MAMVI: 3D Test-Time Adaptation via Masked Multi-View Point Clouds

Test-time adaptation (TTA) has emerged as a promising paradigm for vision-language models (VLMs) to bridge the distribution gap between pre-training and test data. Recent works have focused on backpropagation-free TTA methods that rely on cache-based designs, but these introduce two key limitations. First, inference latency increases as the cache grows with the number of classes, leading to inefficiencies in large-scale settings. Second, suboptimal performance occurs when the cache contains insufficient or incorrect samples. In this paper, we present Prototype-Based Test-Time Adaptation (PTA), an efficient and effective TTA paradigm that uses a set of class-specific knowledge prototypes to accumulate knowledge from test samples. Particularly, knowledge prototypes are adaptively weighted based on the zero-shot class confidence of each test sample, incorporating the sample's visual features into the corresponding class-specific prototype. It is worth highlighting that the knowledge from past test samples is integrated and utilized solely in the prototypes, eliminating the overhead of cache population and retrieval that hinders the efficiency of existing TTA methods. This endows PTA with extremely high efficiency while achieving state-of-the-art performance on 15 image recognition benchmarks and 4 robust point cloud analysis benchmarks. For example, PTA improves CLIP's accuracy from 65.64% to 69.38% on 10 cross-domain benchmarks, while retaining 92% of CLIP's inference speed on large-scale ImageNet-1K. In contrast, the cache-based TDA achieves a lower accuracy of 67.97% and operates at only 50% of CLIP's inference speed.

3D CT vision-language models (VLMs) classify abnormalities from text prompts in a zero-shot manner, enabling cross-institution deployment where labels are scarce and clinical tasks shift faster than supervised models can be retrained. A real CT scan, however, typically contains several co-occurring abnormalities, and the reliability of zero-shot multi-label prediction under distribution shift remains poorly understood. Test-time adaptation (TTA) updates a model on unlabeled target scans without source data or target annotations, yet existing TTA methods target multi-class softmax prediction on natural images or 2D medical segmentation, and none addresses unsupervised multi-label adaptation for zero-shot 3D CT VLMs. We study when TTA helps zero-shot 3D CT VLMs. A controlled diagnostic analysis shows that TTA is conditional: the volumetric input must preserve the encoder's depth structure, and the base representation must transfer to the target cohort, with depth reduction alone lowering internal AUROC by more than 0.12. We then focus on the regime where the base model already separates present from absent abnormalities. We introduce CARVE (Cardinality-Aware Retained-View Entropy), the first TTA method for this setting. CARVE estimates a sample-specific positive-label cardinality $\hat{k}$, optimizes a top-$\hat{k}$ objective to preserve co-occurring abnormalities, and performs memory-efficient multi-view adaptation by scoring weak 3D views without gradients before updating on a retained subset. Across contrastive CT-CLIP and anatomy-aware fVLM, CARVE provides the most consistent improvements across multi-label, three-class, and binary CT tasks when the base model is already discriminative. These results establish multi-label TTA for zero-shot 3D CT VLMs as a distinct problem and CARVE as a cardinality-aware solution.

3D point cloud registration in laparoscopic surgery estimates the transformation between an intraoperative organ reconstructed from video and its preoperative mesh. Because ground-truth transformations are unavailable for real data, supervised networks are trained on synthetic organ pairs. At test time, real reconstructions differ from synthetic data and are noisy, sparse, and occluded, which degrades correspondence estimation. Test-time adaptation (TTA) can reduce this domain shift, but existing methods mainly rely on logits, entropy, class prototypes, or cache memories unavailable in registration. Registration also involves paired inputs with an asymmetric shift that primarily affects the intraoperative cloud. We analyse and modify state-of-the-art TTA methods from three families to 3D registration: model, normalization, and input adaptation. We analyze four representative approaches based on auxiliary-task model updates, backpropagation-free token purging, feature alignment, and layer-normalization calibration. We modify them to handle asymmetric shifts between preoperative and intraoperative point clouds and replace classification-based entropy objectives. Using a correspondence-based model trained on clean synthetic source data, we evaluate adaptation to corrupted synthetic and real target data on P2P and P2ILReg. For synthetic targets, we apply eight corruptions, including uniform noise and global density reduction, at five severity levels. All methods improve registration on P2P, whereas normalization adaptation degrades performance on P2ILReg. Considering the computational overhead of backpropagation-based adaptation, input adaptation is the most promising option for laparoscopic surgery, providing low inference latency and consistent error reductions across datasets. Code: https://github.com/ninaa-git/survey_pc_registration_tta