Characterizing Text Branch Sensitivity in Medical Vision-Language Segmentation via Evidence Decoupling — Paper

Abstract

Pretrained vision-language models (VLMs) have shown promising performance in medical image segmentation by incorporating clinical text. However, it remains unclear how much textual information actually contributes to pixel-level predictions. In this work, we systematically investigate the role of text in multimodal medical image segmentation. We first analyze several commonly used fusion strategies and find that segmentation performance is largely insensitive to the choice of fusion module. To further understand modality interactions, we propose an Evidence Decoupling Decoder (EDD) based on evidential deep learning and deep supervision. EDD serves as an internal representation analysis tool that decomposes image evidence and text-modulated evidence throughout the decoding process while maintaining competitive segmentation performance. Experimental results show that the sensitivity to text perturbation varies substantially across datasets. On BUSI and BTMRI, removing text causes catastrophic performance drops, indicating strong model reliance on textual input. On ISIC and Kvasir-SEG, text exerts relatively marginal influence. We further find that text affects predictions mainly through global semantic modulation rather than independent spatial localization, and that the specific semantic components driving text sensitivity differ across datasets. These findings provide a deeper understanding of modality interaction in multimodal medical image segmentation and offer practical insights for future model design.

Authors 3

Ziquan Liu, Zhewei Zhu, Xuyang Shi

Specification

Official page: arxiv.org/abs/2609.02663
Source:arXiv (Atom API + RSS)T1observed 2 h agohigh
Arxiv announce type: cross
Source:arXiv (Atom API + RSS)T1observed 2 h agohigh
arXiv id: 2609.02663
Source:arXiv (Atom API + RSS)T1observed 2 h agohigh
Categories: cs.CV, cs.AI
Source:arXiv (Atom API + RSS)T1observed 2 h agohigh
PDF: arxiv.org/pdf/2609.02663
Source:arXiv (Atom API + RSS)T1observed 2 h agohigh
Primary category: cs.CV
Source:arXiv (Atom API + RSS)T1observed 2 h agohigh
Published: 11 Sept 2026
Source:arXiv (Atom API + RSS)T1observed 2 h agohigh

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Authors: Ziquan Liu, Zhewei Zhu, Xuyang Shi

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Value	Valid from → to	Status	Source	Confidence	Extractor
https://arxiv.org/pdf/2609.02663	11 Sept 2026 21:03 UTC → current	current	arXiv (Atom API + RSS)T1	high	deterministic

Claims are temporal and append-only: a new observation closes the previous claim (valid_to) instead of overwriting it. Conflicting claims from different sources are kept side by side and flagged — never averaged. Methodology →

11 Sept 2026
New paperPaperCharacterizing Text Branch Sensitivity in Medical Vision-Language Segmentation via Evidence Decoupling
New paper: Characterizing Text Branch Sensitivity in Medical Vision-Language Segmentation via Evidence Decoupling
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arXiv (Atom API + RSS)	rss.arxiv.org/rss/cs.AI	feed	T1· Official	2 h ago	1

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