Text-Guided Image Segmentation

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Text-guided image segmentation studies how to turn class names, referring expressions, clinical reports, and instructions into precise pixel-level masks. Common approaches align language and visual features with contrastive learning or cross-attention, condition segmentation models such as Segment Anything with text prompts or lightweight adapters, and use generative models or multimodal reasoning to propose and refine masks. These methods support settings from open-vocabulary recognition to medical and remote-sensing segmentation, with training-free, few-shot, and supervised approaches. A central challenge is grounding varied or ambiguous language in accurate boundaries across domains while balancing robustness, reliability, and computational cost.

Latest papers

96 papers10 papers in the last four weeks, up 25% on the four weeks before. 0.1% of all new papers.

May 6, 2026

FlowDIS: Language-Guided Dichotomous Image Segmentation with Flow Matching

Accurate image segmentation is essential for modern computer vision applications such as image editing, autonomous driving, and medical image analysis. In recent years, Dichotomous Image Segmentation (DIS) has become a standard task for training and evaluating highly accurate segmentation models. Existing DIS approaches often fail to preserve fine-grained details or fully capture the semantic structure of the foreground. To address these challenges, we present FlowDIS, a novel dichotomous image segmentation method built on the flow matching framework, which learns a time-dependent vector field to transport the image distribution to the corresponding mask distribution, optionally conditioned on a text prompt. Moreover, with our Position-Aware Instance Pairing (PAIP) training strategy, FlowDIS offers strong controllability through text prompts, enabling precise, pixel-level object segmentation. Extensive experiments demonstrate that our method significantly outperforms state-of-the-art approaches both with and without language guidance. Compared with the best prior DIS method, FlowDIS achieves a 5.5% higher

F_β^ω

measure and 43% lower MAE (

\mathcal{M}

) on the DIS-TE test set. The code is available at: https://github.com/Picsart-AI-Research/FlowDIS

Andranik Sargsyan, Shant Navasardyan

Picsart AI Research (PAIR)

Image Segmentation Text-Guided Image Segmentation Promptable Image Segmentation Semantic Segmentation

May 6, 2026

From Diffusion to Rectified Flow: Rethinking Text-Based Segmentation

Text-based image segmentation aims to delineate object boundaries within an image from text prompts, offering higher flexibility and broader application scope compared to traditional fixed-category segmentation tasks. Recent studies have shown that diffusion models (e.g., Stable Diffusion) can provide rich multimodal semantic features, leading to studies of using diffusion models as feature extractors for segmentation tasks. Such methods, however, inherit the generative natures of diffusion models that are harmful to discriminative segmentation tasks. In response, we propose RLFSeg, a novel framework that leverages Rectified Flow to learn direct mapping from the image to the segmentation mask within the latent space. The model is thus freed from the noise-denoise process and the need to optimize the time step of diffusion models, resulting in substantially better performance than previous diffusion-based methods, especially on zero-shot scenarios. By introducing label refinement and an Adaptive One-Step Sampling strategy, the model achieves higher accuracy even on a single inference step. The framework redirects a pretrained generative model to the discriminative segmentation task with zero modification to model structure, thus reveals promising application potential and significant research value.

Zishen Qu, Xuesong Li, Haijian Gu +5

Zhejiang University · bytedance · Southeast University

Image Segmentation Text-Guided Image Segmentation Zero-Shot Referring Image Segmentation Semantic Segmentation Diffusion Models

Apr 27, 2026

ESICA: A Scalable Framework for Text-Guided 3D Medical Image Segmentation

Text guided 3D medical image segmentation offers a flexible alternative to class based and spatial prompt based models by allowing users to specify regions of interest directly in natural language. This paradigm avoids reliance on predefined label sets, reduces ambiguous outputs, and aligns more naturally with clinical workflows. However, existing text guided frameworks are often computationally expensive, exhibit weak text volume feature alignment, and fail to capture fine anatomical details. We propose ESICA, a lightweight and scalable framework that addresses these challenges through three innovations: (1) a similarity matrix based mask prediction formulation that enhances semantic alignment, (2) an efficient decomposed decoder with adapter modules for accurate volumetric decoding, and (3) a two pass refinement strategy that sharpens boundaries and resolves uncertain regions. To improve training stability and generalization, ESICA adopts a two stage scheme consisting of positive only pretraining followed by balanced fine tuning. On the CVPR BiomedSegFM benchmark spanning five imaging modalities (CT, MRI, PET, ultrasound, and microscopy), ESICA achieves state of the art segmentation accuracy, while the compact ESICA4 Lite variant attains similar segmentation performance with substantially fewer parameters, yielding a superior efficiency accuracy trade off. Our framework advances text guided segmentation toward efficient, scalable, and clinically deployable systems. Code will be made publicly available at https://github.com/mirthAI/ESICA.

Yu Xin, Gorkem Can Ates, Jun Ma +5

University of Florida · University of Toronto · NVIDIA Corporation

Image Segmentation Text-Guided Image Segmentation 3D Medical Image Segmentation

Apr 27, 2026

Diffusion Model as a Generalist Segmentation Learner

Diffusion models are primarily trained for image synthesis, yet their denoising trajectories encode rich, spatially aligned visual priors. In this paper, we demonstrate that these priors can be utilized for text-conditioned semantic and open-vocabulary segmentation, and this approach can be generalized to various downstream tasks to make a general-purpose diffusion segmentation framework. Concretely, we introduce DiGSeg (Diffusion Models as a Generalist Segmentation Learner), which repurposes a pretrained diffusion model into a unified segmentation framework. Our approach encodes the input image and ground-truth mask into the latent space and concatenates them as conditioning signals for the diffusion U-Net. A parallel CLIP-aligned text pathway injects language features across multiple scales, enabling the model to align textual queries with evolving visual representations. This design transforms an off-the-shelf diffusion backbone into a universal interface that produces structured segmentation masks conditioned on both appearance and arbitrary text prompts. Extensive experiments demonstrate state-of-the-art performance on standard semantic segmentation benchmarks, as well as strong open-vocabulary generalization and cross-domain transfer to medical, remote sensing, and agricultural scenarios-without domain-specific architectural customization. These results indicate that modern diffusion backbones can serve as generalist segmentation learners rather than pure generators, narrowing the gap between visual generation and visual understanding.

