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Text-Image Co-Alignment for Weakly Supervised Polyp Segmentation
IEEE Transactions on Medical Imaging
|March 17, 2026
Summary
This study introduces Text-Image Co-Alignment (TICoA) for polyp segmentation, using large language models for weak supervision. TICoA achieves competitive performance, reducing the need for extensive manual annotations in medical imaging.
Area of Science:
- Medical image analysis
- Computer vision
- Artificial intelligence in healthcare
Background:
- Fully supervised polyp segmentation requires expensive pixel-level annotations.
- Existing semi- and weakly supervised methods still need partial mask supervision.
- Text-supervised segmentation offers a promising alternative but faces challenges in precise phrase-region grounding for polyps.
Purpose of the Study:
- To develop a text-supervised framework for accurate polyp segmentation.
- To leverage large language models (LLMs) for generating weak supervision from clinical descriptions.
- To address the challenge of grounding instance-specific phrases to correct polyp regions.
Main Methods:
- Proposed Text-Image Co-Alignment (TICoA) framework for text-supervised polyp segmentation.
- Utilized LLM-generated structured clinical descriptions as weak supervision.
- Employed contrastive learning for explicit phrase-region association and a State-Space Model (Mamba) with a Mamba Fusion module and Bi-Dimension Fusion (BiDF) for efficient modeling of long-range dependencies and cross-modal interaction.
Main Results:
- TICoA demonstrates competitive performance compared to state-of-the-art weakly supervised methods on polyp segmentation tasks.
- Validation on skin lesion segmentation datasets further supports the framework's effectiveness.
- The proposed Mamba-based architecture efficiently handles long-range dependencies and cross-modal fusion.
Conclusions:
- Text-Image Co-Alignment (TICoA) provides an effective text-supervised approach for polyp segmentation.
- The framework successfully grounds textual descriptions to image regions, reducing reliance on manual annotations.
- TICoA shows promise for advancing automated analysis in medical imaging, with potential applications beyond polyp segmentation.

