# Ultrasound Vision-Language Alignment via Contrastive Learning

arXiv: https://arxiv.org/abs/2605.02126 · HTML: https://mlsanity.com/paper/2605.02126/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 13 of its 24 references that are in the map.
- First posted on arXiv 4 May 2026.

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

- [Learning Transferable Visual Models From Natural Language Supervision](https://mlsanity.com/paper/2103.00020/) (2021)
- [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)
- [Swin Transformer V2: Scaling Up Capacity and Resolution](https://mlsanity.com/paper/2111.09883/) (2021)
- [A Survey on Deep Learning in Medical Image Analysis](https://mlsanity.com/paper/1702.05747/) (2017)
- [Publicly Available Clinical BERT Embeddings](https://mlsanity.com/paper/1904.03323/) (2019)
- [Contrastive Learning of Medical Visual Representations from Paired Images and Text](https://mlsanity.com/paper/2010.00747/) (2020)
- [BiomedCLIP: a multimodal biomedical foundation model pretrained from fifteen million scientific image-text pairs](https://mlsanity.com/paper/2303.00915/) (2023)
- [USFM: A Universal Ultrasound Foundation Model Generalized to Tasks and Organs towards Label Efficient Image Analysis](https://mlsanity.com/paper/2401.00153/) (2023)
- [Robotic Ultrasound Imaging: State-of-the-Art and Future Perspectives](https://mlsanity.com/paper/2307.05545/) (2023)
- [Ultrasound Report Generation with Cross-Modality Feature Alignment via Unsupervised Guidance](https://mlsanity.com/paper/2406.00644/) (2024)
- [A Fully Open and Generalizable Foundation Model for Ultrasound Clinical Applications](https://mlsanity.com/paper/2509.11752/) (2025)
- [A Chain-of-thought Reasoning Breast Ultrasound Dataset Covering All Histopathology Categories](https://mlsanity.com/paper/2509.17046/) (2025)

## Abstract (arXiv)

Ultrasound foundation models have achieved strong performance on structured prediction tasks but remain exclusively vision-based, limiting zero-shot and few-shot transfer to novel tasks where task-specific annotation is scarce. We address this gap with EchoCare-CLIP, a CLIP-style dual-encoder contrastive framework that aligns ultrasound images with clinical text in a shared embedding space. We curate a multi-organ corpus of over 16K image-text pairs spanning breast, liver, lung, and thyroid, with over 78% of captions derived from expert-annotated reports, and complement the remainder with a three-tier template-based and LLM-based caption generation pipeline. We evaluate model configurations spanning two text encoder families (CLIP, BioClinicalBERT) and two caption strategies (template-based, LLM-generated) against OpenAI CLIP and BiomedCLIP baselines. Our trained models consistently improve cross-modal alignment over baselines, with the best configuration achieving a paired alignment score of 0.682. However, stronger alignment does not guarantee better downstream performance: CLIP-based variants with partial fine-tuning achieve the strongest zero-shot classification on external held-out datasets (0.709 on BUSI; 0.626 on AULI), while full end-to-end fine-tuning degrades transfer due to overfitting. On linear probing and few-shot adaptation, model rankings are dataset-dependent, reflecting a trade-off between domain adaptation and representational generalizability. We further show that template-based captions match or outperform LLM-generated captions, suggesting lexical diversity is not a proxy for caption quality. Taken together, our results demonstrate that ultrasound vision-language alignment is achievable from public data alone, but robust clinical transfer requires careful balancing of domain adaptation, encoder capacity, and caption supervision quality.