# Building Universal Foundation Models for Medical Image Analysis with Spatially Adaptive Networks

arXiv: https://arxiv.org/abs/2312.07630 · HTML: https://mlsanity.com/paper/2312.07630/

## Key facts

- Cited by 4 papers in the map (data through 14 Oct 2026).
- Builds on 35 of its 82 references that are in the map.
- First posted on arXiv 12 Dec 2023.

## Builds on (most cited first, 30 of 35)

- [Attention Is All You Need](https://mlsanity.com/paper/1706.03762/) (2017)
- [BERT: Pre-training of Deep Bidirectional Transformers for Language Understanding](https://mlsanity.com/paper/1810.04805/) (2018)
- [An Image is Worth 16x16 Words: Transformers for Image Recognition at Scale](https://mlsanity.com/paper/2010.11929/) (2020)
- [Masked Autoencoders Are Scalable Vision Learners](https://mlsanity.com/paper/2111.06377/) (2021)
- [Neural Discrete Representation Learning](https://mlsanity.com/paper/1711.00937/) (2017)
- [RoFormer: Enhanced Transformer with Rotary Position Embedding](https://mlsanity.com/paper/2104.09864/) (2021)
- [On the Opportunities and Risks of Foundation Models](https://mlsanity.com/paper/2108.07258/) (2021)
- [Taming Transformers for High-Resolution Image Synthesis](https://mlsanity.com/paper/2012.09841/) (2020)
- [Categorical Reparameterization with Gumbel-Softmax](https://mlsanity.com/paper/1611.01144/) (2016)
- [BEiT: BERT Pre-Training of Image Transformers](https://mlsanity.com/paper/2106.08254/) (2021)
- [Estimating or Propagating Gradients Through Stochastic Neurons for Conditional Computation](https://mlsanity.com/paper/1308.3432/) (2013)
- [CheXpert: A Large Chest Radiograph Dataset with Uncertainty Labels and Expert Comparison](https://mlsanity.com/paper/1901.07031/) (2019)
- [The Concrete Distribution: A Continuous Relaxation of Discrete Random Variables](https://mlsanity.com/paper/1611.00712/) (2016)
- [ChestX-ray8: Hospital-scale Chest X-ray Database and Benchmarks on Weakly-Supervised Classification and Localization of Common Thorax Diseases](https://mlsanity.com/paper/1705.02315/) (2017)
- [EVA: Exploring the Limits of Masked Visual Representation Learning at Scale](https://mlsanity.com/paper/2211.07636/) (2022)
- [MedMNIST v2 -- A large-scale lightweight benchmark for 2D and 3D biomedical image classification](https://mlsanity.com/paper/2110.14795/) (2021)
- [Skin Lesion Analysis Toward Melanoma Detection 2018: A Challenge Hosted by the International Skin Imaging Collaboration (ISIC)](https://mlsanity.com/paper/1902.03368/) (2019)
- [The Medical Segmentation Decathlon](https://mlsanity.com/paper/2106.05735/) (2021)
- [TotalSegmentator: robust segmentation of 104 anatomical structures in CT images](https://mlsanity.com/paper/2208.05868/) (2022)
- [The Liver Tumor Segmentation Benchmark (LiTS)](https://mlsanity.com/paper/1901.04056/) (2019)
- [EVA-02: A Visual Representation for Neon Genesis](https://mlsanity.com/paper/2303.11331/) (2023)
- [A large annotated medical image dataset for the development and evaluation of segmentation algorithms](https://mlsanity.com/paper/1902.09063/) (2019)
- [CHAOS Challenge -- Combined (CT-MR) Healthy Abdominal Organ Segmentation](https://mlsanity.com/paper/2001.06535/) (2020)
- [nnFormer: Interleaved Transformer for Volumetric Segmentation](https://mlsanity.com/paper/2109.03201/) (2021)
- [VerSe: A Vertebrae Labelling and Segmentation Benchmark for Multi-detector CT Images](https://mlsanity.com/paper/2001.09193/) (2020)
- [MedPerf: Open Benchmarking Platform for Medical Artificial Intelligence using Federated Evaluation](https://mlsanity.com/paper/2110.01406/) (2021)
- [Masked Image Modeling Advances 3D Medical Image Analysis](https://mlsanity.com/paper/2204.11716/) (2022)
- [UniMiSS: Universal Medical Self-Supervised Learning via Breaking Dimensionality Barrier](https://mlsanity.com/paper/2112.09356/) (2021)
- [The ASNR-MICCAI Brain Tumor Segmentation (BraTS) Challenge 2023: Intracranial Meningioma](https://mlsanity.com/paper/2305.07642/) (2023)
- [Regularized Vector Quantization for Tokenized Image Synthesis](https://mlsanity.com/paper/2303.06424/) (2023)

## Built on by (most cited first, 4 of 4)

- [VividMed: Vision Language Model with Versatile Visual Grounding for Medicine](https://mlsanity.com/paper/2410.12694/) (2024)
- [Vision Language Models in Medicine](https://mlsanity.com/paper/2503.01863/) (2025)
- [Foundation Models in Biomedical Imaging: Turning Hype into Reality](https://mlsanity.com/paper/2512.15808/) (2025)
- [Modality-Projection Universal Model for Comprehensive Full-Body Medical Imaging Segmentation](https://mlsanity.com/paper/2412.19026/) (2024)

## Abstract (arXiv)

Recent advancements in foundation models, typically trained with self-supervised learning on large-scale and diverse datasets, have shown great potential in medical image analysis. However, due to the significant spatial heterogeneity of medical imaging data, current models must tailor specific structures for different datasets, making it challenging to leverage the abundant unlabeled data. In this work, we propose a universal foundation model for medical image analysis that processes images with heterogeneous spatial properties using a unified structure. To accomplish this, we propose spatially adaptive networks (SPAD-Nets), a family of networks that dynamically adjust the structures to adapt to the spatial properties of input images, to build such a universal foundation model. We pre-train a spatial adaptive visual tokenizer (SPAD-VT) and then a spatial adaptive Vision Transformer (SPAD-ViT) via masked image modeling (MIM) on 55 public medical image datasets. The pre-training data comprises over 9 million image slices, representing the largest, most comprehensive, and most diverse dataset to our knowledge for pre-training universal foundation models for medical image analysis. The experimental results on downstream medical image classification and segmentation tasks demonstrate the superior performance and label efficiency of our model. Our code is available at https://github.com/function2-llx/PUMIT.