Vision foundation models (VFMs) are valuable in data-scarce domains such as surgery, where a single pretrained backbone can provide rich representations for many downstream tasks. Yet the dominant self-supervised pretraining paradigm uses only RGB images, leaving readily available complementary signals, such as depth maps, unused. This is a particular missed opportunity in surgery, where natural-image VFMs transfer poorly while the scene geometry is rich and informative. With strong off-the-shelf models now able to produce pseudo-labeled dense depth for any image corpus, we hypothesize that such signals can be folded into pretraining to learn better representations. We present DART, an RGB-D pretraining recipe that builds on DINOv2 with a simple modification: a pixel-space depth reconstruction objective applied to masked iBOT patches, supervised by pseudo-labeled depth. Depth is used only during pretraining, so fine-tuning and inference remain RGB-only. We find that this pixel-level reconstruction head improves representation quality rather than disrupting it. We further show that depth, which encodes scene geometry, is more effective as a target than alternative dense signals such as Canny edges, confirming that the gains stem from depth rather than added supervision alone. Across eight surgical benchmarks spanning segmentation, depth estimation, and image-level recognition, DART outperforms both natural-image and in-domain baselines, including a vanilla DINOv2 trained on identical data, improving dense prediction while also strengthening image-level understanding. More broadly, DART shows that freely available geometric pseudo-labels can strengthen foundation model pretraining without extra labels or added inference cost, pointing toward stronger backbones for surgery.
Figures & tables
Figure 1: An overview of our method for a single global crop example. We build on the DINOv2 framework and maintain all components and loss terms. In DINOv2, global crops are 50%-masked and enter the student backbone. The iBOT objective enforces student patch features to match the teacher’s patch at the masked locations. DART adds a lightweight head that regresses pixel-wise depth from the student’s patch features. A reconstruction ℓ1 loss is minimized to match pseudo-labeled depth maps. Loss is computed only at masked patch locations, similar to iBOT. This simple modification lends itself to a RGB-D pre-training recipe that improves downstream tasks without requiring depth maps at fine-tuning/runtime. Local crops are processed identically to the DINOv2 recipe. “sg” stands for stop-gradient.
Figure 2: Samples from the RGB-D dataset and qualitative results displaying the depth reconstruction quality of DART. Each sample is ordered as RGB, pseudo-labeled depth, and reconstructed depth of DART. Note that the objective of our approach is not for good depth estimation but rather improving representation learning for downstream tasks.
EndoVis18
CholecISeg
SARRARP50
CholecSeg8k
PhaKIR
Data
Method
Depth
lin.
+ms.
lin.
+ms.
lin.
+ms.
lin.
+ms.
lin.
+ms.
Natural
DINOv2
–
28.8
31.8
48.3
52.6
53.5
62.0
36.7
38.5
10.3
10.4
DINOv3
–
30.1
32.5
53.5
55.2
58.0
64.0
50.0
43.7
11.6
10.6
MAE
–
26.0
28.0
37.1
47.1
52.7
55.1
37.9
38.9
7.6
8.8
MultiMAE
PT
26.6
27.0
40.7
48.7
51.2
56.1
36.0
36.7
8.3
10.1
LEMON
LEMON-FM
–
25.7
31.2
40.6
51.0
52.0
66.6
33.9
42.4
8.7
11.0
Table 1: Semantic segmentation with frozen features , linear (lin.) and multiscale (+ms). Depth marks whether depth is used in pre-training (PT) and/or fine-tuning (FT). Bold is best and underline is second best among the RGB-only fine-tuning settings; the RGB-D fine-tuning row (gray) is excluded from the ranking. Mean over 3 seeds; per-cell std reported in the appendix. CholecISeg = CholecInstanceSeg. Natural images refer to LVD for DINO models and IN-1k for MAE models. We report the mean over 3 seeds; standard deviations are in the appendices due to space constraints.
Figure 3: Qualitative results displaying segmentation results on EndoVis18, CholecInstanceSeg, and CholecSeg8k under the multiscale setting. We only display results for models pretrained on the surgical data. We refer the reader to the appendices for more qualitative results.