Haoxiao Wang, Antao Xiang, Haiyang Sun +8

Zhejiang University · South China University of Technology · Nanjing University +1

Image Segmentation Text-Guided Image Segmentation Open-Vocabulary Semantic Segmentation Semantic Segmentation Diffusion Models

Apr 27, 2026

Open-Vocabulary Semantic Segmentation Network Integrating Object-Level Label and Scene-Level Semantic Features for Multimodal Remote Sensing Images

Semantic segmentation of multi-modal remote sensing imagery plays a pivotal role in land use/land cover (LULC) mapping, environmental monitoring, and precision earth observation. Current multi-modal approaches mainly focus on integrating complementary visual modalities, yet neglect the incorporating of non-visual textual data - a rich source of knowledge that can bridge semantic gaps between visual patterns and real-world concepts. To address this limitation, we propose TSMNet, a text supervised multi-modal open vocabulary semantic segmentation network that synergistically integrates textual supervision with visual representation for open-vocabulary semantic segmentation. Unlike conventional multi-modal segmentation frameworks, TSMNet introduces a dual-branch text encoder to extract both scene-level semantic and object-level label information from various textual data, enabling dynamic cross-modal fusion. These text-derived features dynamically interact with visual embeddings through the proposed text-guided visual semantic fusion module, enabling domain-aware feature refinement and human-interpretable decision-making. To verify our method, we innovatively construct two new multi-modal datasets, and carry out extensive experiments to make a comprehensive comparison between the proposed method and other state-of-the-art (SOTA) semantic segmentation models. Results demonstrate that TSMNet achieves superior segmentation accuracy while exhibiting robust generalization capabilities across diverse geographical and sensor-specific scenarios. This work establishes a new paradigm for explainable remote sensing analysis, demonstrating that textual knowledge integration significantly enhances model generalizability. The source code will be available at https://github.com/yeyuanxin110/TSMNet

Jinkun Dai, Yuanxin Ye, Peng Tang +4

Faculty of Geosciences and Engineering, Southwest Jiaotong University, Chengdu 611756, China · State-Province Joint Engineering Laboratory of Spatial Information Technology for High-Speed Railway Safety, Southwest Jiaotong University, Chengdu 611756, China · School of Artificial Intelligence, Wuhan University, Wuhan 430072, China +1

Remote Sensing Image Segmentation Text-Guided Image Segmentation Open-Vocabulary Semantic Segmentation Multimodal Fusion Semantic Segmentation Multimodal Semantic Segmentation

Apr 20, 2026

Align then Refine: Text-Guided 3D Prostate Lesion Segmentation

Automated 3D segmentation of prostate lesions from biparametric MRI (bp-MRI) is essential for reliable algorithmic analysis, but achieving high precision remains challenging. Volumetric methods must combine multiple modalities while ensuring anatomical consistency, but current models struggle to integrate cross-modal information reliably. While vision-language models (VLMs) are replacing the currently used architectural designs, they still lack the fine-grained, lesion-level semantics required for effective localized guidance. To address these limitations, we propose a new multi-encoder U-Net architecture incorporating three key innovations: (1) an alignment loss that enhances foreground text-image similarity to inject lesion semantics; (2) a heatmap loss that calibrates the similarity map and suppresses spurious background activations; and (3) a final-stage, confidence-gated multi-head cross-attention refiner that performs localized boundary edits in high-confidence regions. A phase-scheduled training regime stabilizes the optimization of these components. Our method consistently outperforms prior approaches, establishing a new state-of-the-art on the PI-CAI dataset through enhanced multi-modal fusion and localized text guidance. Our code is available at https://github.com/NUBagciLab/Prostate-Lesion-Segmentation.

Cuiling Sun, Linkai Peng, Adam Murphy +9

Department of Radiology, Northwestern University, Chicago, USA · Department of Urology, Northwestern University, Chicago, USA · Center for Cancer Research, National Cancer Institute, Bethesda, USA

Cross-Modality Medical Image Segmentation Text-Guided Image Segmentation Medical Image Segmentation 3D Medical Image Segmentation

Apr 20, 2026

AnchorSeg: Language Grounded Query Banks for Reasoning Segmentation

Reasoning segmentation requires models to ground complex, implicit textual queries into precise pixel-level masks. Existing approaches rely on a single segmentation token

\texttt{<SEG>}

, whose hidden state implicitly encodes both semantic reasoning and spatial localization, limiting the model's ability to explicitly disentangle what to segment from where to segment. We introduce AnchorSeg, which reformulates reasoning segmentation as a structured conditional generation process over image tokens, conditioned on language grounded query banks. Instead of compressing all semantic reasoning and spatial localization into a single embedding, AnchorSeg constructs an ordered sequence of query banks: latent reasoning tokens that capture intermediate semantic states, and a segmentation anchor token that provides explicit spatial grounding. We model spatial conditioning as a factorized distribution over image tokens, where the anchor query determines localization signals while contextual queries provide semantic modulation. To bridge token-level predictions and pixel-level supervision, we propose Token--Mask Cycle Consistency (TMCC), a bidirectional training objective that enforces alignment across resolutions. By explicitly decoupling spatial grounding from semantic reasoning through structured language grounded query banks, AnchorSeg achieves state-of-the-art results on ReasonSeg test set (67.7% gIoU and 68.1% cIoU). All code and models are publicly available at https://github.com/rui-qian/AnchorSeg.

