CORE-Seg: Reasoning-Driven Segmentation for Complex Lesions via Reinforcement Learning

Fuente: arXiv
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Autori principali: Xie, Yuxin, Chen, Yuming, Yang, Yishan, Zhou, Yi, Zhou, Tao, Zhao, Zhen, Liu, Jiacheng, Fu, Huazhu
Natura: Preprint
Pubblicazione: 2026
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author Xie, Yuxin
Chen, Yuming
Yang, Yishan
Zhou, Yi
Zhou, Tao
Zhao, Zhen
Liu, Jiacheng
Fu, Huazhu
author_facet Xie, Yuxin
Chen, Yuming
Yang, Yishan
Zhou, Yi
Zhou, Tao
Zhao, Zhen
Liu, Jiacheng
Fu, Huazhu
contents Medical image segmentation is undergoing a paradigm shift from conventional visual pattern matching to cognitive reasoning analysis. Although Multimodal Large Language Models (MLLMs) have shown promise in integrating linguistic and visual knowledge, significant gaps remain: existing general MLLMs possess broad common sense but lack the specialized visual reasoning required for complex lesions, whereas traditional segmentation models excel at pixel-level segmentation but lack logical interpretability. In this paper, we introduce ComLesion-14K, the first diverse Chain-of-Thought (CoT) benchmark for reasoning-driven complex lesion segmentation. To accomplish this task, we propose CORE-Seg, an end-to-end framework integrating reasoning with segmentation through a Semantic-Guided Prompt Adapter. We design a progressive training strategy from SFT to GRPO, equipped with an adaptive dual-granularity reward mechanism to mitigate reward sparsity. Our Method achieves state-of-the-art results with a mean Dice of 37.06\% (14.89\% higher than the second-best baseline), while reducing the failure rate to 18.42\%. Project Page: https://xyxl024.github.io/CORE-Seg.github.io/
format Preprint
id arxiv_https___arxiv_org_abs_2603_05911
institution arXiv
publishDate 2026
record_format arxiv
spellingShingle CORE-Seg: Reasoning-Driven Segmentation for Complex Lesions via Reinforcement Learning
Xie, Yuxin
Chen, Yuming
Yang, Yishan
Zhou, Yi
Zhou, Tao
Zhao, Zhen
Liu, Jiacheng
Fu, Huazhu
Computer Vision and Pattern Recognition
Artificial Intelligence
Medical image segmentation is undergoing a paradigm shift from conventional visual pattern matching to cognitive reasoning analysis. Although Multimodal Large Language Models (MLLMs) have shown promise in integrating linguistic and visual knowledge, significant gaps remain: existing general MLLMs possess broad common sense but lack the specialized visual reasoning required for complex lesions, whereas traditional segmentation models excel at pixel-level segmentation but lack logical interpretability. In this paper, we introduce ComLesion-14K, the first diverse Chain-of-Thought (CoT) benchmark for reasoning-driven complex lesion segmentation. To accomplish this task, we propose CORE-Seg, an end-to-end framework integrating reasoning with segmentation through a Semantic-Guided Prompt Adapter. We design a progressive training strategy from SFT to GRPO, equipped with an adaptive dual-granularity reward mechanism to mitigate reward sparsity. Our Method achieves state-of-the-art results with a mean Dice of 37.06\% (14.89\% higher than the second-best baseline), while reducing the failure rate to 18.42\%. Project Page: https://xyxl024.github.io/CORE-Seg.github.io/
title CORE-Seg: Reasoning-Driven Segmentation for Complex Lesions via Reinforcement Learning
topic Computer Vision and Pattern Recognition
Artificial Intelligence
url https://arxiv.org/abs/2603.05911