RADIOlogy: A Single-Pass Approach to Training-Free Zero-Shot Anomaly Detection

Current zero-shot anomaly detection methods often rely on complex prompt-learning techniques or computationally expensive sliding-window strategies to achieve fine-grained visual alignment to detect small-scale anomalies. This reliance stems from the fundamental limitation of standard CLIP architectures, where [CLS] token attention and spatial patch pooling struggle to capture subtle, localized anomaly features. While prompt-learning approaches aim to bridge this gap, they typically require a large number of ground-truth segmentation masks from auxiliary datasets, which are often unavailable in specialized domains. In this work, we show an emerging property of multi-head attention pooling in vision-language models: remarkable zero-shot anomaly localization and detection right out of the box. We translate this property into a single-pass anomaly detection technique, RADIOlogy, that does not require dense, windowed execution and significantly outperforms other training-free baselines. Instead, the method relies on a simple contrastive scoring approach that compares the average similarity between vision features and a suite of normal and abnormal prompts. Furthermore, we leverage the agglomerative features of RADIO models to enhance pixel-level anomaly segmentation using a dense anomaly refinement pipeline. Finally, we show how the vision-language family of training-free zero-shot anomaly detection techniques can be applied successfully to the medical domain with minimal modifications. Code is available at https://github.com/jacomof/RADIOlogy.