# The Texture-Shape Dilemma: Boundary-Safe Synthetic Generation for 3D Medical Transformers

arXiv: https://arxiv.org/abs/2603.00985 · HTML: https://mlsanity.com/paper/2603.00985/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 13 of its 19 references that are in the map.
- First posted on arXiv 1 Mar 2026.

## Builds on (most cited first, 13 of 13)

- [An Image is Worth 16x16 Words: Transformers for Image Recognition at Scale](https://mlsanity.com/paper/2010.11929/) (2020)
- [Swin Transformer: Hierarchical Vision Transformer using Shifted Windows](https://mlsanity.com/paper/2103.14030/) (2021)
- [UNETR: Transformers for 3D Medical Image Segmentation](https://mlsanity.com/paper/2103.10504/) (2021)
- [Swin UNETR: Swin Transformers for Semantic Segmentation of Brain Tumors in MRI Images](https://mlsanity.com/paper/2201.01266/) (2022)
- [The Medical Segmentation Decathlon](https://mlsanity.com/paper/2106.05735/) (2021)
- [Self-Supervised Pre-Training of Swin Transformers for 3D Medical Image Analysis](https://mlsanity.com/paper/2111.14791/) (2021)
- [VoCo: A Simple-yet-Effective Volume Contrastive Learning Framework for 3D Medical Image Analysis](https://mlsanity.com/paper/2402.17300/) (2024)
- [Masked Image Modeling Advances 3D Medical Image Analysis](https://mlsanity.com/paper/2204.11716/) (2022)
- [RadGenome-Chest CT: A Grounded Vision-Language Dataset for Chest CT Analysis](https://mlsanity.com/paper/2404.16754/) (2024)
- [SwinMM: Masked Multi-view with Swin Transformers for 3D Medical Image Segmentation](https://mlsanity.com/paper/2307.12591/) (2023)
- [Visual Atoms: Pre-training Vision Transformers with Sinusoidal Waves](https://mlsanity.com/paper/2303.01112/) (2023)
- [Pre-training Vision Transformers with Very Limited Synthesized Images](https://mlsanity.com/paper/2307.14710/) (2023)
- [SegRCDB: Semantic Segmentation via Formula-Driven Supervised Learning](https://mlsanity.com/paper/2309.17083/) (2023)

## Abstract (arXiv)

Vision Transformers (ViTs) have revolutionized medical image analysis, yet their data-hungry nature clashes with the scarcity and privacy constraints of clinical archives. Formula-Driven Supervised Learning (FDSL) has emerged as a promising solution to this bottleneck, synthesizing infinite annotated samples from mathematical formulas without utilizing real patient data. However, existing FDSL paradigms rely on simple geometric shapes with homogeneous intensities, creating a substantial gap by neglecting tissue textures and noise patterns inherent in modalities like CT and MRI. In this paper, we identify a critical optimization conflict termed boundary aliasing: when high-frequency synthetic textures are naively added, they corrupt the image gradient signals necessary for learning structural boundaries, causing the model to fail in delineating real anatomical margins. To bridge this gap, we propose a novel Physics-inspired Spatially-Decoupled Synthesis framework. Our approach orthogonalizes the synthesis process: it first constructs a gradient-shielded buffer zone based on boundary distance to ensure stable shape learning, and subsequently injects physics-driven spectral textures into the object core. This design effectively reconciles robust shape representation learning with invariance to acquisition noise. Extensive experiments on the BTCV and MSD datasets demonstrate that our method significantly outperforms previous FDSL, as well as SSL methods trained on real-world medical datasets, by 1.43% on BTCV and up to 1.51% on MSD task, offering a scalable, annotation-free foundation for medical ViTs. The code will be made publicly available upon acceptance.