Knowledge to Sight: Reasoning over Visual Attributes via Knowledge Decomposition for Abnormality Grounding
This addresses the challenge of rare and domain-specific terms in medical imaging for clinicians, offering a more resource-efficient solution, though it is incremental as it builds on existing vision-language models with structured supervision.
The paper tackles the problem of grounding abnormalities in medical images by localizing clinical findings from text, proposing a framework that decomposes clinical concepts into visual attributes to enable data-efficient training of compact models, achieving performance comparable to or better than larger models with up to 9.82% improvement in mAP50 using only 1.5% of the data.
In this work, we address the problem of grounding abnormalities in medical images, where the goal is to localize clinical findings based on textual descriptions. While generalist Vision-Language Models (VLMs) excel in natural grounding tasks, they often struggle in the medical domain due to rare, compositional, and domain-specific terms that are poorly aligned with visual patterns. Specialized medical VLMs address this challenge via large-scale domain pretraining, but at the cost of substantial annotation and computational resources. To overcome these limitations, we propose \textbf{Knowledge to Sight (K2Sight)}, a framework that introduces structured semantic supervision by decomposing clinical concepts into interpretable visual attributes, such as shape, density, and anatomical location. These attributes are distilled from domain ontologies and encoded into concise instruction-style prompts, which guide region-text alignment during training. Unlike conventional report-level supervision, our approach explicitly bridges domain knowledge and spatial structure, enabling data-efficient training of compact models. We train compact models with 0.23B and 2B parameters using only 1.5\% of the data required by state-of-the-art medical VLMs. Despite their small size and limited training data, these models achieve performance on par with or better than 7B+ medical VLMs, with up to 9.82\% improvement in $mAP_{50}$. Code and models: \href{https://lijunrio.github.io/K2Sight/}{\textcolor{SOTAPink}{https://lijunrio.github.io/K2Sight/}}.