Pretrain. data
Method
Depth
Linear
DPT
LEMON
LEMON-FM
–
0.485 ± 0.005
0.608 ± 0.006
MAE
–
0.512 ± 0.003
0.609 ± 0.026
MultiMAE
PT
0.498 ± 0.004
0.605 ± 0.007
DINOv2
–
0.542 ± 0.003
0.626 ± 0.009
Ours
PT
0.557 ± 0.008
0.653 ± 0.009
Natural
DINOv2
–
0.506 ± 0.011
0.613 ± 0.037
Table 2: Depth estimation on SCARED-C ( δ1↑ ). Mean ± std over 3 seeds. Bold is best and underline is second best across all rows. We exclude MultiMAE RGB-D since it would be a trivial task to regress depth from RGB-D. Depth marks whether depth is used in pre-training (PT). Natural images refer to LVD and IN-1k for DINO and MAE models respectively.
Figure 4: Qualitative results displaying depth estimation results on the SCARED-C dataset under the DPT setting. We only display results for models pretrained on the surgical data. We refer the reader to the appendices for more qualitative results.
Cholec80
CholecT50 Triplet Recognition
Pretrain. data
Method
F1 Score
AP i
AP v
AP t
AP it
AP iv
AP ivt
LEMON
MAE
45.0 ± 0.4
36.4 ± 0.1
23.9 ± 0.2
15.8 ± 0.5
5.9 ± 0.1
9.6 ± 0.2
3.6 ± 0.1
MultiMAE
43.9 ± 0.3
37.8 ± 0.3
23.7 ± 0.2
15.7 ± 0.4
5.2 ± 0.2
9.5 ± 0.1
3.5 ± 0.3
DINOv2
70.8 ± 0.1
58.8 ± 0.5
34.6 ± 0.2
25.9 ± 0.1
10.4 ± 0.5
15.4 ± 0.1
6.4 ± 0.1
Ours
71.5 ± 0.1
62.1 ± 0.2
37.0 ± 0.1
28.2 ± 0.2
11.6 ± 0.1
16.2 ± 0.5
6.9 ± 0.1
LEMON-FM
67.1 ± 0.1
73.6 ± 0.4
44.6 ± 0.2
30.0 ± 0.1
13.3 ± 0.4
20.0 ± 0.1
7.9 ± 0.3
Table 3: Image-level surgical understanding. Cholec80 phase recognition F1 Score (%) and CholecT50 triplet recognition (AP, %). Mean ± std over 3 seeds. Bold = best and underline = second best per column, across all rows. Natural image datasets are LVD for DINO models and IN-1k for MAE models.
EndoVis18
CholecISeg
SARRARP50
CholecSeg8k
PhaKIR
Aux. signal
lin.
+ms.
lin.
+ms.
lin.
+ms.
lin.
+ms.
lin.
+ms.
None (DINOv2)
30.4
30.9
48.5
50.9
57.4
54.6
39.9
42.7
10.3
9.5
Canny edges
29.1
30.9
48.6
49.9
56.3
55.3
38.5
43.7
10.6
8.7
Blurred grayscale
28.2
29.2
45.4
50.0
55.9
53.8
38.4
44.2
10.4
9.3
Depth (ours)
31.4
31.2
48.5
47.4
57.8
55.6
41.0
42.7
10.7
10.7
Table 4: Auxiliary reconstruction signal ablation (ViT-S; linear (lin.) and multiscale (+ms.) mIoU, mean over 3 seeds). Bold = best and underline = second best per column. We report mIoU. CholecISeg = CholecInstanceSeg.
Depth decoder
dw
EV18 (mIoU)
Cholec80 (F1)
–
0
29.3
62.4
MLP
0.025
29.2
62.2
0.05
29.6
64.0
0.1
30.6
65.5
0.25
7.8
17.2
Transformer
0.05
18.5
37.2
Table 5: Depth decoder and loss-weight sweep. EndoVis18 (EV18) linear (lin.) mIoU as a function of the depth decoder architecture and the depth-loss weight dw . The top row ( dw=0 ) is the depth-free baseline; the Transformer decoder follows the MAE decoder design.
Figure 5: PCA visualization of the features learned by DINOv2 compared to DART at 640×640 resolution. Generally, DART has smoother features which is reflected in its superior quantitative results. Because we do not incorporate registers in our ViTs, we clip outliers outside of 95% for improved visualization.
