Less Could Be Better: Parameter-efficient Fine-tuning Advances Medical Vision Foundation Models
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Abstract (arXiv)
Parameter-efficient fine-tuning (PEFT) that was initially developed for exploiting pre-trained large language models has recently emerged as an effective approach to perform transfer learning on computer vision tasks. However, the effectiveness of PEFT on medical vision foundation models is still unclear and remains to be explored. As a proof of concept, we conducted a detailed empirical study on applying PEFT to chest radiography foundation models. Specifically, we delved into LoRA, a representative PEFT method, and compared it against full-parameter fine-tuning (FFT) on two self-supervised radiography foundation models across three well-established chest radiograph datasets. Our results showed that LoRA outperformed FFT in 13 out of 18 transfer learning tasks by at most 2.9% using fewer than 1% tunable parameters. Combining LoRA with foundation models, we set up new state-of-the-art on a range of data-efficient learning tasks, such as an AUROC score of 80.6% using 1% labeled data on NIH ChestX-ray14. We hope this study can evoke more attention from the community in the use of PEFT for transfer learning on medical imaging tasks. Code and models are available at https://github.com/RL4M/MED-PEFT.
Key facts. Cited by 18 papers in the map (data through 14 Oct 2026). Builds on 17 of its 23 references that are in the map. First posted on arXiv 22 Jan 2024.
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17 of 23 references.
References · 17
- 2020An Image is Worth 16x16 Words: Transformers for Image Recognition at Scalecited by 30,186
- 2021LoRA: Low-Rank Adaptation of Large Language Modelscited by 14,380
- 2023DINOv2: Learning Robust Visual Features without Supervisioncited by 7,974
- 2021Masked Autoencoders Are Scalable Vision Learnerscited by 7,403
- 2019Parameter-Efficient Transfer Learning for NLPcited by 4,236
- 2022Visual Prompt Tuningcited by 1,681
- 2019CheXpert: A Large Chest Radiograph Dataset with Uncertainty Labels and Expert Comparisoncited by 1,423
- 2017ChestX-ray8: Hospital-scale Chest X-ray Database and Benchmarks on Weakly-Supervised Classification and Localization of Common Thorax Diseasescited by 972
- 2022Few-Shot Parameter-Efficient Fine-Tuning is Better and Cheaper than In-Context Learningcited by 896
- 2021VL-Adapter: Parameter-Efficient Transfer Learning for Vision-and-Language Taskscited by 320
- 2023AIM: Adapting Image Models for Efficient Video Action Recognitioncited by 148
- 2023Advancing Radiograph Representation Learning with Masked Record Modelingcited by 75
5 more
- 2023Parameter-Efficient Fine-Tuning for Medical Image Analysis: The Missed Opportunitycited by 56
- 2023A Transformer-based representation-learning model with unified processing of multimodal input for clinical diagnosticscited by 43
- 2023MeLo: Low-rank Adaptation is Better than Fine-tuning for Medical Image Diagnosiscited by 33
- 2023Anatomical Invariance Modeling and Semantic Alignment for Self-supervised Learning in 3D Medical Image Analysiscited by 26
- 2020Difficulty-aware Glaucoma Classification with Multi-Rater Consensus Modelingcited by 17
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Citing papers per year: 2024: 3; 2025: 11; 2026: 4.
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- 2025MedVLM-R1: Incentivizing Medical Reasoning Capability of Vision-Language Models (VLMs) via Reinforcement Learningcited by 173
- 2024BAPLe: Backdoor Attacks on Medical Foundational Models using Prompt Learningcited by 16
- 2025Kvasir-VQA-x1: A Multimodal Dataset for Medical Reasoning and Robust MedVQA in Gastrointestinal Endoscopycited by 11
- 2025Foundation Models in Medical Imaging: A Review and Outlookcited by 8
- 2025Efficient Medical Vision-Language Alignment Through Adapting Masked Vision Modelscited by 5
- 2025Medical Knowledge Intervention Prompt Tuning for Medical Image Classificationcited by 5
- 2025Benchmarking Foundation Models and Parameter-Efficient Fine-Tuning for Prognosis Prediction in Medical Imagingcited by 4
- 2024Low-Rank Adaption on Transformer-based Oriented Object Detector for Satellite Onboard Processing of Remote Sensing Imagescited by 3
- 2024Multi LoRA Meets Vision: Merging multiple adapters to create a multi task modelcited by 3
- 2025RAU: Reference-based Anatomical Understanding with Vision Language Modelscited by 3
- 2025Robustness Tokens: Towards Adversarial Robustness of Transformerscited by 2
- 2025TAP: Two-Stage Adaptive Personalization of Multi-Task and Multi-Modal Foundation Models in Federated Learningcited by 2
6 more
- 2026Fine-tuning a multimodal large language model for clinician-grade autism behavioral scoring from short home videoscited by 1
- 2025Efficient Self-Supervised Adaptation for Medical Image Analysiscited by 0
