# ACE-LoRA: Graph-Attentive Context Enhancement for Parameter-Efficient Adaptation of Medical Vision-Language Models

arXiv: https://arxiv.org/abs/2603.17079 · HTML: https://mlsanity.com/paper/2603.17079/

## Key facts

- Cited by 1 papers in the map (data through 14 Oct 2026).
- Placed in Medical vision-language models, one of 16 directions in Multimodal LLMs / vision-language models.
- Builds on 65 of its 72 references that are in the map.
- First posted on arXiv 17 Mar 2026.

## Placed in

- Multimodal LLMs / vision-language models / [Medical vision-language models](https://mlsanity.com/mllm/medical-vision-language-models/)

## Builds on (most cited first, 30 of 65)

- [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)
- [An Image is Worth 16x16 Words: Transformers for Image Recognition at Scale](https://mlsanity.com/paper/2010.11929/) (2020)
- [LoRA: Low-Rank Adaptation of Large Language Models](https://mlsanity.com/paper/2106.09685/) (2021)
- [Semi-Supervised Classification with Graph Convolutional Networks](https://mlsanity.com/paper/1609.02907/) (2016)
- [Graph Attention Networks](https://mlsanity.com/paper/1710.10903/) (2017)
- [Representation Learning with Contrastive Predictive Coding](https://mlsanity.com/paper/1807.03748/) (2018)
- [SGDR: Stochastic Gradient Descent with Warm Restarts](https://mlsanity.com/paper/1608.03983/) (2016)
- [Scaling Up Visual and Vision-Language Representation Learning With Noisy Text Supervision](https://mlsanity.com/paper/2102.05918/) (2021)
- [The Power of Scale for Parameter-Efficient Prompt Tuning](https://mlsanity.com/paper/2104.08691/) (2021)
- [Delving Deep into Rectifiers: Surpassing Human-Level Performance on ImageNet Classification](https://mlsanity.com/paper/1502.01852/) (2015)
- [YOLOv3: An Incremental Improvement](https://mlsanity.com/paper/1804.02767/) (2018)
- [Learning to Prompt for Vision-Language Models](https://mlsanity.com/paper/2109.01134/) (2021)
- [Conditional Prompt Learning for Vision-Language Models](https://mlsanity.com/paper/2203.05557/) (2022)
- [CheXpert: A Large Chest Radiograph Dataset with Uncertainty Labels and Expert Comparison](https://mlsanity.com/paper/1901.07031/) (2019)
- [Unified Perceptual Parsing for Scene Understanding](https://mlsanity.com/paper/1807.10221/) (2018)
- [Reproducible scaling laws for contrastive language-image learning](https://mlsanity.com/paper/2212.07143/) (2022)
- [CLIP-Adapter: Better Vision-Language Models with Feature Adapters](https://mlsanity.com/paper/2110.04544/) (2021)
- [ChestX-ray8: Hospital-scale Chest X-ray Database and Benchmarks on Weakly-Supervised Classification and Localization of Common Thorax Diseases](https://mlsanity.com/paper/1705.02315/) (2017)
- [Open-vocabulary Object Detection via Vision and Language Knowledge Distillation](https://mlsanity.com/paper/2104.13921/) (2021)
- [How Attentive are Graph Attention Networks?](https://mlsanity.com/paper/2105.14491/) (2021)
- [MaPLe: Multi-modal Prompt Learning](https://mlsanity.com/paper/2210.03117/) (2022)
- [Contrastive Learning of Medical Visual Representations from Paired Images and Text](https://mlsanity.com/paper/2010.00747/) (2020)
- [MIMIC-CXR-JPG, a large publicly available database of labeled chest radiographs](https://mlsanity.com/paper/1901.07042/) (2019)
- [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)
- [BiomedCLIP: a multimodal biomedical foundation model pretrained from fifteen million scientific image-text pairs](https://mlsanity.com/paper/2303.00915/) (2023)
- [Hypergraph Neural Networks](https://mlsanity.com/paper/1809.09401/) (2018)
- [Prompt-aligned Gradient for Prompt Tuning](https://mlsanity.com/paper/2205.14865/) (2022)
- [Learning to Prompt for Open-Vocabulary Object Detection with Vision-Language Model](https://mlsanity.com/paper/2203.14940/) (2022)

## Built on by (most cited first, 1 of 1)

- [MedPrune: Topology-Efficient Multimodal Multi-Agent Communication Evolution for Medical VQA Tasks](https://mlsanity.com/paper/2610.06695/) (2026)

## Abstract (arXiv)

The success of CLIP-like vision-language models (VLMs) on natural images has inspired medical counterparts, yet existing approaches largely fall into two extremes: specialist models trained on single-domain data, which capture domain-specific details but generalize poorly, and generalist medical VLMs trained on multi-domain data, which retain broad semantics but dilute fine-grained diagnostic cues. Bridging this specialization-generalization trade-off remains challenging. To address this problem, we propose ACE-LoRA, a parameter-efficient adaptation framework for generalist medical VLMs that maintains robust zero-shot generalization. ACE-LoRA integrates Low-Rank Adaptation (LoRA) modules into frozen image-text encoders and introduces an Attention-based Context Enhancement Hypergraph Neural Network (ACE-HGNN) module that captures higher-order contextual interactions beyond pairwise similarity to enrich global representations with localized diagnostic cues, addressing a key limitation of prior Parameter-Efficient Fine-Tuning (PEFT) methods that overlook fine-grained details. To further enhance cross-modal alignment, we formulate a label-guided InfoNCE loss to effectively suppress false negatives between semantically related image-text pairs. Despite adding only 0.95M trainable parameters, ACE-LoRA consistently outperforms state-of-the-art medical VLMs and PEFT baselines across zero-shot classification, segmentation, and detection benchmarks spanning multiple domains. Our code is available at https://github.com/icon-lab/ACE-LoRA.