Parameter Efficient Fine-tuning for Domain-specific Gastrointestinal Disease Recognition

Adapting large pretrained vision models to medical image classification is often limited by memory, computation, and task-specific specializations. Parameter-efficient fine-tuning (PEFT) methods like LoRA reduce this cost by learning low-rank updates, but operating directly in feature space can struggle to capture the localized, multi-scale features common in medical imaging. We propose WaRA, a wavelet-structured adaptation module that performs low-rank adaptation in a wavelet domain. WaRA reshapes patch tokens into a spatial grid, applies a fixed discrete wavelet transform, updates subband coefficients using a shared low-rank adapter, and reconstructs the additive update through an inverse wavelet transform. This design provides a compact trainable interface while biasing the update toward both coarse structure and fine detail. For extremely low-resource settings, we introduce Tiny-WaRA, which further reduces trainable parameters by learning only a small set of coefficients in a fixed basis derived from the pretrained weights through a truncated SVD. Experiments on medical image classification across four modalities and datasets demonstrate that WaRA consistently improves performance over strong PEFT baselines, while retaining a favorable efficiency profile. Our code is publicly available at https://github.com/moeinheidari7829/WaRA.

Gastrointestinal diseases impose a growing global health burden, and endoscopy is a primary tool for early diagnosis. However, routine endoscopic image interpretation still suffers from missed lesions and limited efficiency. Although AI-assisted diagnosis has shown promise, existing models often lack generalizability, adaptability, robustness, and scalability because of limited medical data, domain shift, and heterogeneous annotations. To address these challenges, we develop RATNet, a foundation model for gastrointestinal endoscopy imaging based on analogical reasoning. RATNet acquires and transfers knowledge from heterogeneous expert annotations across five gastrointestinal endoscopy datasets through a cyclic pre-training strategy. Its architecture consists of an encoder, a relevance-knowledge acquisition and transfer (RAT) module, a projector, and a multi-task head, and supports fine-tuning, linear probing, and zero-shot transfer. Evaluations show that RATNet outperforms existing foundation models, including GastroNet and GastroVision, across six scenarios: diagnosis of common gastrointestinal diseases, few-shot learning for rare diseases, zero-shot transfer to new medical sites, robustness under long-tailed disease distributions, adaptation to novel diseases, and privacy-preserving deployment via federated learning. Its advantage comes from an analogical reasoning mechanism that matches image-derived posterior knowledge to a learned prior knowledge base and transfers relative knowledge to guide diagnosis, improving generalization and resistance to bias. RATNet is open and cost-effective, supports automatic integration of heterogeneous annotations without manual label unification, and reduces data acquisition costs, making it a practical foundation for intelligent gastrointestinal diagnosis, especially in resource-limited settings.

Parameter-efficient fine-tuning (PEFT) has emerged as a promising paradigm for adapting pretrained models under limited data conditions. However, most existing PEFT methods are designed for matrix-structured parameters and are not well suited for high-dimensional convolutional kernels in medical imaging models. Moreover, they typically rely on additive updates and lack mechanisms to preserve the geometric structure of pretrained parameters, while multiplicative (geometry-aware) updates are difficult to integrate within a unified framework. To address this issue, this paper proposes GLT-PEFT, a gated Lie-Tucker parameter-efficient fine-tuning framework for Alzheimer's disease (AD) diagnosis. The proposed approach transfers a hippocampal segmentation pretrained model to a downstream classification task. Tucker decomposition enables tensor-aware low-rank adaptation of 3D convolutional kernels, while Lie group-based transformations provide structure-preserving multiplicative updates. A gating mechanism further reconciles additive and multiplicative update forms, resulting in a unified and more stable fine-tuning strategy. Extensive experiments demonstrate that GLT-PEFT achieves effective cross-task transfer while significantly reducing trainable parameters, highlighting its effectiveness for efficient and robust adaptation in medical imaging models.