# Dual-Domain Cross-Modal Decoding for Clinical Text-Guided Medical Image Segmentation

arXiv: https://arxiv.org/abs/2608.11335 · HTML: https://mlsanity.com/paper/2608.11335/

## Key facts

- Cited by 1 papers in the map (data through 14 Oct 2026).
- Builds on 15 of its 25 references that are in the map.
- First posted on arXiv 11 Aug 2026.

## Builds on (most cited first, 15 of 15)

- [U-Net: Convolutional Networks for Biomedical Image Segmentation](https://mlsanity.com/paper/1505.04597/) (2015)
- [A ConvNet for the 2020s](https://mlsanity.com/paper/2201.03545/) (2022)
- [FiLM: Visual Reasoning with a General Conditioning Layer](https://mlsanity.com/paper/1709.07871/) (2017)
- [UNet++: A Nested U-Net Architecture for Medical Image Segmentation](https://mlsanity.com/paper/1807.10165/) (2018)
- [Swin-Unet: Unet-like Pure Transformer for Medical Image Segmentation](https://mlsanity.com/paper/2105.05537/) (2021)
- [Domain-Specific Language Model Pretraining for Biomedical Natural Language Processing](https://mlsanity.com/paper/2007.15779/) (2020)
- [LAVT: Language-Aware Vision Transformer for Referring Image Segmentation](https://mlsanity.com/paper/2112.02244/) (2021)
- [LViT: Language meets Vision Transformer in Medical Image Segmentation](https://mlsanity.com/paper/2206.14718/) (2022)
- [MosMedData: Chest CT Scans With COVID-19 Related Findings Dataset](https://mlsanity.com/paper/2005.06465/) (2020)
- [OSegNet: Operational Segmentation Network for COVID-19 Detection using Chest X-ray Images](https://mlsanity.com/paper/2202.10185/) (2022)
- [Loss Functions in the Era of Semantic Segmentation: A Survey and Outlook](https://mlsanity.com/paper/2312.05391/) (2023)
- [Cross-Modal Conditioned Reconstruction for Language-guided Medical Image Segmentation](https://mlsanity.com/paper/2404.02845/) (2024)
- [A dwt, dct and svd based watermarking technique to protect the image piracy](https://mlsanity.com/paper/1307.3294/) (2013)
- [Frequency-domain Multi-modal Fusion for Language-guided Medical Image Segmentation](https://mlsanity.com/paper/2509.19719/) (2025)
- [MambaLiteUNet: Cross-Gated Adaptive Feature Fusion for Robust Skin Lesion Segmentation](https://mlsanity.com/paper/2604.20286/) (2026)

## Built on by (most cited first, 1 of 1)

- [Multimodal Routing and Region Refinement for Language-Guided Medical Image Segmentation](https://mlsanity.com/paper/2609.28860/) (2026)

## Abstract (arXiv)

Clinical text can narrow down what to segment, but recent text-guided designs emphasize spatial alignment while overlooking frequency content that governs texture and boundaries. We propose Dual-Domain Cross-Modal Decoding (DD-CMD) for clinical text-guided pulmonary infection segmentation, integrating two complementary forms of language guidance during decoding. In the spatial domain, Text-Guided Spatial Cross-Attention (TGSA) aligns multi-scale visual tokens with text semantics and updates features through gated residual fusion. In the frequency domain, Spectral-Text Adaptive Modulation (STAM) applies a 2D DCT to compute learnable band-energy statistics and predicts text-conditioned FiLM parameters to recalibrate decoder channels for frequency-aware decoding. DD-CMD embeds TGSA and STAM into a coarse-to-fine decoder (7x7 to 56x56) and restores full-resolution masks using a lightweight two-stage refinement module. Experiments on QaTa-COV19 and MosMedData+ show that DD-CMD achieves 91.46% Dice / 84.26% mIoU and 81.95% Dice / 69.42% mIoU, respectively, with average gains of +1.96 Dice and +2.67 mIoU over the strongest prior baselines. Code: https://github.com/maklachur/DD-CMD.