Rui Qian, Chuanhang Deng, Qiang Huang +6

College of Computer Science and Artificial Intelligence, Fudan University · 2BEDI Cloud

Image Segmentation Text-Guided Image Segmentation Vision-Language Grounding Visually Grounded Reasoning Reasoning Segmentation

Apr 13, 2026

RADA: Region-Aware Dual-encoder Auxiliary learning for Barely-supervised Medical Image Segmentation

Deep learning has greatly advanced medical image segmentation, but its success relies heavily on fully supervised learning, which requires dense annotations that are costly and time-consuming for 3D volumetric scans. Barely-supervised learning reduces annotation burden by using only a few labeled slices per volume. Existing methods typically propagate sparse annotations to unlabeled slices through geometric continuity to generate pseudo-labels, but this strategy lacks semantic understanding, often resulting in low-quality pseudo-labels. Furthermore, medical image segmentation is inherently a pixel-level visual understanding task, where accuracy fundamentally depends on the quality of local, fine-grained visual features. Inspired by this, we propose RADA, a novel Region-Aware Dual-encoder Auxiliary learning pipeline which introduces a dual-encoder framework pre-trained on Alpha-CLIP to extract fine-grained, region-specific visual features from the original images and limited annotations. The framework combines image-level fine-grained visual features with text-level semantic guidance, providing region-aware semantic supervision that bridges image-level semantics and pixel-level segmentation. Integrated into a triple-view training framework, RADA achieves SOTA performance under extremely sparse annotation settings on LA2018, KiTS19 and LiTS, demonstrating robust generalization across diverse datasets.

Shuang Zeng, Boxu Xie, Lei Zhu +6

Medical Image Segmentation 3D Medical Image Segmentation Text-Guided Image Segmentation

Apr 13, 2026

TAMISeg: Text-Aligned Multi-scale Medical Image Segmentation with Semantic Encoder Distillation

Medical image segmentation remains challenging due to limited fine-grained annotations, complex anatomical structures, and image degradation from noise, low contrast, or illumination variation. We propose TAMISeg, a text-guided segmentation framework that incorporates clinical language prompts and semantic distillation as auxiliary semantic cues to enhance visual understanding and reduce reliance on pixel-level fine-grained annotations. TAMISeg integrates three core components: a consistency-aware encoder pretrained with strong perturbations for robust feature extraction, a semantic encoder distillation module with supervision from a frozen DINOv3 teacher to enhance semantic discriminability, and a scale-adaptive decoder that segments anatomical structures across different spatial scales. Experiments on the Kvasir-SEG, MosMedData+, and QaTa-COV19 datasets demonstrate that TAMISeg consistently outperforms existing uni-modal and multi-modal methods in both qualitative and quantitative evaluations. Code will be made publicly available at https://github.com/qczggaoqiang/TAMISeg.

Qiang Gao, Yi Wang, Yong Zhang +4

Department of Data Science and AI, Monash University, Melbourne, Australia · College of Computer Science, Chongqing University, Chongqing, China · Chongqing University Central Hospital, School of Medicine, Chongqing, China

Image Segmentation Medical Image Segmentation Text-Guided Image Segmentation

Apr 11, 2026

MedVeriSeg: Teaching LISA-Like Medical Segmentation Models to Verify Query Validity Without Extra Training

Despite recent progress in text-prompt-based medical image segmentation, existing LISA-like MLLM-based methods typically generate masks regardless of whether the target specified in the query is present, leading to hallucinated segmentation. In this work, we propose MedVeriSeg, a training-free query verification framework that enables LISA-like medical segmentation models to reject false segmentation queries. MedVeriSeg first quantifies the response quality between the [SEG] token and image features through a Similarity Response Quality Scoring Module. To further improve robustness, it employs a Lightweight Routed Multi-Agent Verification Module, which fuses quantitative score evidence with qualitative agent evidence to comprehensively verify the validity of the query. To support systematic evaluation, we construct MedVeriSeg-Bench, a benchmark designed for query verification in medical image segmentation. Experimental results demonstrate that MedVeriSeg effectively identifies false segmentation queries and reduces hallucinated segmentation, while maintaining a high acceptance rate for valid queries, thereby largely preserving the segmentation utility of LISA-like medical segmentation models.

Qinyue Tong, Xiaozhen Wang, Ziqian Lu +3

School of Aeronautics and Astronautics, Zhejiang University, Hangzhou 310027, China · Southern Medical University, Guangzhou 510515, Guangdong, China · School of Computer Science and Technology (School of Artificial Intelligence), Zhejiang Sci-Tech University, Hangzhou 310018, Zhejiang, China +1

Medical Image Segmentation Hallucination Detection in VLMs Medical VLMs Text-Guided Image Segmentation

Apr 11, 2026

SwinTextUNet: Integrating CLIP-Based Text Guidance into Swin Transformer U-Nets for Medical Image Segmentation

Precise medical image segmentation is fundamental for enabling computer aided diagnosis and effective treatment planning. Traditional models that rely solely on visual features often struggle when confronted with ambiguous or low contrast patterns. To overcome these limitations, we introduce SwinTextUNet, a multimodal segmentation framework that incorporates Contrastive Language Image Pretraining (CLIP), derived textual embeddings into a Swin Transformer UNet backbone. By integrating cross attention and convolutional fusion, the model effectively aligns semantic text guidance with hierarchical visual representations, enhancing robustness and accuracy. We evaluate our approach on the QaTaCOV19 dataset, where the proposed four stage variant achieves an optimal balance between performance and complexity, yielding Dice and IoU scores of 86.47% and 78.2%, respectively. Ablation studies further validate the importance of text guidance and multimodal fusion. These findings underscore the promise of vision language integration in advancing medical image segmentation and supporting clinically meaningful diagnostic tools.

Ashfak Yeafi, Parthaw Goswami, Md Khairul Islam +1

Department of Electrical and Electronic Engineering Khulna University of Engineering & Technology Khulna-9203, Bangladesh · Department of Electronics and Communication Engineering Khulna University of Engineering & Technology Khulna-9203, Bangladesh · Department of Mathematics and Computer Science Hobart and William Smith Colleges Geneva, NY, USA

