SD-MAD: Sign-Driven Few-shot Multi-Anomaly Detection in Medical Images
Kaiyu Guo, Tan Pan, Chen Jiang, Zijian Wang, Brian C. Lovell, Limei Han, Yuan Cheng, Mahsa Baktashmotlagh

TL;DR
SD-MAD is a novel framework for few-shot medical image anomaly detection that leverages radiological signs and large-language models to identify multiple anomaly categories effectively.
Contribution
The paper introduces SD-MAD, a two-stage sign-driven framework that aligns radiological signs with anomalies and employs automatic sign selection, addressing multi-anomaly detection in few-shot medical imaging.
Findings
Effective multi-anomaly detection demonstrated in experiments
Outperforms existing few-shot medical AD methods
Robustness to limited data scenarios
Abstract
Medical anomaly detection (AD) is crucial for early clinical intervention, yet it faces challenges due to limited access to high-quality medical imaging data, caused by privacy concerns and data silos. Few-shot learning has emerged as a promising approach to alleviate these limitations by leveraging the large-scale prior knowledge embedded in vision-language models (VLMs). Recent advancements in few-shot medical AD have treated normal and abnormal cases as a one-class classification problem, often overlooking the distinction among multiple anomaly categories. Thus, in this paper, we propose a framework tailored for few-shot medical anomaly detection in the scenario where the identification of multiple anomaly categories is required. To capture the detailed radiological signs of medical anomaly categories, our framework incorporates diverse textual descriptions for each category…
Peer Reviews
Decision·Submitted to ICLR 2026
1. The paper proposes a few-shot anomaly detection model that can inherently handle multiple anomaly classes within a single framework. By aligning radiological signs with anomaly categories, the method introduces a novel and innovative approach. 2. Experiments conducted across multiple evaluation metrics demonstrate strong and consistent performance gains over baseline methods such as vanilla CLIP, highlighting the effectiveness of the proposed approach. The provided visualizations further cor
1. The methodology section contains a relatively large number of mathematical formulations, yet several key equations and symbols are insufficiently explained. Clearer definitions and intuitive interpretations would improve readability and reproducibility. 2. The paper devotes substantial space to the Sign Selection process during inference; however, this component appears to have a limited positive effect in certain experiments. The authors should analyze and discuss potential reasons behind t
1.The paper is well written and organized, with clear diagrams (Fig. 1–3) and detailed appendices. 2.It defines and benchmarks few-shot multi-anomaly detection in medical AD area.
1.Only limited baseline (CLIP and MedCLIP) are compared. 2.The framework relies heavily on manually designed textual signs to represent anomaly semantics. It may make the system sensitive to the quality and accuracy of these textual descriptions. In practice, such signs may contain noise, redundancy, or mismatched terminology relative to the specific medical domain or dataset. When the textual prompts do not align well with the actual imaging characteristics, the performance of SD-MAD may degra
- Incorporating radiological sign descriptions into visual-language alignment is an interesting idea. - The few-shot multi-label formulation is practically relevant for real-world medical datasets.
- The work is not anomaly detection but closed-set multi-label classification. The method assumes all anomaly labels are known during training and requires per-class support images. It does not detect abnormality in an open-set or unsupervised manner, which is the central definition of anomaly detection. The title and claims are therefore misleading. - No open-set or unseen-class evaluation. There is no experiment for detecting unseen anomaly types. In real clinical anomaly detection, new or rar
Videos
No videos yet. Explain this paper in a talk, walkthrough, or lecture? Add one.
Taxonomy
TopicsAnomaly Detection Techniques and Applications · Domain Adaptation and Few-Shot Learning · COVID-19 diagnosis using AI
