Multimodal Causal-Driven Representation Learning for Generalizable Medical Image Segmentation

Vision-Language Models (VLMs), such as CLIP, have demonstrated remarkable zero-shot capabilities in various computer vision tasks. However, their application to medical imaging remains challenging due to the high variability and complexity of medical data. Specifically, medical images often exhibit significant domain shifts caused by various confounders, including equipment differences, procedure artifacts, and imaging modes, which can lead to poor generalization when models are applied to unseen domains. To address this limitation, we propose Multimodal Causal-Driven Representation Learning (MCDRL), a novel framework that integrates causal inference with the VLM to tackle domain generalization in medical image segmentation. MCDRL is implemented in two steps: first, it leverages CLIP's cross-modal capabilities to identify candidate lesion regions and construct a confounder dictionary through text prompts, specifically designed to represent domain-specific variations; second, it trains a causal intervention network that utilizes this dictionary to identify and eliminate the influence of these domain-specific variations while preserving the anatomical structural information critical for segmentation tasks. Extensive experiments demonstrate that MCDRL consistently outperforms competing methods, yielding superior segmentation accuracy and exhibiting robust generalizability.

Bayesian Test-Time Adaptation for Vision-Language Models

Test-time adaptation with pre-trained vision-language models, such as CLIP, aims to adapt the model to new, potentially out-of-distribution test data. Existing methods calculate the similarity between visual embedding and learnable class embeddings, which are initialized by text embeddings, for zero-shot image classification. In this work, we first analyze this process based on Bayes theorem, and observe that the core factors influencing the final prediction are the likelihood and the prior. However, existing methods essentially focus on adapting class embeddings to adapt likelihood, but they often ignore the importance of prior. To address this gap, we propose a novel approach, \textbf{B}ayesian \textbf{C}lass \textbf{A}daptation (BCA), which in addition to continuously updating class embeddings to adapt likelihood, also uses the posterior of incoming samples to continuously update the prior for each class embedding. This dual updating mechanism allows the model to better adapt to distribution shifts and achieve higher prediction accuracy. Our method not only surpasses existing approaches in terms of performance metrics but also maintains superior inference rates and memory usage, making it highly efficient and practical for real-world applications.