We introduce a novel uncertainty-aware multimodal segmentation framework that leverages both radiological images and associated clinical text for precise medical diagnosis. We propose a Modality Decoding Attention Block (MoDAB) with a lightweight State Space Mixer (SSMix) to enable efficient cross-modal fusion and long-range dependency modelling. To guide learning under ambiguity, we propose the Spectral-Entropic Uncertainty (SEU) Loss, which jointly captures spatial overlap, spectral consistency, and predictive uncertainty in a unified objective. In complex clinical circumstances with poor image quality, this formulation improves model reliability. Extensive experiments on various publicly available medical datasets, QATA-COVID19, MosMed++, and Kvasir-SEG, demonstrate that our method achieves superior segmentation performance while being significantly more computationally efficient than existing State-of-the-Art (SoTA) approaches. Our results highlight the importance of incorporating uncertainty modelling and structured modality alignment in vision-language medical segmentation tasks. Code: https://github.com/arya-domain/UA-VLS
@article{arxiv.2602.14498,
title = {Uncertainty-Aware Vision-Language Segmentation for Medical Imaging},
author = {Aryan Das and Tanishq Rachamalla and Koushik Biswas and Swalpa Kumar Roy and Vinay Kumar Verma},
journal= {arXiv preprint arXiv:2602.14498},
year = {2026}
}