- 2025Adapting Foundation Vision-Language Models to Medical Diagnosis via Query-Driven Expert Bridgingcited by 0
- 2026TAP-SLF: Parameter-Efficient Adaptation of Vision Foundation Models for Multi-Task Ultrasound Image Analysiscited by 0
- 2026CMRVision: A Foundation Model for Cardiac MR Image Analysiscited by 0
- 2026Beyond Training from Scratch: Foundation Models for Data-Efficient and Generalizable Cardiac MRI Reconstructioncited by 0
- 2026Beyond Training from Scratch: Foundation Models for Data-Efficient and Generalizable Cardiac MRI Reconstruction6 Oct 2026
- 2026CMRVision: A Foundation Model for Cardiac MR Image Analysis1 Sep 2026
- 2026Fine-tuning a multimodal large language model for clinician-grade autism behavioral scoring from short home videos25 Jun 2026
- 2026TAP-SLF: Parameter-Efficient Adaptation of Vision Foundation Models for Multi-Task Ultrasound Image Analysis28 Feb 2026
- 2025Medical Knowledge Intervention Prompt Tuning for Medical Image Classification16 Nov 2025
- 2025TAP: Two-Stage Adaptive Personalization of Multi-Task and Multi-Modal Foundation Models in Federated Learning30 Sep 2025
- 2025RAU: Reference-based Anatomical Understanding with Vision Language Models26 Sep 2025
- 2025Benchmarking Foundation Models and Parameter-Efficient Fine-Tuning for Prognosis Prediction in Medical Imaging23 Jun 2025
- 2025Kvasir-VQA-x1: A Multimodal Dataset for Medical Reasoning and Robust MedVQA in Gastrointestinal Endoscopy11 Jun 2025
- 2025Foundation Models in Medical Imaging: A Review and Outlook10 Jun 2025
- 2025Efficient Medical Vision-Language Alignment Through Adapting Masked Vision Models10 Jun 2025
- 2025Adapting Foundation Vision-Language Models to Medical Diagnosis via Query-Driven Expert Bridging27 May 2025
6 more
- 2025Efficient Self-Supervised Adaptation for Medical Image Analysis24 Mar 2025
- 2025Robustness Tokens: Towards Adversarial Robustness of Transformers13 Mar 2025
- 2025MedVLM-R1: Incentivizing Medical Reasoning Capability of Vision-Language Models (VLMs) via Reinforcement Learning26 Feb 2025
- 2024Multi LoRA Meets Vision: Merging multiple adapters to create a multi task model21 Nov 2024
- 2024BAPLe: Backdoor Attacks on Medical Foundational Models using Prompt Learning14 Aug 2024
- 2024Low-Rank Adaption on Transformer-based Oriented Object Detector for Satellite Onboard Processing of Remote Sensing Images4 Jun 2024
- 2025Foundation Models in Medical Imaging: A Review and Outlookcited by 8
- 2025Efficient Medical Vision-Language Alignment Through Adapting Masked Vision Modelscited by 5
- 2025Benchmarking Foundation Models and Parameter-Efficient Fine-Tuning for Prognosis Prediction in Medical Imagingcited by 4
- 2024Low-Rank Adaption on Transformer-based Oriented Object Detector for Satellite Onboard Processing of Remote Sensing Imagescited by 3
- 2024Multi LoRA Meets Vision: Merging multiple adapters to create a multi task modelcited by 3
- 2025Robustness Tokens: Towards Adversarial Robustness of Transformerscited by 2
- 2025TAP: Two-Stage Adaptive Personalization of Multi-Task and Multi-Modal Foundation Models in Federated Learningcited by 2
- 2026Fine-tuning a multimodal large language model for clinician-grade autism behavioral scoring from short home videoscited by 1
- 2025Efficient Self-Supervised Adaptation for Medical Image Analysiscited by 0
- 2026TAP-SLF: Parameter-Efficient Adaptation of Vision Foundation Models for Multi-Task Ultrasound Image Analysiscited by 0
- 2026CMRVision: A Foundation Model for Cardiac MR Image Analysiscited by 0
- 2026Beyond Training from Scratch: Foundation Models for Data-Efficient and Generalizable Cardiac MRI Reconstructioncited by 0
- 2026Beyond Training from Scratch: Foundation Models for Data-Efficient and Generalizable Cardiac MRI Reconstruction6 Oct 2026
- 2026CMRVision: A Foundation Model for Cardiac MR Image Analysis1 Sep 2026
- 2026Fine-tuning a multimodal large language model for clinician-grade autism behavioral scoring from short home videos25 Jun 2026
- 2026TAP-SLF: Parameter-Efficient Adaptation of Vision Foundation Models for Multi-Task Ultrasound Image Analysis28 Feb 2026
- 2025TAP: Two-Stage Adaptive Personalization of Multi-Task and Multi-Modal Foundation Models in Federated Learning30 Sep 2025
- 2025Benchmarking Foundation Models and Parameter-Efficient Fine-Tuning for Prognosis Prediction in Medical Imaging23 Jun 2025
- 2025Foundation Models in Medical Imaging: A Review and Outlook10 Jun 2025
- 2025Efficient Medical Vision-Language Alignment Through Adapting Masked Vision Models10 Jun 2025
- 2025Efficient Self-Supervised Adaptation for Medical Image Analysis24 Mar 2025
- 2025Robustness Tokens: Towards Adversarial Robustness of Transformers13 Mar 2025
- 2024Multi LoRA Meets Vision: Merging multiple adapters to create a multi task model21 Nov 2024
- 2024Low-Rank Adaption on Transformer-based Oriented Object Detector for Satellite Onboard Processing of Remote Sensing Images4 Jun 2024