Medical Image Segmentation Text-Guided Image Segmentation

Apr 9, 2026

Tarot-SAM3: Training-free SAM3 for Any Referring Expression Segmentation

Referring Expression Segmentation (RES) aims to segment image regions described by natural-language expressions, serving as a bridge between vision and language understanding. Existing RES methods, however, rely heavily on large annotated datasets and are limited to either explicit or implicit expressions, hindering their ability to generalize to any referring expression. Recently, the Segment Anything Model 3 (SAM3) has shown impressive robustness in Promptable Concept Segmentation. Nonetheless, applying it to RES remains challenging: (1) SAM3 struggles with longer or implicit expressions; (2) naive coupling of SAM3 with a multimodal large language model (MLLM) makes the final results overly dependent on the MLLM's reasoning capability, without enabling refinement of SAM3's segmentation outputs. To this end, we present Tarot-SAM3, a novel training-free framework that can accurately segment from any referring expression. Specifically, Tarot-SAM3 consists of two key phases. First, the Expression Reasoning Interpreter (ERI) phase introduces reasoning-assisted prompt options to support structured expression parsing and evaluation-aware rephrasing. This transforms arbitrary queries into robust heterogeneous prompts for generating reliable masks with SAM3. Second, the Mask Self-Refining (MSR) phase selects the best mask across prompt types and performs self-refinement by leveraging rich feature relationships from DINOv3 to compare discriminative regions among ERI outputs. It then infers region affiliation to the target, thereby correcting over- and under-segmentation. Extensive experiments demonstrate that Tarot-SAM3 achieves strong performance on both explicit and implicit RES benchmarks, as well as open-world scenarios. Ablation studies further validate the effectiveness of each phase.

Weiming Zhang, Dingwen Xiao, Songyue Guo +5

The Hong Kong University of Science and Technology (Guangzhou) · Nanyang Technological University

Referring Expression Segmentation Text-Guided Image Segmentation Referring Expression Comprehension Promptable Image Segmentation

Apr 7, 2026

Selective Aggregation of Attention Maps Improves Diffusion-Based Visual Interpretation

Numerous studies on text-to-image (T2I) generative models have utilized cross-attention maps to boost application performance and interpret model behavior. However, the distinct characteristics of attention maps from different attention heads remain relatively underexplored. In this study, we show that selectively aggregating cross-attention maps from heads most relevant to a target concept can improve visual interpretability. Compared to the diffusion-based segmentation method DAAM, our approach achieves higher mean IoU scores. We also find that the most relevant heads capture concept-specific features more accurately than the least relevant ones, and that selective aggregation helps diagnose prompt misinterpretations. These findings suggest that attention head selection offers a promising direction for improving the interpretability and controllability of T2I generation.

Jungwon Park, Jungmin Ko, Dongnam Byun +1

Department of Intelligence and Information, Seoul National University, Seoul, Republic of Korea · Interdisciplinary Program in Artificial Intelligence, Seoul National University, Seoul, Republic of Korea

T2I Diffusion Models Cross-Attention Transformer Interpretability Text-Guided Image Segmentation

Apr 7, 2026

Semantic-Topological Graph Reasoning for Language-Guided Pulmonary Screening

Medical image segmentation driven by free-text clinical instructions is a critical frontier in computer-aided diagnosis. However, existing multimodal and foundation models struggle with the semantic ambiguity of clinical reports and fail to disambiguate complex anatomical overlaps in low-contrast scans. Furthermore, fully fine-tuning these massive architectures on limited medical datasets invariably leads to severe overfitting. To address these challenges, we propose a novel Semantic-Topological Graph Reasoning (STGR) framework for language-guided pulmonary screening. Our approach elegantly synergizes the reasoning capabilities of large language models (LLaMA-3-V) with the zero-shot delineation of vision foundation models (MedSAM). Specifically, we introduce a Text-to-Vision Intent Distillation (TVID) module to extract precise diagnostic guidance. To resolve anatomical ambiguity, we formulate mask selection as a dynamic graph reasoning problem, where candidate lesions are modeled as nodes and edges capture spatial and semantic affinities. To ensure deployment feasibility, we introduce a Selective Asymmetric Fine-Tuning (SAFT) strategy that updates less than 1% of the parameters. Rigorous 5-fold cross-validation on the LIDC-IDRI and LNDb datasets demonstrates that our framework establishes a new state-of-the-art. Notably, it achieves an 81.5% Dice Similarity Coefficient (DSC) on LIDC-IDRI, outperforming leading LLM-based tools like LISA by over 5%. Crucially, our SAFT strategy acts as a powerful regularizer, yielding exceptional cross-fold stability (0.6% DSC variance) and paving the way for robust, context-aware clinical deployment.

Chenyu Xue, Yiran Liu, Mian Zhou +2

Xi’an Jiaotong-Liverpool University, Jiangsu, China · University College London, London, United Kingdom · University of Liverpool, Liverpool, United Kingdom

Text-Guided Image Segmentation Medical Image Segmentation Graph Reasoning Parameter-Efficient Fine-Tuning

Apr 2, 2026

An Explainable Vision-Language Model Framework with Adaptive PID-Tversky Loss for Lumbar Spinal Stenosis Diagnosis

Lumbar Spinal Stenosis (LSS) diagnosis remains a critical clinical challenge, with diagnosis heavily dependent on labor-intensive manual interpretation of multi-view Magnetic Resonance Imaging (MRI), leading to substantial inter-observer variability and diagnostic delays. Existing vision-language models simultaneously fail to address the extreme class imbalance prevalent in clinical segmentation datasets while preserving spatial accuracy, primarily due to global pooling mechanisms that discard crucial anatomical hierarchies. We present an end-to-end Explainable Vision-Language Model framework designed to overcome these limitations, achieved through two principal objectives. We propose a Spatial Patch Cross-Attention module that enables precise, text-directed localization of spinal anomalies with spatial precision. A novel Adaptive PID-Tversky Loss function by integrating control theory principles dynamically further modifies training penalties to specifically address difficult, under-segmented minority instances. By incorporating foundational VLMs alongside an Automated Radiology Report Generation module, our framework demonstrates considerable performance: a diagnostic classification accuracy of 90.69%, a macro-averaged Dice score of 0.9512 for segmentation, and a CIDEr score of 92.80%. Furthermore, the framework shows explainability by converting complex segmentation predictions into radiologist-style clinical reports, thereby establishing a new benchmark for transparent, interpretable AI in clinical medical imaging that keeps essential human supervision while enhancing diagnostic capabilities.

Md. Sajeebul Islam Sk., Md. Mehedi Hasan Shawon, Md. Golam Rabiul Alam

Department of Computer Science and Engineering, , Dhaka, 1212, , Bangladesh. · Department of Electrical and Computer Engineering, , College Park, 20742, Maryland, USA.

