Vision-Language Enhanced Foundation Model for Semi-Supervised Medical Image Segmentation

Semi-supervised learning (SSL) has emerged as an efficient paradigm for medical image segmentation, reducing the reliance on extensive expert annotations. Vision-language models (VLMs) have demonstrated strong generalization and few-shot capabilities across diverse visual domains. In this work, we integrate a VLM into a semi-supervised medical image segmentation model by adding a Vision-Language Enhanced Semi-supervised Segmentation Assistant (VESSA) that incorporates foundation-level visual-semantic understanding into SSL frameworks. Our approach consists of two stages. In Stage 1, the VLM-enhanced segmentation foundation model VESSA is trained as a reference-guided segmentation assistant using a template bank containing gold-standard exemplars, simulating learning from limited labeled data. Given an input-template pair, VESSA performs visual feature matching to extract representative semantic and spatial cues from exemplar segmentations, generating structured prompts for a Segment Anything Model (SAM)-inspired mask decoder to produce segmentation masks. In Stage 2, VESSA is integrated into an SSL framework as a plug-and-play teacher, providing template-guided pseudo-labels that complement the task-specific student model and strengthen supervision under scarce annotations. Extensive experiments across multiple segmentation datasets and domains show that VESSA-augmented SSL significantly enhances segmentation accuracy, outperforming state-of-the-art baselines under extremely limited annotation conditions.