Medical Referring Image Segmentation via Next-Token Mask Prediction

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Hauptverfasser: Chen, Xinyu, Wang, Yiran, Pang, Gaoyang, Hao, Jiafu, Yue, Chentao, Zhou, Luping, Li, Yonghui
Format: Preprint
Veröffentlicht: 2025
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author Chen, Xinyu
Wang, Yiran
Pang, Gaoyang
Hao, Jiafu
Yue, Chentao
Zhou, Luping
Li, Yonghui
author_facet Chen, Xinyu
Wang, Yiran
Pang, Gaoyang
Hao, Jiafu
Yue, Chentao
Zhou, Luping
Li, Yonghui
contents Medical Referring Image Segmentation (MRIS) involves segmenting target regions in medical images based on natural language descriptions. While achieving promising results, recent approaches usually involve complex design of multimodal fusion or multi-stage decoders. In this work, we propose NTP-MRISeg, a novel framework that reformulates MRIS as an autoregressive next-token prediction task over a unified multimodal sequence of tokenized image, text, and mask representations. This formulation streamlines model design by eliminating the need for modality-specific fusion and external segmentation models, supports a unified architecture for end-to-end training. It also enables the use of pretrained tokenizers from emerging large-scale multimodal models, enhancing generalization and adaptability. More importantly, to address challenges under this formulation-such as exposure bias, long-tail token distributions, and fine-grained lesion edges-we propose three novel strategies: (1) a Next-k Token Prediction (NkTP) scheme to reduce cumulative prediction errors, (2) Token-level Contrastive Learning (TCL) to enhance boundary sensitivity and mitigate long-tail distribution effects, and (3) a memory-based Hard Error Token (HET) optimization strategy that emphasizes difficult tokens during training. Extensive experiments on the QaTa-COV19 and MosMedData+ datasets demonstrate that NTP-MRISeg achieves new state-of-the-art performance, offering a streamlined and effective alternative to traditional MRIS pipelines.
format Preprint
id arxiv_https___arxiv_org_abs_2511_05044
institution arXiv
publishDate 2025
record_format arxiv
spellingShingle Medical Referring Image Segmentation via Next-Token Mask Prediction
Chen, Xinyu
Wang, Yiran
Pang, Gaoyang
Hao, Jiafu
Yue, Chentao
Zhou, Luping
Li, Yonghui
Computer Vision and Pattern Recognition
Medical Referring Image Segmentation (MRIS) involves segmenting target regions in medical images based on natural language descriptions. While achieving promising results, recent approaches usually involve complex design of multimodal fusion or multi-stage decoders. In this work, we propose NTP-MRISeg, a novel framework that reformulates MRIS as an autoregressive next-token prediction task over a unified multimodal sequence of tokenized image, text, and mask representations. This formulation streamlines model design by eliminating the need for modality-specific fusion and external segmentation models, supports a unified architecture for end-to-end training. It also enables the use of pretrained tokenizers from emerging large-scale multimodal models, enhancing generalization and adaptability. More importantly, to address challenges under this formulation-such as exposure bias, long-tail token distributions, and fine-grained lesion edges-we propose three novel strategies: (1) a Next-k Token Prediction (NkTP) scheme to reduce cumulative prediction errors, (2) Token-level Contrastive Learning (TCL) to enhance boundary sensitivity and mitigate long-tail distribution effects, and (3) a memory-based Hard Error Token (HET) optimization strategy that emphasizes difficult tokens during training. Extensive experiments on the QaTa-COV19 and MosMedData+ datasets demonstrate that NTP-MRISeg achieves new state-of-the-art performance, offering a streamlined and effective alternative to traditional MRIS pipelines.
title Medical Referring Image Segmentation via Next-Token Mask Prediction
topic Computer Vision and Pattern Recognition
url https://arxiv.org/abs/2511.05044