Two-Stage Mixture-of-LoRA for Multi-Task Medical Vision-Language Learning

Adapting a single vision-language model to medical image parsing requires training choices that reflect the demands of each task. We study task-specific adaptation with Qwen3.5-9B for FLARE 2026 Task 3, covering six task families and seven imaging modalities. Our system couples a shared, frozen 4-bit backbone with LoRA adapters selected from the input question. We customize adapter ranks and prompts, rebalance rare classification targets, and supplement regression training with dermatology classification examples. On the fixed internal holdout, the task-specific adapters achieve a dataset-macro balanced accuracy of 0.7791 for classification, a dataset-macro micro-F1 of 0.6286 for multi-label classification, a counting mean absolute error (MAE) of 11.73, a dataset-macro detection F1 of 0.8914, a dataset-macro regression MAE of 9.78, and a report-generation CRIMSON score of 0.8204. On the organizer's 1,703-example hidden-validation set, the submitted system achieves 0.8496 classification balanced accuracy, 0.5338 sample-averaged multi-label F1, and 14.5950 regression MAE. The final 30.1 GB container averages 3.1 seconds per case, including model loading, and produces identical outputs across repeated verification runs. The benefits vary across tasks, supporting the use of task-specific adapter configurations and image budgets within a shared medical vision-language model. Code is available at https://github.com/TahaSabir0/FLARE26-Hexapus.

The success of CLIP-like vision-language models (VLMs) on natural images has inspired medical counterparts, yet existing approaches largely fall into two extremes: specialist models trained on single-domain data, which capture domain-specific details but generalize poorly, and generalist medical VLMs trained on multi-domain data, which retain broad semantics but dilute fine-grained diagnostic cues. Bridging this specialization-generalization trade-off remains challenging. To address this problem, we propose ACE-LoRA, a parameter-efficient adaptation framework for generalist medical VLMs that maintains robust zero-shot generalization. ACE-LoRA integrates Low-Rank Adaptation (LoRA) modules into frozen image-text encoders and introduces an Attention-based Context Enhancement Hypergraph Neural Network (ACE-HGNN) module that captures higher-order contextual interactions beyond pairwise similarity to enrich global representations with localized diagnostic cues, addressing a key limitation of prior Parameter-Efficient Fine-Tuning (PEFT) methods that overlook fine-grained details. To further enhance cross-modal alignment, we formulate a label-guided InfoNCE loss to effectively suppress false negatives between semantically related image-text pairs. Despite adding only 0.95M trainable parameters, ACE-LoRA consistently outperforms state-of-the-art medical VLMs and PEFT baselines across zero-shot classification, segmentation, and detection benchmarks spanning multiple domains. Our code is available at https://github.com/icon-lab/ACE-LoRA.

Large vision-language models (LVLMs) can be adapted to specialized medical imaging tasks via parameter-efficient fine-tuning approaches such as low-rank adaptation (LoRA), leading to a growing ecosystem of expert models tailored to specific imaging modalities and clinical scenarios. However, deploying multiple expert LVLMs in practice incurs substantial computational and operational overhead. Model merging provides a promising solution by consolidating multiple experts into a single model without retraining, yet it remains largely unexplored in the medical domain. In this work, we present the first systematic study of model merging for medical LVLMs. We introduce MergeMedBench, a comprehensive benchmark spanning eight imaging modalities and diverse clinical task types, comprising 16 LoRA fine-tuned models built upon two mainstream architectures. We conduct an extensive evaluation of existing merging methods and further propose winner-take-all, a simple and hyperparameter-free approach that retains only the most dominant parameters across expert models. By preserving the critical parameters that govern model behavior and discarding weaker ones, our method avoids the information dilution inherent in averaging- or alignment-based strategies. Despite its simplicity, winner-take-all consistently outperforms existing approaches, offering both a new perspective on LoRA merging and a strong practical baseline for future research.