# Text-Guided Medical Image Segmentation via Residual Aggregation and Dense Alignment Representations

arXiv: https://arxiv.org/abs/2610.14944 · HTML: https://mlsanity.com/paper/2610.14944/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 29 of its 41 references that are in the map.
- First posted on arXiv 10 Oct 2026.

## Builds on (most cited first, 29 of 29)

- [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)
- [An Image is Worth 16x16 Words: Transformers for Image Recognition at Scale](https://mlsanity.com/paper/2010.11929/) (2020)
- [U-Net: Convolutional Networks for Biomedical Image Segmentation](https://mlsanity.com/paper/1505.04597/) (2015)
- [LoRA: Low-Rank Adaptation of Large Language Models](https://mlsanity.com/paper/2106.09685/) (2021)
- [Segment Anything](https://mlsanity.com/paper/2304.02643/) (2023)
- [Layer Normalization](https://mlsanity.com/paper/1607.06450/) (2016)
- [Fully Convolutional Networks for Semantic Segmentation](https://mlsanity.com/paper/1411.4038/) (2014)
- [Scaling Up Visual and Vision-Language Representation Learning With Noisy Text Supervision](https://mlsanity.com/paper/2102.05918/) (2021)
- [QLoRA: Efficient Finetuning of Quantized LLMs](https://mlsanity.com/paper/2305.14314/) (2023)
- [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)
- [Kvasir-SEG: A Segmented Polyp Dataset](https://mlsanity.com/paper/1911.07069/) (2019)
- [Extract Free Dense Labels from CLIP](https://mlsanity.com/paper/2112.01071/) (2021)
- [MedCLIP: Contrastive Learning from Unpaired Medical Images and Text](https://mlsanity.com/paper/2210.10163/) (2022)
- [GLaMM: Pixel Grounding Large Multimodal Model](https://mlsanity.com/paper/2311.03356/) (2023)
- [CAT-Seg: Cost Aggregation for Open-Vocabulary Semantic Segmentation](https://mlsanity.com/paper/2303.11797/) (2023)
- [CLIPSelf: Vision Transformer Distills Itself for Open-Vocabulary Dense Prediction](https://mlsanity.com/paper/2310.01403/) (2023)
- [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)
- [EVF-SAM: Early Vision-Language Fusion for Text-Prompted Segment Anything Model](https://mlsanity.com/paper/2406.20076/) (2024)
- [OSegNet: Operational Segmentation Network for COVID-19 Detection using Chest X-ray Images](https://mlsanity.com/paper/2202.10185/) (2022)
- [MedCLIP-SAMv2: Towards Universal Text-Driven Medical Image Segmentation](https://mlsanity.com/paper/2409.19483/) (2024)
- [Ariadne's Thread:Using Text Prompts to Improve Segmentation of Infected Areas from Chest X-ray images](https://mlsanity.com/paper/2307.03942/) (2023)
- [Cross-Modal Conditioned Reconstruction for Language-guided Medical Image Segmentation](https://mlsanity.com/paper/2404.02845/) (2024)
- [Effective SAM Combination for Open-Vocabulary Semantic Segmentation](https://mlsanity.com/paper/2411.14723/) (2024)
- [Deep Instruction Tuning for Segment Anything Model](https://mlsanity.com/paper/2404.00650/) (2024)
- [Uncertainty-Aware Vision-Language Segmentation for Medical Imaging](https://mlsanity.com/paper/2602.14498/) (2026)
- [MedCLIPSeg: Probabilistic Vision-Language Adaptation for Data-Efficient and Generalizable Medical Image Segmentation](https://mlsanity.com/paper/2602.20423/) (2026)

## Abstract (arXiv)

Specifying segmentation targets with natural language provides flexible semantic conditioning for medical image segmentation. However, existing methods still struggle to reliably ground high-level textual semantics into accurate pixel-level spatial prompts, especially under low-contrast lesions, ambiguous boundaries, and visually similar anatomical contexts. In this paper, we propose RADAR (Residual Aggregation and Dense Alignment Representations), a parameter-efficient framework for text-guided medical image segmentation. RADAR explicitly decouples and synergizes the medical semantic anchoring capability of BiomedCLIP with the prompt-driven mask decoding ability of MedSAM2, while enabling low-cost task adaptation via LoRA. Specifically, Guided Residual Depth Aggregation adaptively aggregates cross-layer features under semantic guidance to alleviate delayed textual injection and deep semantic dilution. Structured Dense Representation Alignment leverages a frozen BiomedCLIP to construct crop-level target, boundary, and context anchors, improving the local discriminability of dense features and the reliability of automatic prompts. Multi-modal Prompt Generation further converts cross-modal semantic responses into composite text, point, and mask prompts for MedSAM2 decoding. Experiments on three public medical image segmentation datasets show that RADAR achieves competitive performance with only 0.74M trainable parameters, demonstrating its effectiveness in parameter-efficient adaptation, semantic grounding, and dense representation enhancement. The source code is available at https://github.com/JGuiidev/RADAR.