Radiology VLMs Medical Diagnosis Medical Image Segmentation Explainable Medical Image Analysis Text-Guided Image Segmentation Radiology Report Generation

Apr 2, 2026

Efficient Reasoning via Thought Compression for Language Segmentation

Chain-of-thought (CoT) reasoning has significantly improved the performance of large multimodal models in language-guided segmentation, yet its prohibitive computational cost, stemming from generating verbose rationales, limits real-world applicability. We introduce WISE (Wisdom from Internal Self-Exploration), a novel paradigm for efficient reasoning guided by the principle of thinking twice -- once for learning, once for speed. WISE trains a model to generate a structured sequence: a concise rationale, the final answer, and then a detailed explanation. By placing the concise rationale first, our method leverages autoregressive conditioning to enforce that the concise rationale acts as a sufficient summary for generating the detailed explanation. This structure is reinforced by a self-distillation objective that jointly rewards semantic fidelity and conciseness, compelling the model to internalize its detailed reasoning into a compact form. At inference, the detailed explanation is omitted. To address the resulting conditional distribution shift, our inference strategy, WISE-S, employs a simple prompting technique that injects a brevity-focused instruction into the user's query. This final adjustment facilitates the robust activation of the learned concise policy, unlocking the full benefits of our framework. Extensive experiments show that WISE-S achieves state-of-the-art zero-shot performance on the ReasonSeg benchmark with 58.3 cIoU, while reducing the average reasoning length by nearly \textbf{5

\times

} -- from 112 to just 23 tokens. Code is available at WISE.

Qing Zhou, Shiyu Zhang, Yuyu Jia +4

Northwestern Polytechnical University, China · Northwest Institute of Nuclear Technology, China.

Reasoning Segmentation CoT Compression Efficient VLM Inference Multimodal CoT Reasoning Text-Guided Image Segmentation

Mar 26, 2026

Adapting Segment Anything Model 3 for Concept-Driven Lesion Segmentation in Medical Images: An Experimental Study

Accurate lesion segmentation is essential in medical image analysis, yet most existing methods are designed for specific anatomical sites or imaging modalities, limiting their generalizability. Recent vision-language foundation models enable concept-driven segmentation in natural images, offering a promising direction for more flexible medical image analysis. However, concept-prompt-based lesion segmentation, particularly with the latest Segment Anything Model 3 (SAM3), remains underexplored. In this work, we present a systematic evaluation of SAM3 for lesion segmentation. We assess its performance using geometric bounding boxes and concept-based text and image prompts across multiple modalities, including multiparametric MRI, CT, ultrasound, dermoscopy, and endoscopy. To improve robustness, we incorporate additional prior knowledge, such as adjacent-slice predictions, multiparametric information, and prior annotations. We further compare different fine-tuning strategies, including partial module tuning, adapter-based methods, and full-model optimization. Experiments on 13 datasets covering 11 lesion types demonstrate that SAM3 achieves strong cross-modality generalization, reliable concept-driven segmentation, and accurate lesion delineation. These results highlight the potential of concept-based foundation models for scalable and practical medical image segmentation. Code and trained models will be released at: https://github.com/apple1986/lesion-sam3

Guoping Xu, Jayaram K. Udupa, Yubing Tong +5

The Medical Artificial Intelligence and Automation (MAIA) Laboratory, Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA · Medical Image Processing Group, Department of Radiology, University of Pennsylvania, Philadelphia, PA 19104, USA · Division of Digestive and Liver Diseases, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA

Medical Image Segmentation Promptable Image Segmentation Cross-Modality Medical Image Segmentation Text-Guided Image Segmentation Medical Imaging Foundation Models

Mar 23, 2026

PEARL: Geometry Aligns Semantics for Training-Free Open-Vocabulary Semantic Segmentation

Training-free open-vocabulary semantic segmentation (OVSS) promises rapid adaptation to new label sets without retraining. Yet, many methods rely on heavy post-processing or handle text and vision in isolation, leaving cross-modal geometry underutilized. Others introduce auxiliary vision backbones or multi-model pipelines, which increase complexity and latency while compromising design simplicity. We present PEARL, Procrustes alignment with text-aware Laplacian propagation, a compact two-step inference that follows an align-then-propagate principle. The Procrustes alignment step performs an orthogonal projection inside the last self-attention block, rotating keys toward the query subspace via a stable polar iteration. The text-aware Laplacian propagation then refines per-pixel logits on a small grid through a confidence-weighted, text-guided graph solve: text provides both a data-trust signal and neighbor gating, while image gradients preserve boundaries. In this work, our method is fully training-free, plug-and-play, and uses only fixed constants, adding minimal latency with a small per-head projection and a few conjugate-gradient steps. Our approach, PEARL, sets a new state-of-the-art in training-free OVSS without extra data or auxiliary backbones across standard benchmarks, achieving superior performance under both with-background and without-background protocols.

Gensheng Pei, Xiruo Jiang, Xinhao Cai +3

Department of Electrical and Computer Engineering, Sungkyunkwan University · School of Computing and Artificial Intelligence, Southwest Jiaotong University · School of Computer Science and Engineering, Nanjing University of Science and Technology

Graph-Based Label Propagation Open-Vocabulary Semantic Segmentation Text-Guided Image Segmentation Vision-Language Alignment

Mar 22, 2026

DGRNet: Disagreement-Guided Refinement for Uncertainty-Aware Brain Tumor Segmentation

Accurate brain tumor segmentation from MRI scans is critical for diagnosis and treatment planning. Despite the strong performance of recent deep learning approaches, two fundamental limitations remain: (1) the lack of reliable uncertainty quantification in single-model predictions, which is essential for clinical deployment because the level of uncertainty may impact treatment decision-making, and (2) the under-utilization of rich information in radiology reports that can guide segmentation in ambiguous regions. In this paper, we propose the Disagreement-Guided Refinement Network (DGRNet), a novel framework that addresses both limitations through multi-view disagreement-based uncertainty estimation and text-conditioned refinement. DGRNet generates diverse predictions via four lightweight view-specific adapters attached to a shared encoder-decoder, enabling efficient uncertainty quantification within a single forward pass. Afterward, we build disagreement maps to identify regions of high segmentation uncertainty, which are then selectively refined according to clinical reports. Moreover, we introduce a diversity-preserving training strategy that combines pairwise similarity penalties and gradient isolation to prevent view collapse. The experimental results on the TextBraTS dataset show that DGRNet favorably improves state-of-the-art segmentation accuracy by 2.4% and 11% in main metrics Dice and HD95, respectively, while providing meaningful uncertainty estimates.

