# Advancing Generalizable Tumor Segmentation with Anomaly-Aware Open-Vocabulary Attention Maps and Frozen Foundation Diffusion Models

arXiv: https://arxiv.org/abs/2505.02753 · HTML: https://mlsanity.com/paper/2505.02753/

## Key facts

- Cited by 1 papers in the map (data through 14 Oct 2026).
- Placed in Medical imaging and segmentation, one of 14 directions in Diffusion models.
- Builds on 38 of its 50 references that are in the map.
- First posted on arXiv 5 May 2025.

## Placed in

- Diffusion models / [Medical imaging and segmentation](https://mlsanity.com/diffusion/medical-imaging-and-segmentation/)

## Builds on (most cited first, 30 of 38)

- [Learning Transferable Visual Models From Natural Language Supervision](https://mlsanity.com/paper/2103.00020/) (2021)
- [Segment Anything](https://mlsanity.com/paper/2304.02643/) (2023)
- [Adding Conditional Control to Text-to-Image Diffusion Models](https://mlsanity.com/paper/2302.05543/) (2023)
- [SAM 2: Segment Anything in Images and Videos](https://mlsanity.com/paper/2408.00714/) (2024)
- [Masked-attention Mask Transformer for Universal Image Segmentation](https://mlsanity.com/paper/2112.01527/) (2021)
- [V-Net: Fully Convolutional Neural Networks for Volumetric Medical Image Segmentation](https://mlsanity.com/paper/1606.04797/) (2016)
- [RePaint: Inpainting using Denoising Diffusion Probabilistic Models](https://mlsanity.com/paper/2201.09865/) (2022)
- [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)
- [Open-Vocabulary Semantic Segmentation with Mask-adapted CLIP](https://mlsanity.com/paper/2210.04150/) (2022)
- [Scaling Open-Vocabulary Image Segmentation with Image-Level Labels](https://mlsanity.com/paper/2112.12143/) (2021)
- [Diffusion Models for Medical Anomaly Detection](https://mlsanity.com/paper/2203.04306/) (2022)
- [CLIP-Driven Universal Model for Organ Segmentation and Tumor Detection](https://mlsanity.com/paper/2301.00785/) (2023)
- [Diffusion Models for Implicit Image Segmentation Ensembles](https://mlsanity.com/paper/2112.03145/) (2021)
- [MedSegDiff: Medical Image Segmentation with Diffusion Probabilistic Model](https://mlsanity.com/paper/2211.00611/) (2022)
- [MedSegDiff-V2: Diffusion based Medical Image Segmentation with Transformer](https://mlsanity.com/paper/2301.11798/) (2023)
- [The KiTS21 Challenge: Automatic segmentation of kidneys, renal tumors, and renal cysts in corticomedullary-phase CT](https://mlsanity.com/paper/2307.01984/) (2023)
- [FreeSeg: Unified, Universal and Open-Vocabulary Image Segmentation](https://mlsanity.com/paper/2303.17225/) (2023)
- [Ambiguous Medical Image Segmentation using Diffusion Models](https://mlsanity.com/paper/2304.04745/) (2023)
- [MAISI: Medical AI for Synthetic Imaging](https://mlsanity.com/paper/2409.11169/) (2024)
- [Adapting Visual-Language Models for Generalizable Anomaly Detection in Medical Images](https://mlsanity.com/paper/2403.12570/) (2024)
- [Towards Generalizable Tumor Synthesis](https://mlsanity.com/paper/2402.19470/) (2024)
- [Label-Free Liver Tumor Segmentation](https://mlsanity.com/paper/2303.14869/) (2023)
- [Diffusion Adversarial Representation Learning for Self-supervised Vessel Segmentation](https://mlsanity.com/paper/2209.14566/) (2022)
- [The Brain Tumor Segmentation (BraTS) Challenge 2023: Glioma Segmentation in Sub-Saharan Africa Patient Population (BraTS-Africa)](https://mlsanity.com/paper/2305.19369/) (2023)
- [Unleashing the Potential of SAM for Medical Adaptation via Hierarchical Decoding](https://mlsanity.com/paper/2403.18271/) (2024)
- [UniSeg: A Prompt-driven Universal Segmentation Model as well as A Strong Representation Learner](https://mlsanity.com/paper/2304.03493/) (2023)
- [Learning Fixed Points in Generative Adversarial Networks: From Image-to-Image Translation to Disease Detection and Localization](https://mlsanity.com/paper/1908.06965/) (2019)
- [Training Like a Medical Resident: Context-Prior Learning Toward Universal Medical Image Segmentation](https://mlsanity.com/paper/2306.02416/) (2023)
- [BerDiff: Conditional Bernoulli Diffusion Model for Medical Image Segmentation](https://mlsanity.com/paper/2304.04429/) (2023)

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

- [Unlocking Diffusion Hierarchies: Adaptive Timestep Selection for Zero-Shot Segmentation](https://mlsanity.com/paper/2606.15590/) (2026)

## Abstract (arXiv)

We explore Generalizable Tumor Segmentation, aiming to train a single model for zero-shot tumor segmentation across diverse anatomical regions. Existing methods face limitations related to segmentation quality, scalability, and the range of applicable imaging modalities. In this paper, we uncover the potential of the internal representations within frozen medical foundation diffusion models as highly efficient zero-shot learners for tumor segmentation by introducing a novel framework named DiffuGTS. DiffuGTS creates anomaly-aware open-vocabulary attention maps based on text prompts to enable generalizable anomaly segmentation without being restricted by a predefined training category list. To further improve and refine anomaly segmentation masks, DiffuGTS leverages the diffusion model, transforming pathological regions into high-quality pseudo-healthy counterparts through latent space inpainting, and applies a novel pixel-level and feature-level residual learning approach, resulting in segmentation masks with significantly enhanced quality and generalization. Comprehensive experiments on four datasets and seven tumor categories demonstrate the superior performance of our method, surpassing current state-of-the-art models across multiple zero-shot settings. Codes are available at https://github.com/Yankai96/DiffuGTS.