DINO-Med3D: Bridging Dimension and Domain Gaps in Volumetric Segmentation via Progressive Adaptation

Although DINOv3 has demonstrated remarkable semantic discrimination in natural imagery, its direct application to volumetric medical segmentation is hindered by inherent dimension and domain disparities. To resolve these issues, we propose DINO-Med3D, a two-stage progressive framework that repurpose the pre-trained DINOv3 encoder for 3D medical tasks. In the first stage, we mitigate the dimension gap by introducing a multi-slice embedding module that incorporates pseudo-3D context, while simultaneously employing a segmentation proxy task to adapt representations learned from natural scenes to the medical domain. Subsequently, we further enhance volumetric understanding by adding lightweight 3D adapters into the frozen backbone to enforce global inter-slice continuity. Finally, to compensate for the spatial information loss inherent in the embedding process, we design a parallel detail recovery stream to explicitly preserve high-frequency boundary cues. Extensive experiments on five public datasets demonstrate that our approach successfully adapts DINOv3 to the medical domain and significantly outperforms state-of-the-art baselines.