Config
MAE
MultiMAE †
DINOv2
DART
Optimization
Optimizer
AdamW
Base LR
1e−4
1e−4
1.5e−3
1.5e−3
Weight decay
0.05
0.05
0.04
0.04
β1,β2
0.9, 0.95
0.9, 0.95
0.9, 0.999
0.9, 0.999
Batch size
4096
2048
1024
1024
Table S1: Pre-training configurations for in-domain baselines and DART, all trained on the LEMON corpus. “—” denotes parameters not applicable to a given method.
Config
lin. + ms.
DPT
Image-level Tasks
Optimization
Optimizer
AdamW
AdamW
SGD
Learning rate
1e−3
1e-3
1e-3
β1,β2
0.9, 0.999
0.9, 0.999
–
Weight decay
0.05
0.05
0.0
Batch size
64
64
256
Table S2: Fine-tuning configuration used across downstream segmentation experiments. The backbone is frozen and only the task head is trained, so depth supervision affects evaluation solely through the learned representations. Input resolution is 224×224 with patch size 16 . We normalize images based on the pre-training data source, e.g., ImageNet-pretrained models undergoes ImageNet normalization.
Dataset
Task
Procedure
Modality
In/Ex
Cls.
Size
Cholec80
Phase recog.
Cholecystectomy
Manual lap.
In
7
80 videos
CholecT50
Triplet recog.
Cholecystectomy
Manual lap.
In
100 ∗
50 vid. / ∼100 k fr.
SCARED-C
Depth estimation
Porcine abdomen
Robotic
Ex
—
17,135 RGB-D fr.
EndoVis18
Scene seg.
Porcine nephrectomy
Robotic
Ex
12
19 video seq.
CholecInstanceSeg
Instrument seg.
Cholecystectomy
Manual lap.
In
8
41,933 fr. / 85 proc.
SAR-RARP50
Instrument seg.
Radical prostatectomy
Robotic
In
10
50 vid. / ∼16 k fr.
Table S3: Downstream evaluation datasets used in this work. “In/Ex” denotes in-vivo versus ex-vivo . “Classes” refers to the number of label categories used in this work. Lap. = laparoscopy.
EndoVis18
CholecISeg
SARRARP50
CholecSeg8k
PhaKIR
Data
Method
Depth
lin.
+ms.
lin.
+ms.
lin.
+ms.
lin.
+ms.
lin.
+ms.
LEMON
DINOv2 ViT-S
–
30.4
30.9
48.5
50.9
57.4
54.6
39.9
42.7
10.3
9.5
Ours ViT-S
PT
31.4
31.2
48.5
47.4
57.8
55.6
41.0
42.7
10.7
10.7
DINOv2 ViT-B
–
32.1
31.8
52.8
56.3
61.5
65.1
41.6
46.1
11.8
12.8
Ours ViT-B
PT
32.1
32.2
57.2
63.5
63.5
67.0
43.9
50.3
12.3
13.6
Table S4: ViT-S semantic segmentation with frozen features , linear (lin.) and multiscale (+ms), with ViT-B counterparts for reference. Depth marks whether depth is used in pre-training (PT) and/or fine-tuning (FT). Mean over 3 seeds. CholecISeg = CholecInstanceSeg. For these experiments, we use batch size = 256 due to compute constraints.
Dataset
Head
DINOv2
DART-128
DART-256
DART-512
EndoVis18
lin.
30.4
29.6
31.4
29.5
+ms.
30.9
31.4
31.2
30.8
CholecInstanceSeg
lin.
48.5
47.2
48.5
46.8
+ms.
50.9
47.2
47.4
46.4
CholecSeg8k
lin.
39.9
42.9
41.0
39.1
+ms.
42.7
42.5
42.7
40.3
Table S5: Depth-head hidden dimension sweep (ViT-S). Linear (lin.) and multiscale (+ms.) frozen-feature mIoU on four surgical segmentation benchmarks. Hidden dimensions are reported in ascending order; the leftmost column is the depth-free DINOv2 baseline. Best per row in bold .
EndoVis18
CholecInstanceSeg
SARRARP50
Data
Method
Depth
lin.
+ms.
lin.
+ms.
lin.
+ms.