Bahram Mohammadi, Yanqiu Wu, Vu Minh Hieu Phan +6

Macquarie University, Sydney, NSW, Australia · Adelaide University, Adelaide, SA, Australia · Flinders University, Adelaide, SA, Australia +1

Medical Image Segmentation Brain Tumor Segmentation Segmentation Uncertainty Estimation Text-Guided Image Segmentation

Mar 22, 2026

Hierarchical Text-Guided Brain Tumor Segmentation via Sub-Region-Aware Prompts

Brain tumor segmentation remains challenging because the three standard sub-regions, i.e., whole tumor (WT), tumor core (TC), and enhancing tumor (ET), often exhibit ambiguous visual boundaries. Integrating radiological description texts with imaging has shown promise. However, most multimodal approaches typically compress a report into a single global text embedding shared across all sub-regions, overlooking their distinct clinical characteristics. We propose TextCSP (text-modulated soft cascade architecture), a hierarchical text-guided framework that builds on the TextBraTS baseline with three novel components: (1) a text-modulated soft cascade decoder that predicts WT->TC->ET in a coarse-to-fine manner consistent with their anatomical containment hierarchy. (2) sub-region-aware prompt tuning, which uses learnable soft prompts with a LoRA-adapted BioBERT encoder to generate specialized text representations tailored for each sub-region; (3) text-semantic channel modulators that convert the aforementioned representations into channel-wise refinement signals, enabling the decoder to emphasize features aligned with clinically described patterns. Experiments on the TextBraTS dataset demonstrate consistent improvements across all sub-regions against state-of-the-art methods by 1.7% and 6% on the main metrics Dice and HD95.

Bahram Mohammadi, Ta Duc Huy, Afrouz Sheikholeslami +8

Macquarie University, Sydney, NSW, Australia · Adelaide University, Adelaide, SA, Australia · Flinders University, Adelaide, SA, Australia +1

Medical Image Segmentation Brain Tumor Segmentation Text-Guided Image Segmentation BraTS Prompt Tuning

Mar 18, 2026

Eye image segmentation using visual and concept prompts with Segment Anything Model 3 (SAM3)

Previous work has reported that vision foundation models show promising zero-shot performance in eye image segmentation. Here we examine whether the latest iteration of the Segment Anything Model, SAM3, offers better eye image segmentation performance than SAM2, and explore the performance of its new concept (text) prompting mode. Eye image segmentation performance was evaluated using diverse datasets encompassing both high-resolution high-quality videos from a lab environment and the TEyeD dataset consisting of challenging eye videos acquired in the wild. Results show that in most cases SAM3 with either visual or concept prompts did not perform better than SAM2, for both lab and in-the-wild datasets. Since SAM2 not only performed better but was also faster, we conclude that SAM2 remains the best option for eye image segmentation. We provide our adaptation of SAM3's codebase that allows processing videos of arbitrary duration.

Diederick C. Niehorster, Marcus Nyström

Lund University Humanities Lab & Dept. of Psychology, Lund University, Lund, Sweden · Lund University Humanities Lab, Lund, Sweden

Medical Image Segmentation Promptable Image Segmentation Vision Foundation Models Text-Guided Image Segmentation Video Object Segmentation

Mar 18, 2026

LoGSAM: Parameter-Efficient Cross-Modal Grounding for MRI Segmentation

Precise localization and delineation of brain tumors using magnetic resonance imaging (MRI) are essential for planning therapy and guiding surgical decisions. To address this, we propose LoGSAM, a parameter-efficient, detection-driven framework that transforms radiologist dictation into text prompts for foundation-model-based localization and segmentation. Radiologist speech is first transcribed and translated using a pretrained Whisper ASR model, followed by negation-aware clinical NLP to extract tumor-specific textual prompts. These prompts guide text-conditioned tumor localization via a LoRA-adapted vision-language detection model, Grounding DINO (GDINO). The predicted bounding boxes are used as prompts for MedSAM to generate pixel-level tumor masks without any additional fine-tuning. On BRISC 2025, LoGSAM attains a Dice score of 80.32%, reaching 98.6% of a fully fine-tuned GDINO + MedSAM baseline while training fewer than 5% of its parameters, indicating a favorable accuracy/parameter trade-off. In addition, we evaluate the full pipeline using German dictations from a board-certified radiologist on unseen MRI scans, achieving 91.7% case-level class-extraction accuracy. These results highlight the feasibility of constructing a modular speech-to-segmentation pipeline from pretrained foundation models with minimal parameter updates.

Mohammad Robaitul Islam Bhuiyan, Sheethal Bhat, Melika Qahqaie +4

Pattern Recognition Lab, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany · Siemens Healthineers, Erlangen, Germany

Image Segmentation Medical Imaging Foundation Models Text-Guided Image Segmentation Medical Image Segmentation Medical Image Grounding Brain Tumor Segmentation

Mar 18, 2026

SSP-SAM: SAM with Semantic-Spatial Prompt for Referring Expression Segmentation

The Segment Anything Model (SAM) excels at general image segmentation but has limited ability to understand natural language, which restricts its direct application in Referring Expression Segmentation (RES). Toward this end, we propose SSP-SAM, a framework that fully utilizes SAM's segmentation capabilities by integrating a Semantic-Spatial Prompt (SSP) encoder. Specifically, we incorporate both visual and linguistic attention adapters into the SSP encoder, which highlight salient objects within the visual features and discriminative phrases within the linguistic features. This design enhances the referent representation for the prompt generator, resulting in high-quality SSPs that enable SAM to generate precise masks guided by language. Although not specifically designed for Generalized RES (GRES), where the referent may correspond to zero, one, or multiple objects, SSP-SAM naturally supports this more flexible setting without additional modifications. Extensive experiments on widely used RES and GRES benchmarks confirm the superiority of our method. Notably, our approach generates segmentation masks of high quality, achieving strong precision even at strict thresholds such as [email protected]. Further evaluation on the PhraseCut dataset demonstrates improved performance in open-vocabulary scenarios compared to existing state-of-the-art RES methods. The code and checkpoints are available at: https://github.com/WayneTomas/SSP-SAM.

