# TGC-Net: A Structure-Aware and Semantically-Aligned Framework for Text-Guided Medical Image Segmentation

arXiv: https://arxiv.org/abs/2512.21135 · HTML: https://mlsanity.com/paper/2512.21135/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 35 of its 50 references that are in the map.
- First posted on arXiv 24 Dec 2025.

## Builds on (most cited first, 30 of 35)

- [Attention Is All You Need](https://mlsanity.com/paper/1706.03762/) (2017)
- [Learning Transferable Visual Models From Natural Language Supervision](https://mlsanity.com/paper/2103.00020/) (2021)
- [PyTorch: An Imperative Style, High-Performance Deep Learning Library](https://mlsanity.com/paper/1912.01703/) (2019)
- [U-Net: Convolutional Networks for Biomedical Image Segmentation](https://mlsanity.com/paper/1505.04597/) (2015)
- [Segment Anything](https://mlsanity.com/paper/2304.02643/) (2023)
- [Deformable DETR: Deformable Transformers for End-to-End Object Detection](https://mlsanity.com/paper/2010.04159/) (2020)
- [SAM 2: Segment Anything in Images and Videos](https://mlsanity.com/paper/2408.00714/) (2024)
- [TransUNet: Transformers Make Strong Encoders for Medical Image Segmentation](https://mlsanity.com/paper/2102.04306/) (2021)
- [UNet++: A Nested U-Net Architecture for Medical Image Segmentation](https://mlsanity.com/paper/1807.10165/) (2018)
- [ViLT: Vision-and-Language Transformer Without Convolution or Region Supervision](https://mlsanity.com/paper/2102.03334/) (2021)
- [Swin-Unet: Unet-like Pure Transformer for Medical Image Segmentation](https://mlsanity.com/paper/2105.05537/) (2021)
- [MedCLIP: Contrastive Learning from Unpaired Medical Images and Text](https://mlsanity.com/paper/2210.10163/) (2022)
- [A large annotated medical image dataset for the development and evaluation of segmentation algorithms](https://mlsanity.com/paper/1902.09063/) (2019)
- [LAVT: Language-Aware Vision Transformer for Referring Image Segmentation](https://mlsanity.com/paper/2112.02244/) (2021)
- [AbdomenCT-1K: Is Abdominal Organ Segmentation A Solved Problem?](https://mlsanity.com/paper/2010.14808/) (2020)
- [CAT-Seg: Cost Aggregation for Open-Vocabulary Semantic Segmentation](https://mlsanity.com/paper/2303.11797/) (2023)
- [UCTransNet: Rethinking the Skip Connections in U-Net from a Channel-wise Perspective with Transformer](https://mlsanity.com/paper/2109.04335/) (2021)
- [Medical Image Segmentation Review: The success of U-Net](https://mlsanity.com/paper/2211.14830/) (2022)
- [Medical SAM 2: Segment medical images as video via Segment Anything Model 2](https://mlsanity.com/paper/2408.00874/) (2024)
- [DoubleU-Net: A Deep Convolutional Neural Network for Medical Image Segmentation](https://mlsanity.com/paper/2006.04868/) (2020)
- [LViT: Language meets Vision Transformer in Medical Image Segmentation](https://mlsanity.com/paper/2206.14718/) (2022)
- [SegVol: Universal and Interactive Volumetric Medical Image Segmentation](https://mlsanity.com/paper/2311.13385/) (2023)
- [Perceive-IR: Learning to Perceive Degradation Better for All-in-One Image Restoration](https://mlsanity.com/paper/2408.15994/) (2024)
- [TGANet: Text-guided attention for improved polyp segmentation](https://mlsanity.com/paper/2205.04280/) (2022)
- [CNN-based Segmentation of Medical Imaging Data](https://mlsanity.com/paper/1701.03056/) (2017)
- [OSegNet: Operational Segmentation Network for COVID-19 Detection using Chest X-ray Images](https://mlsanity.com/paper/2202.10185/) (2022)
- [Ariadne's Thread:Using Text Prompts to Improve Segmentation of Infected Areas from Chest X-ray images](https://mlsanity.com/paper/2307.03942/) (2023)
- [Cross-Modal Conditioned Reconstruction for Language-guided Medical Image Segmentation](https://mlsanity.com/paper/2404.02845/) (2024)
- [I-MedSAM: Implicit Medical Image Segmentation with Segment Anything](https://mlsanity.com/paper/2311.17081/) (2023)
- [ZePT: Zero-Shot Pan-Tumor Segmentation via Query-Disentangling and Self-Prompting](https://mlsanity.com/paper/2312.04964/) (2023)

## Abstract (arXiv)

Text-guided medical segmentation enhances segmentation accuracy by utilizing clinical reports as auxiliary information. However, existing methods typically rely on unaligned image and text encoders, which necessitate complex interaction modules for multimodal fusion. While CLIP provides a pre-aligned multimodal feature space, its direct application to medical imaging is limited by three main issues: insufficient preservation of fine-grained anatomical structures, inadequate modeling of complex clinical descriptions, and domain-specific semantic misalignment. To tackle these challenges, we propose TGC-Net, a CLIP-based framework focusing on parameter-efficient, task-specific adaptations. Specifically, it incorporates a Semantic-Structural Synergy Encoder (SSE) that augments CLIP's ViT with a CNN branch for multi-scale structural refinement, a Domain-Augmented Text Encoder (DATE) that injects large-language-model-derived medical knowledge, and a Vision-Language Calibration Module (VLCM) that refines cross-modal correspondence in a unified feature space. Experiments on five datasets across chest X-ray and thoracic CT modalities demonstrate that TGC-Net achieves state-of-the-art performance with substantially fewer trainable parameters, including notable Dice gains on challenging benchmarks.