Comprehensive language-image pre-training for 3D medical image understanding

Tassilo Wald, Ibrahim Ethem Hamamci, Yuan Gao, Sam Bond-Taylor, Harshita Sharma +11 more
10/16/2025
cs.CVcs.LG

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Abstract

Vision-language pre-training, i.e., aligning images with paired text, is a powerful paradigm to create encoders that can be directly used for tasks such as classification, retrieval, and segmentation. In the 3D medical image domain, these capabilities allow vision-language encoders (VLEs) to support radiologists by retrieving patients with similar abnormalities, predicting likelihoods of abnormality, or, with downstream adaptation, generating radiological reports. While the methodology holds promise, data availability and domain-specific hurdles limit the capabilities of current 3D VLEs. In this paper, we overcome these challenges by injecting additional supervision via a report generation objective and combining vision-language with vision-only pre-training. This allows us to leverage both image-only and paired image-text 3D datasets, increasing the total amount of data to which our model is exposed. Through these additional objectives, paired with best practices of the 3D medical imaging domain, we develop the Comprehensive Language-Image Pre-training (COLIPRI) encoder family. Our COLIPRI encoders achieve state-of-the-art performance in report generation, semantic segmentation, classification probing, and zero-shot classification. The model is available at https://huggingface.co/microsoft/colipri.

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Cite this paper

@article{wald2025comprehensive,
  title  = {Comprehensive language-image pre-training for 3D medical image understanding},
  author = {Tassilo Wald and Ibrahim Ethem Hamamci and Yuan Gao and Sam Bond-Taylor and Harshita Sharma and Maximilian Ilse and Cynthia Lo and Olesya Melnichenko and Anton Schwaighofer and Noel C. F. Codella and Maria Teodora Wetscherek and Klaus H. Maier-Hein and Panagiotis Korfiatis and Valentina Salvatelli and Javier Alvarez-Valle and Fernando Pérez-García},
  year   = {2025},
  eprint = {2510.15042},
  archivePrefix = {arXiv},
  url    = {http://arxiv.org/abs/2510.15042v2}
}

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