RandP: Effective and Efficient Medical Visual In-Context Learning via a Retrieve-and-Propagate Module for Prompt-Query Fusion

Published: 14 Feb 2026, Last Modified: 25 Apr 2026MIDL 2026 PosterEveryoneRevisionsBibTeXCC BY 4.0
Keywords: Medical imaging; Visual In-Context-Learning
TL;DR: A new framework for medical visual In-Context-Learning
Abstract: Visual In-Context Learning (ICL) has emerged as a promising paradigm for constructing vision generalists by conditioning on prompt pairs. Existing visual ICL methods typically adopt a grid-like prompt-query construction combined with Masked Image Modeling (MIM) as the training strategy. However, directly applying these frameworks to medical imaging tasks often leads to suboptimal performance. Moreover, the reliance on MIM restricts the backbone to Vision Transformer (ViT) and introduces unnecessary computational overhead due to the need to reconstruct the prompt label. In this work, we revisit previous visual ICL paradigms for medical imaging and propose a training-inference aligned masking strategy to replace MIM. We further introduce a Retrieve-and-Propagate (RandP) module to enhance prompt-query fusion under this masking scheme. Experimental results show that our RandP visual ICL framework not only doubles the inference speed compared to prior visual ICL baselines but also achieves superior performance across multiple medical imaging tasks. Furthermore, unlike previous approaches constrained to vanilla ViT, our framework is compatible with U-Net-style architectures, enabling broader applicability and improved effectiveness in the medical imaging domain. Our code will be available.
Primary Subject Area: Application: Other
Secondary Subject Area: Segmentation
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