STAIL: Semantic Text-Anchored Incremental Learning for Medical Imaging via Large Language Models

Deep learning models applied to medical image analysis suffer from severe catastrophic forgetting when continually adapting to new clinical tasks in dynamic environments. Mainstream incremental learning methods typically mitigate this by rehearsing raw historical images. However, this pixel-level rehearsal incurs significant storage overhead, raises privacy concerns, and fails to adequately capture the true data distribution with sparse exemplars. Inspired by human cognitive mechanisms, we propose a novel framework termed Semantic Text-Anchored Incremental Learning (STAIL) for sequential clinical tasks. To overcome the rehearsal bottleneck, STAIL introduces an asymmetric semantic consolidation buffer (SCB). By incorporating a minimal set of image anchors and extensive textual descriptions, the SCB enables dense semantic reconstruction of old tasks at a minimal storage cost. Furthermore, we design an LLM-derived Semantic Anchoring Mechanism (LSAM) that leverages the stable semantic space of frozen large language models as developmental priors. This mechanism explicitly anchors evolving visual features to textual representations, guiding and constraining plasticity and stability at both macroscopic and microscopic levels. Extensive experiments across three heterogeneous medical datasets, covering fundus, ultrasound, and X-ray imaging, demonstrate that STAIL acts as a highly effective plug-and-play module. It comprehensively enhances the performance of various existing baselines, achieving average gains of 2.24\% in AAA-AUC for sustained performance and 3.55\% in BWT-AUC for reduced forgetting. Code is available.

Anatomically Consistent TMJ Disc Segmentation via Semantic Anchoring and Clinical Priors

Segmenting the temporomandibular joint (TMJ) disc from MRI is essential for accurate diagnosis of internal derangement, yet it remains unreliable in practice due to its small size, low contrast, and morphological variability. Existing methods, primarily adapted from general segmentation architectures, often produce fragmented or anatomically inconsistent masks, leading to unstable measurements of disc position and shape for downstream diagnosis. To address these challenges, we propose TISC, a TMJ disc segmentation framework that integrates semantic anchoring with clinical metadata-guided boundary refinement. The framework first establishes robust disc localization in the foundation model feature space via a Prototypical Semantic Anchoring (PSA) module that aggregates adjacent-slice MedDINOv3 features and derives a prototype-driven similarity map. It then performs targeted boundary refinement through a Clinical-Metadata Point Refinement (C-MPR) module, with point-wise predictions modulated by Mouth Open Limitation (MOL), a clinical indicator associated with disc displacement without reduction. On a large-scale cohort of 2,488 PD MRI volumes from 1,300 patients, our method achieves up to a 4.96 Dice improvement over strong baselines across diverse architectures, delivering more anatomically coherent and clinically reliable TMJ disc segmentation.