From Pixels to Concepts: Do Segmentation Models Understand What They Segment?

Recent progress in promptable segmentation has shifted visual perception from object-level localization toward concept-level understanding. However, the notion of a concept remains under-specified, making it unclear whether current methods truly generalize beyond category recognition. In this work, we formalize generalized concept segmentation through a three-level taxonomy consisting of context-independent (CI), context-dependent (CD), and context-reasoning (CR) concepts, which reveals a clear capability gap across increasing levels of cognitive complexity. To address this challenge, we propose ConceptSeg-R1, a unified framework that reformulates concept segmentation as rule-induced concept grounding. At the core of our method is Meta-GRPO, a meta-reinforcement learning mechanism that learns transferable task rules from visual demonstrations and verifies them through proxy reasoning. The inferred reasoning states are then translated into segmentation-ready concept prompts via a lightweight concept translation module, enabling deductive application to target images. A shortcut routing strategy further preserves the native efficiency of segmentation models on simple cases. To systematically evaluate generalized concept segmentation, we conduct extensive experiments across diverse CI, CD, and CR concept segmentation benchmarks spanning natural, industrial, medical and reasoning-intensive domains. Without bells and whistles, ConceptSeg-R1 achieves strong performance across the full concept hierarchy while maintaining the native capability of promptable segmentation backbones. As an initial step toward segmenting any concept, we hope ConceptSeg-R1 can serve as a practical baseline for advancing segmentation from object-level prediction toward concept-level understanding.

SAM3 extends promptable segmentation from geometry-driven mask prediction to open-vocabulary concept segmentation, where a text-conditioned grounding model decides whether a concept is present and segments all matching instances. While this presence-gated design improves concept-level prediction, its adversarial robustness remains unexplored. In this paper, we introduce Universal Concept Disruption (UCD), the first universal cross-concept adversarial attack tailored to SAM3 image segmentation. UCD learns a single bounded image perturbation from (image, noun-phrase) pairs and attacks SAM3 as an integrated concept-grounding system. It jointly disrupts the text-conditioned input path, maximizes divergence in prompt-shared visual features, suppresses the final presence-gated concept scores, and corrupts the spatial validity of retained masks through area collapse and clean-mask Dice disruption. Across SACo-Gold, LVIS, RefCOCO, PhraseCut, and OpenImages datasets, UCD consistently outperforms all baselines under a matched evaluation protocol, reducing average mask AP from 59.43 to 18.73 and average cgF1 from 50.32 to 20.49. The learned perturbation also transfers to SAM3.1 and to SAM3 video inference without re-optimization, while prompt ensembling, lightweight head fine-tuning, and temporal filtering provide limited recovery.

Promptable segmentation foundation models (FMs) such as SAM3 and Medical SAM3 promise few-shot, interactively-specified segmentation for medical imaging through a natural language interface, yet their performance on clinical tasks falls well short of this promise. We posit that this shortfall is not an artefact of insufficient medical pretraining or imperfect prompt phrasing, but a structural limitation that will persist in any domain where paired image-text supervision is scarce, as it is across most clinical modalities. We further hypothesize that the limitation is specific to natural language as a control signal: a visually grounded prompt, learned directly from the target distribution, should recover the lost performance without additional image-text data or backbone retraining. We propose Few-Shot Concept Prompt Learning (FS-CPL), which learns a continuous concept prompt embedding $\mathbf{p}^* \in \mathbb{R}^{T \times d}$ from a small support set of $K$ image--mask pairs via mask supervision, with the encoder-decoder backbone frozen. Across four public benchmarks spanning ultrasound and endoscopy (BUSI, HC18, TN3K, CVC-Clinic), FS-CPL delivers absolute Dice improvements of up to $+0.62$ over canonical text prompts and is \emph{backbone-agnostic}: it lifts both vanilla SAM3 and the domain-specifically pretrained Medical SAM3, showing that visual concept prompting is complementary to in-domain pretraining.