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

arXiv:2608.11335v1 Announce Type: new Abstract: 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.

SourcearXiv Computer VisionAuthor: Md Maklachur Rahman, Tracy Hammond

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[Submitted on 11 Aug 2026]

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

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Abstract: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: this https URL.

Comments: Accepted at MICCAI 2026 (Main). Final version to appear in the MICCAI 2026 proceedings

Subjects:

Computer Vision and Pattern Recognition (cs.CV); Artificial Intelligence (cs.AI); Image and Video Processing (eess.IV)

Cite as: arXiv:2608.11335 [cs.CV]

(or arXiv:2608.11335v1 [cs.CV] for this version)

https://doi.org/10.48550/arXiv.2608.11335

arXiv-issued DOI via DataCite (pending registration)

Submission history

From: Md Maklachur Rahman [view email] [v1] Tue, 11 Aug 2026 18:40:52 UTC (13,354 KB)

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