# CoRE: Concept-Reasoning Expansion for Continual Brain Lesion Segmentation

arXiv: https://arxiv.org/abs/2604.25376 · HTML: https://mlsanity.com/paper/2604.25376/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 39 of its 54 references that are in the map.
- First posted on arXiv 28 Apr 2026.

## Builds on (most cited first, 30 of 39)

- [LoRA: Low-Rank Adaptation of Large Language Models](https://mlsanity.com/paper/2106.09685/) (2021)
- [Emerging Properties in Self-Supervised Vision Transformers](https://mlsanity.com/paper/2104.14294/) (2021)
- [Overcoming catastrophic forgetting in neural networks](https://mlsanity.com/paper/1612.00796/) (2016)
- [Outrageously Large Neural Networks: The Sparsely-Gated Mixture-of-Experts Layer](https://mlsanity.com/paper/1701.06538/) (2017)
- [Learning to Prompt for Vision-Language Models](https://mlsanity.com/paper/2109.01134/) (2021)
- [Visual Prompt Tuning](https://mlsanity.com/paper/2203.12119/) (2022)
- [Learning to Prompt for Continual Learning](https://mlsanity.com/paper/2112.08654/) (2021)
- [Few-Shot Parameter-Efficient Fine-Tuning is Better and Cheaper than In-Context Learning](https://mlsanity.com/paper/2205.05638/) (2022)
- [A Comprehensive Survey of Continual Learning: Theory, Method and Application](https://mlsanity.com/paper/2302.00487/) (2023)
- [DeepSeekMoE: Towards Ultimate Expert Specialization in Mixture-of-Experts Language Models](https://mlsanity.com/paper/2401.06066/) (2024)
- [Swin UNETR: Swin Transformers for Semantic Segmentation of Brain Tumors in MRI Images](https://mlsanity.com/paper/2201.01266/) (2022)
- [DualPrompt: Complementary Prompting for Rehearsal-free Continual Learning](https://mlsanity.com/paper/2204.04799/) (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)
- [CODA-Prompt: COntinual Decomposed Attention-based Prompting for Rehearsal-Free Continual Learning](https://mlsanity.com/paper/2211.13218/) (2022)
- [U-Mamba: Enhancing Long-range Dependency for Biomedical Image Segmentation](https://mlsanity.com/paper/2401.04722/) (2024)
- [Expert Gate: Lifelong Learning with a Network of Experts](https://mlsanity.com/paper/1611.06194/) (2016)
- [Efficient Multi-Scale 3D CNN with Fully Connected CRF for Accurate Brain Lesion Segmentation](https://mlsanity.com/paper/1603.05959/) (2016)
- [Parameter-Efficient Fine-Tuning Methods for Pretrained Language Models: A Critical Review and Assessment](https://mlsanity.com/paper/2312.12148/) (2023)
- [CLIP-Driven Universal Model for Organ Segmentation and Tumor Detection](https://mlsanity.com/paper/2301.00785/) (2023)
- [Boosting Continual Learning of Vision-Language Models via Mixture-of-Experts Adapters](https://mlsanity.com/paper/2403.11549/) (2024)
- [On the Challenges and Perspectives of Foundation Models for Medical Image Analysis](https://mlsanity.com/paper/2306.05705/) (2023)
- [Standardized Assessment of Automatic Segmentation of White Matter Hyperintensities and Results of the WMH Segmentation Challenge](https://mlsanity.com/paper/1904.00682/) (2019)
- [ISLES 2022: A multi-center magnetic resonance imaging stroke lesion segmentation dataset](https://mlsanity.com/paper/2206.06694/) (2022)
- [A Comprehensive Survey of Mixture-of-Experts: Algorithms, Theory, and Applications](https://mlsanity.com/paper/2503.07137/) (2025)
- [Self-Expansion of Pre-trained Models with Mixture of Adapters for Continual Learning](https://mlsanity.com/paper/2403.18886/) (2024)
- [The Brain Tumor Segmentation (BraTS) Challenge 2023: Glioma Segmentation in Sub-Saharan Africa Patient Population (BraTS-Africa)](https://mlsanity.com/paper/2305.19369/) (2023)
- [Training Like a Medical Resident: Context-Prior Learning Toward Universal Medical Image Segmentation](https://mlsanity.com/paper/2306.02416/) (2023)
- [Universal and Extensible Language-Vision Models for Organ Segmentation and Tumor Detection from Abdominal Computed Tomography](https://mlsanity.com/paper/2405.18356/) (2024)
- [Neuralizer: General Neuroimage Analysis without Re-Training](https://mlsanity.com/paper/2305.02644/) (2023)

## Abstract (arXiv)

Accurate brain lesion segmentation in MRI is vital for effective clinical diagnosis and treatment planning. Due to high annotation costs and strict data privacy regulations, universal models require employing Continual Learning (CL) to adapt to evolving clinical tasks without losing previously acquired knowledge. However, existing CL paradigms often suffer from capacity limits or redundant parameter growth, and even advanced dynamic methods rely mostly on image-perception strategies that struggle to handle the substantial pathological and multimodal heterogeneity inherent in brain imaging. To address this issue, we propose Concept-Reasoning Expansion (CoRE) framework, which establishes a joint decision-making mechanism by integrating visual features with structured concepts. Through the alignment of image tokens with a hierarchical concept library, CoRE simulates clinical reasoning to guide both interpretable expert routing and demand-based model growth. This collaborative process ensures model evolution is grounded in clinical priors, preventing redundant parameter expansion while maximizing knowledge reuse. Extensive evaluations across 12 sequential brain lesion MRI tasks demonstrate that CoRE achieves state-of-the-art performance and provides a high knowledge starting point for efficient future adaptation. Its superior few-shot transferability and clinical interpretability further validate its effectiveness in managing non-stationary clinical data streams. Our code will be released soon.