# STAIL: Semantic Text-Anchored Incremental Learning for Medical Imaging via Large Language Models

arXiv: https://arxiv.org/abs/2608.05808 · HTML: https://mlsanity.com/paper/2608.05808/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 20 of its 48 references that are in the map.
- First posted on arXiv 6 Aug 2026.

## Builds on (most cited first, 20 of 20)

- [Deep Residual Learning for Image Recognition](https://mlsanity.com/paper/1512.03385/) (2015)
- [Learning Transferable Visual Models From Natural Language Supervision](https://mlsanity.com/paper/2103.00020/) (2021)
- [The Llama 3 Herd of Models](https://mlsanity.com/paper/2407.21783/) (2024)
- [Grad-CAM: Visual Explanations from Deep Networks via Gradient-based Localization](https://mlsanity.com/paper/1610.02391/) (2016)
- [Learning without Forgetting](https://mlsanity.com/paper/1606.09282/) (2016)
- [iCaRL: Incremental Classifier and Representation Learning](https://mlsanity.com/paper/1611.07725/) (2016)
- [Learning to Prompt for Continual Learning](https://mlsanity.com/paper/2112.08654/) (2021)
- [DualPrompt: Complementary Prompting for Rehearsal-free Continual Learning](https://mlsanity.com/paper/2204.04799/) (2022)
- [DER: Dynamically Expandable Representation for Class Incremental Learning](https://mlsanity.com/paper/2103.16788/) (2021)
- [BioMistral: A Collection of Open-Source Pretrained Large Language Models for Medical Domains](https://mlsanity.com/paper/2402.10373/) (2024)
- [Maintaining Discrimination and Fairness in Class Incremental Learning](https://mlsanity.com/paper/1911.07053/) (2019)
- [New Insights on Reducing Abrupt Representation Change in Online Continual Learning](https://mlsanity.com/paper/2104.05025/) (2021)
- [A Model or 603 Exemplars: Towards Memory-Efficient Class-Incremental Learning](https://mlsanity.com/paper/2205.13218/) (2022)
- [Large-scale and Fine-grained Vision-language Pre-training for Enhanced CT Image Understanding](https://mlsanity.com/paper/2501.14548/) (2025)
- [Rehearsal-Free Modular and Compositional Continual Learning for Language Models](https://mlsanity.com/paper/2404.00790/) (2024)
- [Continual Learning in Medical Image Analysis: A Comprehensive Review of Recent Advancements and Future Prospects](https://mlsanity.com/paper/2312.17004/) (2023)
- [Ultrasound Report Generation with Cross-Modality Feature Alignment via Unsupervised Guidance](https://mlsanity.com/paper/2406.00644/) (2024)
- [Dynamic Prototype Rehearsal for Continual ECG Arrhythmia Detection](https://mlsanity.com/paper/2501.07555/) (2025)
- [Distribution-Level Memory Recall for Continual Learning: Preserving Knowledge and Avoiding Confusion](https://mlsanity.com/paper/2408.02695/) (2024)
- [Welcome New Doctor: Continual Learning with Expert Consultation and Autoregressive Inference for Whole Slide Image Analysis](https://mlsanity.com/paper/2508.02220/) (2025)

## Abstract (arXiv)

Deep learning models applied to medical image analysis suffer from severe catastrophic forgetting when continually adapting to new clinical tasks in dynamic environments. Mainstream incremental learning methods typically mitigate this by rehearsing raw historical images. However, this pixel-level rehearsal incurs significant storage overhead, raises privacy concerns, and fails to adequately capture the true data distribution with sparse exemplars. Inspired by human cognitive mechanisms, we propose a novel framework termed Semantic Text-Anchored Incremental Learning (STAIL) for sequential clinical tasks. To overcome the rehearsal bottleneck, STAIL introduces an asymmetric semantic consolidation buffer (SCB). By incorporating a minimal set of image anchors and extensive textual descriptions, the SCB enables dense semantic reconstruction of old tasks at a minimal storage cost. Furthermore, we design an LLM-derived Semantic Anchoring Mechanism (LSAM) that leverages the stable semantic space of frozen large language models as developmental priors. This mechanism explicitly anchors evolving visual features to textual representations, guiding and constraining plasticity and stability at both macroscopic and microscopic levels. Extensive experiments across three heterogeneous medical datasets, covering fundus, ultrasound, and X-ray imaging, demonstrate that STAIL acts as a highly effective plug-and-play module. It comprehensively enhances the performance of various existing baselines, achieving average gains of 2.24% in AAA-AUC for sustained performance and 3.55% in BWT-AUC for reduced forgetting. Code is available.