can be added with minimal or no modifications to the existing structure. We propose an implementation of FG-DMs by adapting a pre-trained Stable Diffusion (SD) model to implement all FG-DM factors, using only COCO dataset, and show that it is effective in generating images with 15\% higher recall than SD while retaining its generalization ability. We introduce an attention distillation loss that encourages consistency among the attention maps of all factors, improving the fidelity of the generated conditions and image.

Recent advancements in multimodal vision models have highlighted limitations in late-stage feature fusion and suboptimal query selection for hybrid prompts open-world segmentation, alongside constraints from caption-derived vocabularies. To address these challenges, we propose Prompt-DINO, a text-guided visual Prompt DINO framework featuring three key innovations. First, we introduce an early fusion mechanism that unifies text/visual prompts and backbone features at the initial encoding stage, enabling deeper cross-modal interactions to resolve semantic ambiguities. Second, we design order-aligned query selection for DETR-based architectures, explicitly optimizing the structural alignment between text and visual queries during decoding to enhance semantic-spatial consistency. Third, we develop a generative data engine powered by the Recognize Anything via Prompting (RAP) model, which synthesizes 0.5B diverse training instances through a dual-path cross-verification pipeline, reducing label noise by 80.5% compared to conventional approaches. Extensive experiments demonstrate that Prompt-DINO achieves state-of-the-art performance on open-world detection benchmarks while significantly expanding semantic coverage beyond fixed-vocabulary constraints. Our work establishes a new paradigm for scalable multimodal detection and data generation in open-world scenarios. Data&Code are available at https://github.com/WeChatCV/WeVisionOne.

The recent success of CLIP has demonstrated promising results in zero-shot semantic segmentation by transferring muiltimodal knowledge to pixel-level classification. However, leveraging pre-trained CLIP knowledge to closely align text embeddings with pixel embeddings still has limitations in existing approaches. To address this issue, we propose OTSeg, a novel multimodal attention mechanism aimed at enhancing the potential of multiple text prompts for matching associated pixel embeddings. We first propose Multi-Prompts Sinkhorn (MPS) based on the Optimal Transport (OT) algorithm, which leads multiple text prompts to selectively focus on various semantic features within image pixels. Moreover, inspired by the success of Sinkformers in unimodal settings, we introduce the extension of MPS, called Multi-Prompts Sinkhorn Attention (MPSA) , which effectively replaces cross-attention mechanisms within Transformer framework in multimodal settings. Through extensive experiments, we demonstrate that OTSeg achieves state-of-the-art (SOTA) performance with significant gains on Zero-Shot Semantic Segmentation (ZS3) tasks across three benchmark datasets.

We tackle the challenge of open-vocabulary segmentation, where we need to identify objects from a wide range of categories in different environments, using text prompts as our input. To overcome this challenge, existing methods often use multi-modal models like CLIP, which combine image and text features in a shared embedding space to bridge the gap between limited and extensive vocabulary recognition, resulting in a two-stage approach: In the first stage, a mask generator takes an input image to generate mask proposals, and the in the second stage the target mask is picked based on the query. However, the expected target mask may not exist in the generated mask proposals, which leads to an unexpected output mask. In our work, we propose a novel approach named Prompt-guided Mask Proposal (PMP) where the mask generator takes the input text prompts and generates masks guided by these prompts. Compared with mask proposals generated without input prompts, masks generated by PMP are better aligned with the input prompts. To realize PMP, we designed a cross-attention mechanism between text tokens and query tokens which is capable of generating prompt-guided mask proposals after each decoding. We combined our PMP with several existing works employing a query-based segmentation backbone and the experiments on five benchmark datasets demonstrate the effectiveness of this approach, showcasing significant improvements over the current two-stage models (1% ~ 3% absolute performance gain in terms of mIOU). The steady improvement in performance across these benchmarks indicates the effective generalization of our proposed lightweight prompt-aware method.

In this paper, we propose an embarrassingly simple yet highly effective zero-shot semantic segmentation (ZS3) method, based on the pre-trained vision-language model CLIP. First, our study provides a couple of key discoveries: (i) the global tokens (a.k.a [CLS] tokens in Transformer) of the text branch in CLIP provide a powerful representation of semantic information and (ii) these text-side [CLS] tokens can be regarded as category priors to guide CLIP visual encoder pay more attention on the corresponding region of interest. Based on that, we build upon the CLIP model as a backbone which we extend with a One-Way [CLS] token navigation from text to the visual branch that enables zero-shot dense prediction, dubbed ClsCLIP. Specifically, we use the [CLS] token output from the text branch, as an auxiliary semantic prompt, to replace the [CLS] token in shallow layers of the ViT-based visual encoder. This one-way navigation embeds such global category prior earlier and thus promotes semantic segmentation. Furthermore, to better segment tiny objects in ZS3, we further enhance ClsCLIP with a local zoom-in strategy, which employs a region proposal pre-processing and we get ClsCLIP+. Extensive experiments demonstrate that our proposed ZS3 method achieves a SOTA performance, and it is even comparable with those few-shot semantic segmentation methods.

