# Super-Generalist: Towards Comprehensive and Accurate Medical Image Understanding via Generalist-Specialist Synergy

arXiv: https://arxiv.org/abs/2607.09135 · HTML: https://mlsanity.com/paper/2607.09135/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 33 of its 54 references that are in the map.
- First posted on arXiv 10 Jul 2026.

## Builds on (most cited first, 30 of 33)

- [BERT: Pre-training of Deep Bidirectional Transformers for Language Understanding](https://mlsanity.com/paper/1810.04805/) (2018)
- [Learning Transferable Visual Models From Natural Language Supervision](https://mlsanity.com/paper/2103.00020/) (2021)
- [U-Net: Convolutional Networks for Biomedical Image Segmentation](https://mlsanity.com/paper/1505.04597/) (2015)
- [Qwen Technical Report](https://mlsanity.com/paper/2309.16609/) (2023)
- [Swin UNETR: Swin Transformers for Semantic Segmentation of Brain Tumors in MRI Images](https://mlsanity.com/paper/2201.01266/) (2022)
- [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)
- [Making the Most of Text Semantics to Improve Biomedical Vision--Language Processing](https://mlsanity.com/paper/2204.09817/) (2022)
- [nnU-Net: Self-adapting Framework for U-Net-Based Medical Image Segmentation](https://mlsanity.com/paper/1809.10486/) (2018)
- [CoTr: Efficiently Bridging CNN and Transformer for 3D Medical Image Segmentation](https://mlsanity.com/paper/2103.03024/) (2021)
- [PMC-CLIP: Contrastive Language-Image Pre-training using Biomedical Documents](https://mlsanity.com/paper/2303.07240/) (2023)
- [Medical Image Segmentation Review: The success of U-Net](https://mlsanity.com/paper/2211.14830/) (2022)
- [U-KAN Makes Strong Backbone for Medical Image Segmentation and Generation](https://mlsanity.com/paper/2406.02918/) (2024)
- [Multi-Granularity Cross-modal Alignment for Generalized Medical Visual Representation Learning](https://mlsanity.com/paper/2210.06044/) (2022)
- [Joint Learning of Localized Representations from Medical Images and Reports](https://mlsanity.com/paper/2112.02889/) (2021)
- [Advancing Radiograph Representation Learning with Masked Record Modeling](https://mlsanity.com/paper/2301.13155/) (2023)
- [Masked Image Modeling Advances 3D Medical Image Analysis](https://mlsanity.com/paper/2204.11716/) (2022)
- [Machine-Learning-Based Multiple Abnormality Prediction with Large-Scale Chest Computed Tomography Volumes](https://mlsanity.com/paper/2002.04752/) (2020)
- [Large-scale and Fine-grained Vision-language Pre-training for Enhanced CT Image Understanding](https://mlsanity.com/paper/2501.14548/) (2025)
- [MedCLIP-SAMv2: Towards Universal Text-Driven Medical Image Segmentation](https://mlsanity.com/paper/2409.19483/) (2024)
- [GSCo: Towards Generalizable AI in Medicine via Generalist-Specialist Collaboration](https://mlsanity.com/paper/2404.15127/) (2024)
- [MedIAnomaly: A comparative study of anomaly detection in medical images](https://mlsanity.com/paper/2404.04518/) (2024)
- [Bootstrapping Chest CT Image Understanding by Distilling Knowledge from X-ray Expert Models](https://mlsanity.com/paper/2404.04936/) (2024)
- [IMITATE: Clinical Prior Guided Hierarchical Vision-Language Pre-training](https://mlsanity.com/paper/2310.07355/) (2023)
- [Boosting Vision Semantic Density with Anatomy Normality Modeling for Medical Vision-language Pre-training](https://mlsanity.com/paper/2508.03742/) (2025)
- [Towards a Comprehensive, Efficient and Promptable Anatomic Structure Segmentation Model using 3D Whole-body CT Scans](https://mlsanity.com/paper/2403.15063/) (2024)
- [Towards Universal Text-driven CT Image Segmentation](https://mlsanity.com/paper/2503.06030/) (2025)
- [A Chain of Diagnosis Framework for Accurate and Explainable Radiology Report Generation](https://mlsanity.com/paper/2508.09566/) (2025)
- [Generalist versus Specialist Vision Foundation Models for Ocular Disease and Oculomics](https://mlsanity.com/paper/2509.03421/) (2025)
- [UMind-VL: A Generalist Ultrasound Vision-Language Model for Unified Grounded Perception and Comprehensive Interpretation](https://mlsanity.com/paper/2511.22256/) (2025)

## Abstract (arXiv)

Medical images require comprehensive and accurate interpretation to support the diagnosis of diverse clincial conditions. Recent vision-language generalist models offer broad task coverage and promising zero-shot capabilities, yet often lack fine-grained anatomical and lesion awareness for reliable diagnosis and spatial interpretability. In contrast, supervised specialist models achieve strong performance on specific tasks but typically lack generalization across diseases and anatomies. In this work, we present SuG, a Super-Generalist framework that unifies generalist vision-language learning with specialist objectives, enabling both broad generalization and specialist-level diagnostic capability. We perform specialist-enhanced vision-language alignment in SuG by incorporating spatial priors from multiple segmentation experts, including anatomy, class-specific lesion and class-agnostic lesion segmentors that captures lesions beyond anatomies annotated during training. To improve lesion grounding capability, we leverage lesion masks as spatial priors to calibrate text-conditioned visual attention, encouraging disease-related semantics to focus on clinically relevant regions. We evaluate SuG on extensive chest and abdominal CT benchmarks, including CT-RATE, Merlin, MedVL-CT69K, and several in-house tumor datasets. SuG achieves state-of-the-art performance across a wide range of disease diagnosis tasks and surpasses specialist models on several critical tumor diagnosis benchmarks. Furthermore, SuG demonstrates strong lesion grounding capability, including robust generalization to lesion types lacking class-specific supervision.