TAP-SLF: Parameter-Efficient Adaptation of Vision Foundation Models for Multi-Task Ultrasound Image Analysis

Ultrasound images vary widely across scanners, operators, and anatomical targets, which often causes models trained in one setting to generalize poorly to new hospitals and clinical conditions. The Foundation Model Challenge for Ultrasound Image Analysis (FMC-UIA) reflects this difficulty by requiring a single model to handle multiple tasks, including segmentation, detection, classification, and landmark regression across diverse organs and datasets. We propose a unified multi-task framework based on a transformer visual encoder from the Qwen3-VL family. Intermediate token features are projected into spatial feature maps and fused using a lightweight multi-scale feature pyramid, enabling both pixel-level predictions and global reasoning within a shared representation. Each task is handled by a small task-specific prediction head, while training uses task-aware sampling and selective loss balancing to manage heterogeneous supervision and reduce task imbalance. Our method is designed to be simple to optimize and adaptable across a wide range of ultrasound analysis tasks. The performance improved from 67% to 85% on the validation set and achieved an average score of 81.84% on the official test set across all tasks. The code is publicly available at: https://github.com/saitejalekkala33/FMCUIA-ISBI.git

Ultrasound image analysis plays a crucial role in cancer screening and prenatal diagnosis, yet comprehensive assessment requires jointly addressing tasks such as lesion segmentation and benign-malignant classification. While recent vision foundation models have shown remarkable universal representations, unlocking their potential for ultrasound is bottlenecked by the considerable domain gap from natural images. Existing methods typically fine-tune heavy vision encoders for isolated tasks, incurring substantial computational overhead while overlooking the underlying commonalities across heterogeneous tasks. In this work, we propose FreqDINO++, a frequency-guided multi-task routing vision foundation model for universal ultrasound analysis. We first introduce a Multi-task Routing Adapter (MR-Adapter) to support parameter-efficient integration of task-common and task-specific knowledge, a Frequency-aware Feature Enhancer (F$^2$-Enhancer) is then designed to capture the rich multi-scale frequency characteristics of ultrasound images, and a Task-aligned Collaborative Decoder (TC-Decoder) is devised to promote collaboration between dense and global prediction tasks through global-local token interaction. Extensive experiments on large-scale multi-task and external single-task ultrasound benchmarks demonstrate that FreqDINO++ consistently outperforms strong baselines and recent foundation models across 27 diverse clinical task scenarios, while also showing promising generalization to unseen data. The code is at https://github.com/MingLang-FD/FreqDINO-Plus.

Large vision-language models (LVLMs) have achieved strong performance across many medical imaging tasks, yet their application to ultrasound remains limited due to its inherent complexity and variability. In this work, we revisit what is truly needed to enable real-world ultrasound understanding. Instead of introducing complex architectures or elaborate training strategies, we show that data scale and clinically faithful data alignment are the key factors. We construct a large-scale dataset of 1.5M real-world ultrasound examinations, containing 17.7M images, multi-organ coverage, and paired uncurated clinical reports. Crucially, we organize the data at the examination level, aligning multiple images with their corresponding reports to reflect real clinical workflows. We then fine-tune a standard LVLM using low-rank adaptation (LoRA) on this dataset without task-specific modifications. Surprisingly, this simple recipe already leads to strong performance across diverse ultrasound understanding tasks, outperforming prior methods designed with more complex pipelines. Beyond these results, we present model and data scaling analyses that provide insights into the role of scale in ultrasound LVLMs.