Wei Tang, Xuejing Liu, Yanpeng Sun +1

School of Computer Science and Engineering, Nanjing University of Science and Technology, No. 200 Xiaolingwei Road, Nanjing 210094, China. · Institute of Computing Technology, Chinese Academy of Sciences, Beijing 100190, China. · NExT++ Lab, School of Computing, National University of Singapore, Singapore 119077, Singapore.

Referring Expression Segmentation Text-Guided Image Segmentation Promptable Image Segmentation

Mar 14, 2026

DCP-CLIP:A Coarse-to-Fine Framework for Open-Vocabulary Semantic Segmentation with Dual Interaction

The recent years have witnessed the remarkable development for open-vocabulary semantic segmentation (OVSS) using visual-language foundation models, yet still suffer from following fundamental challenges: (1) insufficient cross-modal communications between textual and visual spaces, and (2) significant computational costs from the interactions with massive number of categories. To address these issues, this paper describes a novel coarse-to-fine framework, called DCP-CLIP, for OVSS. Unlike prior efforts that mainly relied on pre-established category content and the inherent spatial-class interaction capability of CLIP, we dynamic constructing category-relevant textual features and explicitly models dual interactions between spatial image features and textual class semantics. Specifically, we first leverage CLIP's open-vocabulary recognition capability to identify semantic categories relevant to the image context, upon which we dynamically generate corresponding textual features to serve as initial textual guidance. Subsequently, we conduct a coarse segmentation by cross-modally integrating semantic information from textual guidance into the visual representations and achieve refined segmentation by integrating spatially enriched features from the encoder to recover fine-grained details and enhance spatial resolution. In final, we leverage spatial information from the segmentation side to refine category predictions for each mask, facilitating more precise semantic labeling. Experiments on multiple OVSS benchmarks demonstrate that DCP-CLIP outperforms existing methods by delivering both higher accuracy and greater efficiency.

Jing Wang, Huimin Shi, Quan Zhou +3

National Engineering Research Center of Communications and Networking, Nanjing University of Posts & Telecommunications, Nanjing 210003, P. R. China. · Institute for Advanced Ocean Research (Nantong), Southeast University, Nantong 226334, P. R. China. · Department of Internet of Things, Nanjing University of Posts & Telecommunications, Nanjing 210003, P. R. China +1

Open-Vocabulary Semantic Segmentation Text-Guided Image Segmentation

Mar 11, 2026

Evidential learning driven Breast Tumor Segmentation with Stage-divided Vision-Language Interaction

Breast cancer is one of the most common causes of death among women worldwide, with millions of fatalities annually. Magnetic Resonance Imaging (MRI) can provide various sequences for characterizing tumor morphology and internal patterns, and becomes an effective tool for detection and diagnosis of breast tumors. However, previous deep-learning based tumor segmentation methods have limitations in accurately locating tumor contours due to the challenge of low contrast between cancer and normal areas and blurred boundaries. Leveraging text prompt information holds promise in ameliorating tumor segmentation effect by delineating segmentation regions. Inspired by this, we propose text-guided Breast Tumor Segmentation model (TextBCS) with stage-divided vision-language interaction and evidential learning. Specifically, the proposed stage-divided vision-language interaction facilitates information mutual between visual and text features at each stage of down-sampling, further exerting the advantages of text prompts to assist in locating lesion areas in low contrast scenarios. Moreover, the evidential learning is adopted to quantify the segmentation uncertainty of the model for blurred boundary. It utilizes the variational Dirichlet to characterize the distribution of the segmentation probabilities, addressing the segmentation uncertainties of the boundaries. Extensive experiments validate the superiority of our TextBCS over other segmentation networks, showcasing the best breast tumor segmentation performance on publicly available datasets.

Jingxing Zhong, Qingtao Pan, Xuchang Zhou +2

Center for Precision Medicine, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China; Department of Laboratory Medicine, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, 361003, China · Maynooth International Engineering College, Fuzhou University, Fuzhou, 350108, China · Department of Computer and Data Science, Case Western Reserve University, Cleveland, Ohio, USA, Cleveland, 44106, Ohio, USA +2

Medical Image Segmentation Text-Guided Image Segmentation Medical VLMs

Mar 10, 2026

A Guideline-Aware AI Agent for Zero-Shot Target Volume Auto-Delineation

Delineating the clinical target volume (CTV) in radiotherapy involves complex margins constrained by tumor location and anatomical barriers. While deep learning models automate this process, their rigid reliance on expert-annotated data requires costly retraining whenever clinical guidelines update. To overcome this limitation, we introduce OncoAgent, a novel guideline-aware AI agent framework that seamlessly converts textual clinical guidelines into three-dimensional target contours in a training-free manner. Evaluated on esophageal cancer cases, the agent achieves a zero-shot Dice similarity coefficient of 0.842 for the CTV and 0.880 for the planning target volume, demonstrating performance highly comparable to a fully supervised nnU-Net baseline. Notably, in a blinded clinical evaluation, physicians strongly preferred OncoAgent over the supervised baseline, rating it higher in guideline compliance, modification effort, and clinical acceptability. Furthermore, the framework generalizes zero-shot to alternative esophageal guidelines and other anatomical sites (e.g., prostate) without any retraining. Beyond mere volumetric overlap, our agent-based paradigm offers near-instantaneous adaptability to alternative guidelines, providing a scalable and transparent pathway toward interpretability in radiotherapy treatment planning.

