# HiMatch-AD: DINOv3-driven Hierarchical Matching for Training-free Medical Anomaly Detection

arXiv: https://arxiv.org/abs/2606.22556 · HTML: https://mlsanity.com/paper/2606.22556/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 23 of its 27 references that are in the map.
- First posted on arXiv 21 Jun 2026.

## Builds on (most cited first, 23 of 23)

- [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)
- [DINOv2: Learning Robust Visual Features without Supervision](https://mlsanity.com/paper/2304.07193/) (2023)
- [DINOv3](https://mlsanity.com/paper/2508.10104/) (2025)
- [Towards Total Recall in Industrial Anomaly Detection](https://mlsanity.com/paper/2106.08265/) (2021)
- [PaDiM: a Patch Distribution Modeling Framework for Anomaly Detection and Localization](https://mlsanity.com/paper/2011.08785/) (2020)
- [The RSNA-ASNR-MICCAI BraTS 2021 Benchmark on Brain Tumor Segmentation and Radiogenomic Classification](https://mlsanity.com/paper/2107.02314/) (2021)
- [DRAEM -- A discriminatively trained reconstruction embedding for surface anomaly detection](https://mlsanity.com/paper/2108.07610/) (2021)
- [The Liver Tumor Segmentation Benchmark (LiTS)](https://mlsanity.com/paper/1901.04056/) (2019)
- [Anomaly Detection via Reverse Distillation from One-Class Embedding](https://mlsanity.com/paper/2201.10703/) (2022)
- [Multiresolution Knowledge Distillation for Anomaly Detection](https://mlsanity.com/paper/2011.11108/) (2020)
- [SimpleNet: A Simple Network for Image Anomaly Detection and Localization](https://mlsanity.com/paper/2303.15140/) (2023)
- [Student-Teacher Feature Pyramid Matching for Anomaly Detection](https://mlsanity.com/paper/2103.04257/) (2021)
- [Deep Learning for Medical Anomaly Detection -- A Survey](https://mlsanity.com/paper/2012.02364/) (2020)
- [BMAD: Benchmarks for Medical Anomaly Detection](https://mlsanity.com/paper/2306.11876/) (2023)
- [A Survey on Visual Anomaly Detection: Challenge, Approach, and Prospect](https://mlsanity.com/paper/2401.16402/) (2024)
- [AnomalyDINO: Boosting Patch-based Few-shot Anomaly Detection with DINOv2](https://mlsanity.com/paper/2405.14529/) (2024)
- [UniVAD: A Training-free Unified Model for Few-shot Visual Anomaly Detection](https://mlsanity.com/paper/2412.03342/) (2024)
- [MedIAnomaly: A comparative study of anomaly detection in medical images](https://mlsanity.com/paper/2404.04518/) (2024)
- [Foundation Models and Transformers for Anomaly Detection: A Survey](https://mlsanity.com/paper/2507.15905/) (2025)
- [Anomaly Detection by Clustering DINO Embeddings using a Dirichlet Process Mixture](https://mlsanity.com/paper/2509.19997/) (2025)
- [DINO-AD: Unsupervised Anomaly Detection with Frozen DINO-V3 Features](https://mlsanity.com/paper/2602.03870/) (2026)
- [RAID: Retrieval-Augmented Anomaly Detection](https://mlsanity.com/paper/2602.19611/) (2026)

## Abstract (arXiv)

Anomaly detection is essential for medical image analysis, where pathological regions often appear as rare deviations from normal anatomical structures. While training-based methods have achieved promising performance, they require task-specific optimization and extensive normal data, which limits scalability across modalities and institutions. Training-free approaches offer greater flexibility by leveraging pretrained visual representations, yet existing methods typically rely on simple nearest-neighbor retrieval and naive aggregation strategies, which may fail to capture hierarchical semantics and ignore the reliability of multiple anomaly responses. In this work, we propose HiMatch-AD, a DINOv3-driven hierarchical matching framework for training-free medical anomaly detection. Our method first retrieves semantically relevant normal references via dual-branch matching that jointly considers global CLS-token similarity and patch-level representations. Hierarchical anomaly maps are then generated across multiple transformer stages by comparing clustered normal features with query representations. To robustly aggregate anomaly responses, we introduce a unified uncertainty-based fusion mechanism that adaptively weights maps according to their reliability. The entire framework operates without any task-specific training. Extensive experiments on the BMAD benchmark, including brain MRI, liver CT, and retinal OCT datasets, demonstrate that HiMatch-AD consistently outperforms both training-based and DINO-based state-of-the-art methods, which highlights the effectiveness of multi-level matching and uncertainty-aware fusion for scalable medical anomaly detection.