# TCSA-UDA: Text-Driven Cross-Semantic Alignment for Unsupervised Domain Adaptation in Medical Image Segmentation

arXiv: https://arxiv.org/abs/2511.05782 · HTML: https://mlsanity.com/paper/2511.05782/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 28 of its 48 references that are in the map.
- First posted on arXiv 8 Nov 2025.

## Builds on (most cited first, 28 of 28)

- [Learning Transferable Visual Models From Natural Language Supervision](https://mlsanity.com/paper/2103.00020/) (2021)
- [Image-to-Image Translation with Conditional Adversarial Networks](https://mlsanity.com/paper/1611.07004/) (2016)
- [DeepLab: Semantic Image Segmentation with Deep Convolutional Nets, Atrous Convolution, and Fully Connected CRFs](https://mlsanity.com/paper/1606.00915/) (2016)
- [BioBERT: a pre-trained biomedical language representation model for biomedical text mining](https://mlsanity.com/paper/1901.08746/) (2019)
- [Learning Transferable Features with Deep Adaptation Networks](https://mlsanity.com/paper/1502.02791/) (2015)
- [ADVENT: Adversarial Entropy Minimization for Domain Adaptation in Semantic Segmentation](https://mlsanity.com/paper/1811.12833/) (2018)
- [Learning to Adapt Structured Output Space for Semantic Segmentation](https://mlsanity.com/paper/1802.10349/) (2018)
- [Extract Free Dense Labels from CLIP](https://mlsanity.com/paper/2112.01071/) (2021)
- [MedCLIP: Contrastive Learning from Unpaired Medical Images and Text](https://mlsanity.com/paper/2210.10163/) (2022)
- [Image Segmentation Using Text and Image Prompts](https://mlsanity.com/paper/2112.10003/) (2021)
- [Confidence Regularized Self-Training](https://mlsanity.com/paper/1908.09822/) (2019)
- [CHAOS Challenge -- Combined (CT-MR) Healthy Abdominal Organ Segmentation](https://mlsanity.com/paper/2001.06535/) (2020)
- [Bidirectional Learning for Domain Adaptation of Semantic Segmentation](https://mlsanity.com/paper/1904.10620/) (2019)
- [DAFormer: Improving Network Architectures and Training Strategies for Domain-Adaptive Semantic Segmentation](https://mlsanity.com/paper/2111.14887/) (2021)
- [Unsupervised Bidirectional Cross-Modality Adaptation via Deeply Synergistic Image and Feature Alignment for Medical Image Segmentation](https://mlsanity.com/paper/2002.02255/) (2020)
- [Synergistic Image and Feature Adaptation: Towards Cross-Modality Domain Adaptation for Medical Image Segmentation](https://mlsanity.com/paper/1901.08211/) (2019)
- [Deep Unsupervised Domain Adaptation: A Review of Recent Advances and Perspectives](https://mlsanity.com/paper/2208.07422/) (2022)
- [UniverSeg: Universal Medical Image Segmentation](https://mlsanity.com/paper/2304.06131/) (2023)
- [AD-CLIP: Adapting Domains in Prompt Space Using CLIP](https://mlsanity.com/paper/2308.05659/) (2023)
- [Collaborative Unsupervised Domain Adaptation for Medical Image Diagnosis](https://mlsanity.com/paper/2007.07222/) (2020)
- [TGANet: Text-guided attention for improved polyp segmentation](https://mlsanity.com/paper/2205.04280/) (2022)
- [Generative Text-Guided 3D Vision-Language Pretraining for Unified Medical Image Segmentation](https://mlsanity.com/paper/2306.04811/) (2023)
- [M-FLAG: Medical Vision-Language Pre-training with Frozen Language Models and Latent Space Geometry Optimization](https://mlsanity.com/paper/2307.08347/) (2023)
- [Ariadne's Thread:Using Text Prompts to Improve Segmentation of Infected Areas from Chest X-ray images](https://mlsanity.com/paper/2307.03942/) (2023)
- [Domain-Agnostic Mutual Prompting for Unsupervised Domain Adaptation](https://mlsanity.com/paper/2403.02899/) (2024)
- [LE-UDA: Label-efficient unsupervised domain adaptation for medical image segmentation](https://mlsanity.com/paper/2212.02078/) (2022)
- [Margin Preserving Self-paced Contrastive Learning Towards Domain Adaptation for Medical Image Segmentation](https://mlsanity.com/paper/2103.08454/) (2021)
- [Energy-constrained Self-training for Unsupervised Domain Adaptation](https://mlsanity.com/paper/2101.00316/) (2021)

## Abstract (arXiv)

Unsupervised domain adaptation (UDA) for medical image segmentation remains challenging due to substantial domain shifts across imaging modalities, such as CT and MRI. Although recent vision-language representation learning methods have shown promise in medical image analysis, their role in cross-modality UDA segmentation remains underexplored. To address this problem, we propose TCSA-UDA, a Text-driven Cross-Semantic Alignment framework that uses modality-aware textual prompting to guide domain-invariant visual representation learning. Specifically, we introduce a vision-language covariance cosine loss (VLCoL) that aligns inter-class visual feature relationships with text-derived semantic relationships, encouraging the image encoder to learn semantically structured and modality-robust representations. In addition, we incorporate a prototype alignment module to reduce residual class-level discrepancies between source and target domains by aligning high-level class prototypes. Extensive experiments on cross-modality cardiac, abdominal, and brain tumor segmentation benchmarks demonstrate that TCSA-UDA consistently improves adaptation performance and outperforms state-of-the-art UDA methods. These results highlight the potential of language-driven semantic guidance for domain-adaptive medical image segmentation. The code is available at https://github.com/lalitmaurya47/TCSA_UDA