TabiMed: Tabularizing Medical Images for Few-Shot In-Context Diagnosis

Achieving accurate predictions with limited samples is a key challenge in biomedical image artificial intelligence. Previous methods rely on pre-trained image foundation models with supervised fine-tuning (SFT) or zero-shot inference to enhance small-data performance. However, SFT is time-consuming and prone to overfitting, whereas zero-shot inference fails to fully exploit available data. Inspired by recent tabular foundation models, which show superior performance on small-sample tasks with in-context learning (ICL), we propose TabiMed, a novel framework that transforms visual representations into structured tabular data, leveraging pre-trained tabular models for fast and accurate analysis on small data. TabiMed consists of three key components: dynamic modality-aware representation engine, tabularization adapter and in-context inference module. Experiments on 10 datasets from different fields demonstrate three major advantages of TabiMed: 1) excellent performance on small datasets, with an average AUC of 14.1% higher than zero-shot; 2) high efficiency, with a training time 250x faster than SFT; 3) scalability to larger datasets through our tabularization adapter. TabiMed proposes a novel pathway to address the challenges of analyzing biomedical images with few samples.