CausalCLIPSeg: Unlocking CLIP's Potential in Referring Medical Image Segmentation with Causal Intervention

Referring medical image segmentation targets delineating lesions indicated by textual descriptions. Aligning visual and textual cues is challenging due to their distinct data properties. Inspired by large-scale pre-trained vision-language models, we propose CausalCLIPSeg, an end-to-end framework for referring medical image segmentation that leverages CLIP. Despite not being trained on medical data, we enforce CLIP's rich semantic space onto the medical domain by a tailored cross-modal decoding method to achieve text-to-pixel alignment. Furthermore, to mitigate confounding bias that may cause the model to learn spurious correlations instead of meaningful causal relationships, CausalCLIPSeg introduces a causal intervention module which self-annotates confounders and excavates causal features from inputs for segmentation judgments. We also devise an adversarial min-max game to optimize causal features while penalizing confounding ones. Extensive experiments demonstrate the state-of-the-art performance of our proposed method. Code is available atthis https URL.

@article{chen2025_2503.15949,
  title={ CausalCLIPSeg: Unlocking CLIP's Potential in Referring Medical Image Segmentation with Causal Intervention },
  author={ Yaxiong Chen and Minghong Wei and Zixuan Zheng and Jingliang Hu and Yilei Shi and Shengwu Xiong and Xiao Xiang Zhu and Lichao Mou },
  journal={arXiv preprint arXiv:2503.15949},
  year={ 2025 }
}