# PPBoost: Progressive Prompt Boosting for Text-Driven Medical Image Segmentation

arXiv: https://arxiv.org/abs/2511.21984 · HTML: https://mlsanity.com/paper/2511.21984/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 28 of its 39 references that are in the map.
- First posted on arXiv 26 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)
- [GPT-4 Technical Report](https://mlsanity.com/paper/2303.08774/) (2023)
- [Segment Anything](https://mlsanity.com/paper/2304.02643/) (2023)
- [Simple and Scalable Predictive Uncertainty Estimation using Deep Ensembles](https://mlsanity.com/paper/1612.01474/) (2016)
- [Skin Lesion Analysis Toward Melanoma Detection 2018: A Challenge Hosted by the International Skin Imaging Collaboration (ISIC)](https://mlsanity.com/paper/1902.03368/) (2019)
- [MedCLIP: Contrastive Learning from Unpaired Medical Images and Text](https://mlsanity.com/paper/2210.10163/) (2022)
- [BiomedCLIP: a multimodal biomedical foundation model pretrained from fifteen million scientific image-text pairs](https://mlsanity.com/paper/2303.00915/) (2023)
- [The RSNA-ASNR-MICCAI BraTS 2021 Benchmark on Brain Tumor Segmentation and Radiogenomic Classification](https://mlsanity.com/paper/2107.02314/) (2021)
- [The Liver Tumor Segmentation Benchmark (LiTS)](https://mlsanity.com/paper/1901.04056/) (2019)
- [Revisiting the Calibration of Modern Neural Networks](https://mlsanity.com/paper/2106.07998/) (2021)
- [End-to-End Semi-Supervised Object Detection with Soft Teacher](https://mlsanity.com/paper/2106.09018/) (2021)
- [CHAOS Challenge -- Combined (CT-MR) Healthy Abdominal Organ Segmentation](https://mlsanity.com/paper/2001.06535/) (2020)
- [Unbiased Teacher for Semi-Supervised Object Detection](https://mlsanity.com/paper/2102.09480/) (2021)
- [A Survey on Deep Semi-supervised Learning](https://mlsanity.com/paper/2103.00550/) (2021)
- [Medical Image Segmentation Review: The success of U-Net](https://mlsanity.com/paper/2211.14830/) (2022)
- [Medical Image Segmentation Using Deep Learning: A Survey](https://mlsanity.com/paper/2009.13120/) (2020)
- [Humble Teachers Teach Better Students for Semi-Supervised Object Detection](https://mlsanity.com/paper/2106.10456/) (2021)
- [BiomedParse: a biomedical foundation model for image parsing of everything everywhere all at once](https://mlsanity.com/paper/2405.12971/) (2024)
- [UniverSeg: Universal Medical Image Segmentation](https://mlsanity.com/paper/2304.06131/) (2023)
- [AutoSAM: Adapting SAM to Medical Images by Overloading the Prompt Encoder](https://mlsanity.com/paper/2306.06370/) (2023)
- [PseCo: Pseudo Labeling and Consistency Training for Semi-Supervised Object Detection](https://mlsanity.com/paper/2203.16317/) (2022)
- [A Survey on Label-efficient Deep Image Segmentation: Bridging the Gap between Weak Supervision and Dense Prediction](https://mlsanity.com/paper/2207.01223/) (2022)
- [MedCLIP-SAMv2: Towards Universal Text-Driven Medical Image Segmentation](https://mlsanity.com/paper/2409.19483/) (2024)
- [Self-Prompting Large Vision Models for Few-Shot Medical Image Segmentation](https://mlsanity.com/paper/2308.07624/) (2023)
- [Foundation Models for Biomedical Image Segmentation: A Survey](https://mlsanity.com/paper/2401.07654/) (2024)
- [Semi-DETR: Semi-Supervised Object Detection with Detection Transformers](https://mlsanity.com/paper/2307.08095/) (2023)
- [Test-Time Adaptation with SaLIP: A Cascade of SAM and CLIP for Zero shot Medical Image Segmentation](https://mlsanity.com/paper/2404.06362/) (2024)
- [Efficient Teacher: Semi-Supervised Object Detection for YOLOv5](https://mlsanity.com/paper/2302.07577/) (2023)

## Abstract (arXiv)

Text-prompted foundation models for medical image segmentation offer an intuitive way to delineate anatomical structures from natural language queries, but their predictions often lack spatial precision and degrade under domain shift. In contrast, visual-prompted models achieve strong segmentation performance across diverse modalities by leveraging spatial cues of precise bounding-box (bbox) prompts to guide the segmentation of target lesions. However, it is costly and challenging to obtain the precise visual prompts in clinical practice. We propose PPBoost (Progressive Prompt-Boosting), a framework that bridges these limitations by transforming weak text-derived signals into strong, spatially grounded visual prompts, operating under a strict zero-shot regime with no image- or pixel-level segmentation labels. PPBoost first uses a vision-language model to produce initial pseudo-bboxes conditioned on the textual object descriptions and applies an uncertainty-aware criterion to filter unreliable predictions. The retained image-bboxes pairs are then leveraged to train a pseudo-labeled detector, producing the high-quality bboxes for the query images. During inference, PPBoost further refines the generated bboxes by appropriately expanding them to tightly cover the target anatomical structures. The enhanced spatially-grounding bbox prompts guide existing segmentation models to generate final dense masks, effectively amplifying weak text cues into strong spatial guidance. Across three datasets spanning diverse modalities and anatomies, PPBoost consistently improves Dice and Normalized Surface Distance over text- and visual-prompted baselines and, notably, surpasses few-shot segmentation models without using labeled data. PPBoost can generalize to multiple typical visual segmentation model backbones.