Yoon Jo Kim, Wonyoung Cho, Jongmin Lee +7

Oncosoft Inc., Seoul, South Korea · Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea

Text-Guided Image Segmentation Medical Image Segmentation 3D Medical Image Segmentation

Mar 6, 2026

Prompt Group-Aware Training for Robust Text-Guided Nuclei Segmentation

Foundation models such as Segment Anything Model 3 (SAM3) enable flexible text-guided medical image segmentation, yet their predictions remain highly sensitive to prompt formulation. Even semantically equivalent descriptions can yield inconsistent masks, limiting reliability in clinical and pathology workflows. We reformulate prompt sensitivity as a group-wise consistency problem. Semantically related prompts are organized into prompt groups sharing the same ground-truth mask, and a prompt group-aware training framework is introduced for robust text-guided nuclei segmentation. The approach combines (i) a quality-guided group regularization that leverages segmentation loss as an implicit ranking signal, and (ii) a logit-level consistency constraint with a stop-gradient strategy to align predictions within each group. The method requires no architectural modification and leaves inference unchanged. Extensive experiments on multi-dataset nuclei benchmarks show consistent gains under textual prompting and markedly reduced performance variance across prompt quality levels. On six zero-shot cross-dataset tasks, our method improves Dice by an average of 2.16 points. These results demonstrate improved robustness and generalization for vision-language segmentation in computational pathology.

Yonghuang Wu, Zhenyang Liang, Wenwen Zeng +2

Fudan University, Shanghai, China

Text-Guided Image Segmentation Medical Image Segmentation VLM Robustness Histopathology Image Segmentation Zero-Shot Medical Image Segmentation Consistency Regularization

Mar 6, 2026

Making Training-Free Diffusion Segmentors Scale with the Generative Power

As powerful generative models, text-to-image diffusion models have recently been explored for discriminative tasks. A line of research focuses on adapting a pre-trained diffusion model to semantic segmentation without any further training, leading to training-free diffusion segmentors. These methods typically rely on cross-attention maps from the model's attention layers, which are assumed to capture semantic relationships between image pixels and text tokens. Ideally, such approaches should benefit from more powerful diffusion models, i.e., stronger generative capability should lead to better segmentation. However, we observe that existing methods often fail to scale accordingly. To understand this issue, we identify two underlying gaps: (i) cross-attention is computed across multiple heads and layers, but there exists a discrepancy between these individual attention maps and a unified global representation. (ii) Even when a global map is available, it does not directly translate to accurate semantic correlation for segmentation, due to score imbalances among different text tokens. To bridge these gaps, we propose two techniques: auto aggregation and per-pixel rescaling, which together enable training-free segmentation to better leverage generative capability. We evaluate our approach on standard semantic segmentation benchmarks and further integrate it into a generative technique, demonstrating both improved performance broad applicability. Codes are at https://github.com/Darkbblue/goca.

Benyuan Meng, Qianqian Xu, Zitai Wang +3

Institute of Information Engineering, CAS · School of Cyber Security, University of Chinese Academy of Sciences · State Key Laboratory of AI Safety, Institute of Computing Technology, CAS +5

Text-Guided Image Segmentation Open-Vocabulary Semantic Segmentation Diffusion Models Cross-Attention T2I Diffusion Models

Feb 27, 2026

Vision-Language Semantic Grounding for Multi-Domain Crop-Weed Segmentation

Fine-grained crop-weed segmentation is essential for enabling targeted herbicide application in precision agriculture. However, existing deep learning models struggle to generalize across heterogeneous agricultural environments due to reliance on dataset-specific visual features. We propose Vision-Language Weed Segmentation (VL-WS), a novel framework that addresses this limitation by grounding pixel-level segmentation in semantically aligned, domain-invariant representations. Our architecture employs a dual-encoder design, where frozen Contrastive Language-Image Pretraining (CLIP) embeddings and task-specific spatial features are fused and modulated via Feature-wise Linear Modulation (FiLM) layers conditioned on natural language captions. This design enables image level textual descriptions to guide channel-wise feature refinement while preserving fine-grained spatial localization. Unlike prior works restricted to training and evaluation on single-source datasets, VL-WS is trained on a unified corpus that includes close-range ground imagery (robotic platforms) and high-altitude UAV imagery, covering diverse crop types, weed species, growth stages, and sensing conditions. Experimental results across four benchmark datasets demonstrate the effectiveness of our framework, with VL-WS achieving a mean Dice score of 91.64% and outperforming the CNN baseline by 4.98%. The largest gains occur on the most challenging weed class, where VL-WS attains 80.45% Dice score compared to 65.03% for the best baseline, representing a 15.42% improvement. VL-WS further maintains stable weed segmentation performance under limited target-domain supervision, indicating improved generalization and data efficiency. These findings highlight the potential of vision-language alignment to enable scalable, label-efficient segmentation models deployable across diverse real-world agricultural domains.

Nazia Hossain, Xintong Jiang, Yu Tian +3

Department of Bioresource Engineering, McGill University, Sainte-Anne-de-Bellevue, QC, Canada · Department of Plant Science, McGill University, Sainte-Anne-de-Bellevue, QC, Canada

Domain Generalization for Semantic Segmentation Semantic Segmentation Text-Guided Image Segmentation Vision-Language Grounding Remote Sensing Image Segmentation

Feb 23, 2026

MedCLIPSeg: Probabilistic Vision-Language Adaptation for Data-Efficient and Generalizable Medical Image Segmentation

Medical image segmentation remains challenging due to limited annotations for training, ambiguous anatomical features, and domain shifts. While vision-language models such as CLIP offer strong cross-modal representations, their potential for dense, text-guided medical image segmentation remains underexplored. We present MedCLIPSeg, a novel framework that adapts CLIP for robust, data-efficient, and uncertainty-aware medical image segmentation. Our approach leverages patch-level CLIP embeddings through probabilistic cross-modal attention, enabling bidirectional interaction between image and text tokens and explicit modeling of predictive uncertainty. Together with a soft patch-level contrastive loss that encourages more nuanced semantic learning across diverse textual prompts, MedCLIPSeg effectively improves data efficiency and domain generalizability. Extensive experiments across 16 datasets spanning five imaging modalities and six organs demonstrate that MedCLIPSeg outperforms prior methods in accuracy, efficiency, and robustness, while providing interpretable uncertainty maps that highlight local reliability of segmentation results. This work demonstrates the potential of probabilistic vision-language modeling for text-driven medical image segmentation.

Taha Koleilat, Hojat Asgariandehkordi, Omid Nejati Manzari +3

Concordia University, Montreal, Canada

Medical Image Segmentation Text-Guided Image Segmentation Medical VLMs VLM Robustness Segmentation Uncertainty Estimation