We present a novel approach for controllable, region-specific style editing driven by textual prompts. Building upon the state-space style alignment framework introduced by StyleMamba, our method integrates a semantic segmentation model into the style transfer pipeline. This allows users to selectively apply text-driven style changes to specific segments (e.g., ``turn the building into a cyberpunk tower'') while leaving other regions (e.g., ``people'' or ``trees'') unchanged. By incorporating region-wise condition vectors and a region-specific directional loss, our method achieves high-fidelity transformations that respect both semantic boundaries and user-driven style descriptions. Extensive experiments demonstrate that our approach can flexibly handle complex scene stylizations in real-world scenarios, improving control and quality over purely global style transfer methods.

We present SLIP (SAM+CLIP), an enhanced architecture for zero-shot object segmentation. SLIP combines the Segment Anything Model (SAM) kirillov2023segment with the Contrastive Language-Image Pretraining (CLIP) radford2021learning. By incorporating text prompts into SAM using CLIP, SLIP enables object segmentation without prior training on specific classes or categories. We fine-tune CLIP on a Pokemon dataset, allowing it to learn meaningful image-text representations. SLIP demonstrates the ability to recognize and segment objects in images based on contextual information from text prompts, expanding the capabilities of SAM for versatile object segmentation. Our experiments demonstrate the effectiveness of the SLIP architecture in segmenting objects in images based on textual cues. The integration of CLIP's text-image understanding capabilities into SAM expands the capabilities of the original architecture and enables more versatile and context-aware object segmentation.

Medical image segmentation has recently demonstrated impressive progress with deep neural networks, yet the heterogeneous modalities and scarcity of mask annotations limit the development of segmentation models on unannotated modalities. This paper investigates a new paradigm for leveraging generative models in medical applications: controllably synthesizing data for unannotated modalities, without requiring registered data pairs. Specifically, we make the following contributions in this paper: (i) we collect and curate a large-scale radiology image-text dataset, MedGen-1M, comprising modality labels, attributes, region, and organ information, along with a subset of organ mask annotations, to support research in controllable medical image generation; (ii) we propose a diffusion-based data engine, termed MRGen, which enables generation conditioned on text prompts and masks, synthesizing MR images for diverse modalities lacking mask annotations, to train segmentation models on unannotated modalities; (iii) we conduct extensive experiments across various modalities, illustrating that our data engine can effectively synthesize training samples and extend MRI segmentation towards unannotated modalities.

We present LlamaSeg, a visual autoregressive framework that unifies multiple image segmentation tasks via natural language instructions. We reformulate image segmentation as a visual generation problem, representing masks as "visual" tokens and employing a LLaMA-style Transformer to predict them directly from image inputs. By adhering to the next-token prediction paradigm, our approach naturally integrates segmentation tasks into autoregressive architectures. To support large-scale training, we introduce a data annotation pipeline and construct the SA-OVRS dataset, which contains 2M segmentation masks annotated with over 5,800 open-vocabulary labels or diverse textual descriptions, covering a wide spectrum of real-world scenarios. This enables our model to localize objects in images based on text prompts and to generate fine-grained masks. To more accurately evaluate the quality of masks produced by visual generative models, we further propose a composite metric that combines Intersection over Union (IoU) with Average Hausdorff Distance (AHD), offering a more precise assessment of contour fidelity. Experimental results demonstrate that our method surpasses existing generative models across multiple datasets and yields more detailed segmentation masks.

Language promptable X-ray image segmentation would enable greater flexibility for human-in-the-loop workflows in diagnostic and interventional precision medicine. Prior efforts have contributed task-specific models capable of solving problems within a narrow scope, but expanding to broader use requires additional data, annotations, and training time. Recently, language-aligned foundation models (LFMs) -- machine learning models trained on large amounts of highly variable image and text data thus enabling broad applicability -- have emerged as promising tools for automated image analysis. Existing foundation models for medical image analysis focus on scenarios and modalities where large, richly annotated datasets are available. However, the X-ray imaging modality features highly variable image appearance and applications, from diagnostic chest X-rays to interventional fluoroscopy, with varying availability of data. To pave the way toward an LFM for comprehensive and language-aligned analysis of arbitrary medical X-ray images, we introduce FluoroSAM, a language-promptable variant of the Segment Anything Model, trained from scratch on 3M synthetic X-ray images from a wide variety of human anatomies, imaging geometries, and viewing angles. These include pseudo-ground truth masks for 128 organ types and 464 tools with associated text descriptions. FluoroSAM is capable of segmenting myriad anatomical structures and tools based on natural language prompts, thanks to the novel incorporation of vector quantization (VQ) of text embeddings in the training process. We demonstrate FluoroSAM's performance quantitatively on real X-ray images and showcase on several applications how FluoroSAM is a key enabler for rich human-machine interaction in the X-ray image acquisition and analysis context. Code is available at https://github.com/arcadelab/fluorosam.