UniPro: Unified Multi-Mode Medical Image Segmentation from 2D Images to 3D Volumes via Propagation
Bangwei Guo, Yunhe Gao, Meng Ye, Yang Zhou, Difei Gu, Guoning Zhang, Leon Axel, Dimitris Metaxas
Medical image segmentation remains fragmented along two axes: segmentation paradigms and data dimensionality. Existing methods are typically developed separately for semantic, in-context, and interactive segmentation, and are further specialized to either native 2D images or 3D volumetric data. In clinical practice, however, segmentation workflows take many forms: a case may be initialized by semantic prediction, reference-guided segmentation, or user interaction. Regardless of how it begins, fine-grained refinement is naturally performed on 2D views; for volumetric scans, such 2D edits must propagate coherently to the rest of the volume. We present UniPro, a unified model that bridges segmentation paradigms and data dimensionality, using propagation to extend 2D segmentation to 3D volumes. Our key insight is that volumetric propagation and in-context segmentation share the same reference-conditioned prediction mechanism, differing only in whether the reference image-mask pairs come from other cases or from previously segmented neighboring slices. Building on this view, UniPro supports semantic, in-context, interactive, and propagation-based segmentation within a single slice-based framework, using class priors, reference exemplars, user clicks, and neighboring-slice predictions as mode-specific conditioning inputs. To improve propagation reliability, UniPro further incorporates bidirectional and 3D supervision to regularize slice-wise propagation beyond per-slice losses. Extensive experiments across diverse modalities and anatomies show that UniPro achieves strong performance across all segmentation settings, enabling annotation-efficient 3D segmentation from sparse 2D initialization and reducing slice-by-slice correction effort.
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