TMLR Journal 2026 Journal Article
Contrastive VQ Priors for Multi-Class Plaque Segmentation via SAM Adaptation
- Ruan Yizhe
- Yusuke Kurose
- JUNICHI IHO
- Yoji Tokunaga
- Makoto Horie
- YUSAKU HAYASHI
- Keisuke Nishizawa
- Yasushi Koyama
Accurate plaque subtype segmentation in coronary CT angiography (CCTA) is clinically relevant yet remains difficult in practice, where annotations are scarce, and the visual evidence for non-calcified lesions is subtle and highly variable. Meanwhile, segmentation foundation models such as SAM provide strong robustness from large-scale pretraining, but their benefits do not reliably transfer to private CCTA tasks under naïve fine-tuning, especially for multi-class plaque taxonomy. We present a targeted strategy to transfer SAM's segmentation robustness to a private CCTA setting by injecting a task-specific, texture-aware prior into the SAM feature stream. Our framework is two-stage: (i) we learn a discrete latent prior from the private CCTA data using a vector-quantized autoencoder, and structure it with supervised contrastive learning to emphasize hard class boundaries; (ii) we fuse this prior into a SAM-based encoder through a query-based feature-aware cross-attention module, and decode with a multi-class head/decoder tailored for plaque taxonomy. On this private CCTA cohort, the proposed design improves overall performance over the compared baselines, with the largest gains on vessel wall and non-calcified plaque. Ablations suggest that the class-structured prior, query-based fusion, and multi-class decoding each contribute to the final result within this setting.