# Language-guided Scale-aware MedSegmentor for Lesion Segmentation in Medical Imaging

arXiv: https://arxiv.org/abs/2408.17347 · HTML: https://mlsanity.com/paper/2408.17347/

## Key facts

- Cited by 1 papers in the map (data through 14 Oct 2026).
- Builds on 35 of its 48 references that are in the map.
- First posted on arXiv 30 Aug 2024.

## 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)
- [Learning Transferable Visual Models From Natural Language Supervision](https://mlsanity.com/paper/2103.00020/) (2021)
- [An Image is Worth 16x16 Words: Transformers for Image Recognition at Scale](https://mlsanity.com/paper/2010.11929/) (2020)
- [U-Net: Convolutional Networks for Biomedical Image Segmentation](https://mlsanity.com/paper/1505.04597/) (2015)
- [Swin Transformer: Hierarchical Vision Transformer using Shifted Windows](https://mlsanity.com/paper/2103.14030/) (2021)
- [Fully Convolutional Networks for Semantic Segmentation](https://mlsanity.com/paper/1411.4038/) (2014)
- [DeepLab: Semantic Image Segmentation with Deep Convolutional Nets, Atrous Convolution, and Fully Connected CRFs](https://mlsanity.com/paper/1606.00915/) (2016)
- [SegFormer: Simple and Efficient Design for Semantic Segmentation with Transformers](https://mlsanity.com/paper/2105.15203/) (2021)
- [Pyramid Scene Parsing Network](https://mlsanity.com/paper/1612.01105/) (2016)
- [V-Net: Fully Convolutional Neural Networks for Volumetric Medical Image Segmentation](https://mlsanity.com/paper/1606.04797/) (2016)
- [TransUNet: Transformers Make Strong Encoders for Medical Image Segmentation](https://mlsanity.com/paper/2102.04306/) (2021)
- [Attention U-Net: Learning Where to Look for the Pancreas](https://mlsanity.com/paper/1804.03999/) (2018)
- [ViLT: Vision-and-Language Transformer Without Convolution or Region Supervision](https://mlsanity.com/paper/2102.03334/) (2021)
- [Swin-Unet: Unet-like Pure Transformer for Medical Image Segmentation](https://mlsanity.com/paper/2105.05537/) (2021)
- [Dual Attention Network for Scene Segmentation](https://mlsanity.com/paper/1809.02983/) (2018)
- [Contrastive Learning of Medical Visual Representations from Paired Images and Text](https://mlsanity.com/paper/2010.00747/) (2020)
- [UNet++: Redesigning Skip Connections to Exploit Multiscale Features in Image Segmentation](https://mlsanity.com/paper/1912.05074/) (2019)
- [MAttNet: Modular Attention Network for Referring Expression Comprehension](https://mlsanity.com/paper/1801.08186/) (2018)
- [LAVT: Language-Aware Vision Transformer for Referring Image Segmentation](https://mlsanity.com/paper/2112.02244/) (2021)
- [Cross-Modal Self-Attention Network for Referring Image Segmentation](https://mlsanity.com/paper/1904.04745/) (2019)
- [Segmentation from Natural Language Expressions](https://mlsanity.com/paper/1603.06180/) (2016)
- [SegNeXt: Rethinking Convolutional Attention Design for Semantic Segmentation](https://mlsanity.com/paper/2209.08575/) (2022)
- [Vision-Language Transformer and Query Generation for Referring Segmentation](https://mlsanity.com/paper/2108.05565/) (2021)
- [UCTransNet: Rethinking the Skip Connections in U-Net from a Channel-wise Perspective with Transformer](https://mlsanity.com/paper/2109.04335/) (2021)
- [Referring Image Segmentation via Cross-Modal Progressive Comprehension](https://mlsanity.com/paper/2010.00514/) (2020)
- [Recurrent Multimodal Interaction for Referring Image Segmentation](https://mlsanity.com/paper/1703.07939/) (2017)
- [Encoder Fusion Network with Co-Attention Embedding for Referring Image Segmentation](https://mlsanity.com/paper/2105.01839/) (2021)
- [LViT: Language meets Vision Transformer in Medical Image Segmentation](https://mlsanity.com/paper/2206.14718/) (2022)
- [MosMedData: Chest CT Scans With COVID-19 Related Findings Dataset](https://mlsanity.com/paper/2005.06465/) (2020)

## Built on by (most cited first, 1 of 1)

- [Medical Referring Image Segmentation via Next-Token Mask Prediction](https://mlsanity.com/paper/2511.05044/) (2025)

## Abstract (arXiv)

In clinical practice, segmenting specific lesions based on the needs of physicians can significantly enhance diagnostic accuracy and treatment efficiency. However, conventional lesion segmentation models lack the flexibility to distinguish lesions according to specific requirements. Given the practical advantages of using text as guidance, we propose a novel model, Language-guided Scale-aware MedSegmentor (LSMS), which segments target lesions in medical images based on given textual expressions. We define this as a new task termed Referring Lesion Segmentation (RLS). To address the lack of suitable benchmarks for RLS, we construct a vision-language medical dataset named Reference Hepatic Lesion Segmentation (RefHL-Seg). LSMS incorporates two key designs: (i) Scale-Aware Vision-Language attention module, which performs visual feature extraction and vision-language alignment in parallel. By leveraging diverse convolutional kernels, this module acquires rich visual representations and interacts closely with linguistic features, thereby enhancing the model's capacity for precise object localization. (ii) Full-Scale Decoder, which globally models multi-modal features across multiple scales and captures complementary information between them to accurately delineate lesion boundaries. Additionally, we design a specialized loss function comprising both segmentation loss and vision-language contrastive loss to better optimize cross-modal learning. We validate the performance of LSMS on RLS as well as on conventional lesion segmentation tasks across multiple datasets. Our LSMS consistently achieves superior performance with significantly lower computational cost. Code and datasets will be released.