Natural
DINOv2
–
28.8 ± 1.0
31.8 ± 0.7
48.3 ± 0.2
52.6 ± 0.5
53.5 ± 0.4
62.0 ± 0.2
DINOv3
–
30.1 ± 0.5
32.5 ± 0.6
53.5 ± 2.7
55.2 ± 4.1
58.0 ± 0.8
64.0 ± 0.4
MAE
–
26.0 ± 0.2
28.0 ± 0.4
37.1 ± 0.3
47.1 ± 0.4
52.7 ± 0.2
55.1 ± 0.5
MultiMAE
PT
26.6 ± 0.3
27.0 ± 0.5
40.7 ± 0.3
48.7 ± 0.4
51.2 ± 0.2
56.1 ± 0.1
LEMON
LEMON-FM
–
25.7 ± 0.4
31.2 ± 0.3
40.6 ± 0.4
51.0 ± 0.1
52.0 ± 0.2
66.6 ± 0.3
Table S6: Semantic segmentation with frozen features, mean ± std (part 1 of 2). Linear (lin.) and multiscale (+ms.). Depth marks whether depth is used in pre-training (PT) and/or fine-tuning (FT). Mean and standard deviation over 3 seeds. CholecISeg = CholecInstanceSeg. Natural images refer to LVD for DINO models and IN-1k for MAE models. Remaining datasets in Table S7 .
CholecSeg8k
PhaKIR
Data
Method
Depth
lin.
+ms.
lin.
+ms.
Natural
DINOv2
–
36.7 ± 0.5
38.5 ± 0.5
10.3 ± 0.6
10.4 ± 0.3
DINOv3
–
50.0 ± 2.9
43.7 ± 0.4
11.6 ± 0.3
10.6 ± 0.1
MAE
–
37.9 ± 2.1
38.9 ± 1.2
7.6 ± 0.8
8.8 ± 0.4
MultiMAE
PT
36.0 ± 1.1
36.7 ± 0.4
8.3 ± 0.5
10.1 ± 0.3
LEMON
LEMON-FM
–
33.9 ± 0.3
42.4 ± 0.8
8.7 ± 0.5
11.0 ± 0.2
Table S7: Semantic segmentation with frozen features, mean ± std (part 2 of 2). Continuation of Table S6 for the CholecSeg8k and PhaKIR datasets. Mean and standard deviation over 3 seeds. Column conventions as in Table S6 .
DAv2
DART
Dataset
H1
H2
H1
H2
EndoVis18
27.1
33.7
34.9
36.8
CholecISeg
46.5
51.0
66.2
68.9
SARRARP50
52.0
59.6
68.7
70.2
CholecSeg8k
36.0
36.8
52.4
50.5
PhaKIR
9.6
10.7
14.5
16.2
Table S8: Quantitative results for frozen Depth Anything v2 ViT-B on dense pixel tasks. H1 is a single linear head; H2 is +m.s. for segmentation and DPT for depth. The first five rows are segmentation (mIoU) and the last is depth estimation ( δ1 ).
Figure S1: EndoVis18 segmentation qualitative results. From left to right: Ground truth, MAE (IN-1k), MultiMAE (IN-1k), DINOv2 (LVD), DINOv3 (LVD), LEMON-FM, MAE (LEMON), MultiMAE (LEMON), DINOv2 (LEMON), DART (LEMON).
Figure S2: CholecSeg8k segmentation qualitative results. From left to right: Ground truth, MAE (IN-1k), MultiMAE (IN-1k), DINOv2 (LVD), DINOv3 (LVD), LEMON-FM, MAE (LEMON), MultiMAE (LEMON), DINOv2 (LEMON), DART (LEMON).
Figure S3: SCARED-C depth estimation qualitative results. From left to right: RGB, Ground truth, MAE (IN-1k), MultiMAE (IN-1k), DINOv2 (LVD), DINOv3 (LVD), LEMON-FM, MAE (LEMON), MultiMAE (LEMON), DINOv2 (LEMON), DART (LEMON).
Visual representation learning develops image and video features that capture useful structure for recognition, retrieval, spatial reasoning, and action.
The Johns Hopkins University, United States · Zhejiang University, China · Zhejiang University-University of Illinois Urbana-Champaign Institute, China +4