# Large Language Model Evaluated Stand-alone Attention-Assisted Graph Neural Network with Spatial and Structural Information Interaction for Precise Endoscopic Image Segmentation

arXiv: https://arxiv.org/abs/2508.07028 · HTML: https://mlsanity.com/paper/2508.07028/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 19 of its 34 references that are in the map.
- First posted on arXiv 9 Aug 2025.

## Builds on (most cited first, 19 of 19)

- [Attention Is All You Need](https://mlsanity.com/paper/1706.03762/) (2017)
- [U-Net: Convolutional Networks for Biomedical Image Segmentation](https://mlsanity.com/paper/1505.04597/) (2015)
- [Graph Attention Networks](https://mlsanity.com/paper/1710.10903/) (2017)
- [Mamba: Linear-Time Sequence Modeling with Selective State Spaces](https://mlsanity.com/paper/2312.00752/) (2023)
- [A ConvNet for the 2020s](https://mlsanity.com/paper/2201.03545/) (2022)
- [UNet++: A Nested U-Net Architecture for Medical Image Segmentation](https://mlsanity.com/paper/1807.10165/) (2018)
- [Diffusion Models: A Comprehensive Survey of Methods and Applications](https://mlsanity.com/paper/2209.00796/) (2022)
- [Heterogeneous Graph Attention Network](https://mlsanity.com/paper/1903.07293/) (2019)
- [Kvasir-SEG: A Segmented Polyp Dataset](https://mlsanity.com/paper/1911.07069/) (2019)
- [Structure-measure: A New Way to Evaluate Foreground Maps](https://mlsanity.com/paper/1708.00786/) (2017)
- [PraNet: Parallel Reverse Attention Network for Polyp Segmentation](https://mlsanity.com/paper/2006.11392/) (2020)
- [A Benchmark for Endoluminal Scene Segmentation of Colonoscopy Images](https://mlsanity.com/paper/1612.00799/) (2016)
- [U-KAN Makes Strong Backbone for Medical Image Segmentation and Generation](https://mlsanity.com/paper/2406.02918/) (2024)
- [Polyp-PVT: Polyp Segmentation with Pyramid Vision Transformers](https://mlsanity.com/paper/2108.06932/) (2021)
- [LLM-Seg: Bridging Image Segmentation and Large Language Model Reasoning](https://mlsanity.com/paper/2404.08767/) (2024)
- [SPAGAN: Shortest Path Graph Attention Network](https://mlsanity.com/paper/2101.03464/) (2021)
- [Physics-informed Score-based Diffusion Model for Limited-angle Reconstruction of Cardiac Computed Tomography](https://mlsanity.com/paper/2405.14770/) (2024)
- [Training-Free Semantic Segmentation via LLM-Supervision](https://mlsanity.com/paper/2404.00701/) (2024)
- [Pre-Trained LLM is a Semantic-Aware and Generalizable Segmentation Booster](https://mlsanity.com/paper/2506.18034/) (2025)

## Abstract (arXiv)

Accurate endoscopic image segmentation on the polyps is critical for early colorectal cancer detection. However, this task remains challenging due to low contrast with surrounding mucosa, specular highlights, and indistinct boundaries. To address these challenges, we propose FOCUS-Med, which stands for Fusion of spatial and structural graph with attentional context-aware polyp segmentation in endoscopic medical imaging. FOCUS-Med integrates a Dual Graph Convolutional Network (Dual-GCN) module to capture contextual spatial and topological structural dependencies. This graph-based representation enables the model to better distinguish polyps from background tissues by leveraging topological cues and spatial connectivity, which are often obscured in raw image intensities. It enhances the model's ability to preserve boundaries and delineate complex shapes typical of polyps. In addition, a location-fused stand-alone self-attention is employed to strengthen global context integration. To bridge the semantic gap between encoder-decoder layers, we incorporate a trainable weighted fast normalized fusion strategy for efficient multi-scale aggregation. Notably, we are the first to introduce the use of a Large Language Model (LLM) to provide detailed qualitative evaluations of segmentation quality. Extensive experiments on public benchmarks demonstrate that FOCUS-Med achieves state-of-the-art performance across five key metrics, underscoring its effectiveness and clinical potential for AI-assisted colonoscopy.