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Towards Segment Anything Model (SAM) for Medical Image Segmentation: A Survey (2305.03678v3)

Published 5 May 2023 in eess.IV and cs.CV

Abstract: Due to the flexibility of prompting, foundation models have become the dominant force in the domains of natural language processing and image generation. With the recent introduction of the Segment Anything Model (SAM), the prompt-driven paradigm has entered the realm of image segmentation, bringing with a range of previously unexplored capabilities. However, it remains unclear whether it can be applicable to medical image segmentation due to the significant differences between natural images and medical images.In this work, we summarize recent efforts to extend the success of SAM to medical image segmentation tasks, including both empirical benchmarking and methodological adaptations, and discuss potential future directions for SAM in medical image segmentation. Although directly applying SAM to medical image segmentation cannot obtain satisfying performance on multi-modal and multi-target medical datasets, many insights are drawn to guide future research to develop foundation models for medical image analysis. To facilitate future research, we maintain an active repository that contains up-to-date paper list and open-source project summary at https://github.com/YichiZhang98/SAM4MIS.

Towards Segment Anything Model (SAM) for Medical Image Segmentation: A Survey

The paper by Yichi Zhang et al. discusses the potential and challenges of applying the Segment Anything Model (SAM) to medical image segmentation. It acknowledges the flexibility of prompting by foundational models as a pivotal advancement in both natural language processing and image generation. The introduction of SAM has brought this innovative paradigm into image segmentation, presenting new capabilities that have yet to be fully realized in medical contexts.

Background and Model Overview

Foundation models, exemplified by the Segment Anything Model, are designed to generalize across various tasks leveraging significant pre-training on diverse datasets. SAM, specifically, has shown proficiency in general image segmentation through its transformer-based architecture, trained on the extensive SA-1B dataset. However, translating this success into the medical domain is challenged by the intrinsic differences between natural and medical imagery, such as modality specificity and object granularity.

Performance on Medical Image Segmentation

Zhang et al. provide a comprehensive review of SAM's application in the medical field, rigorously examining its performance across multiple datasets and modalities, including CT, MRI, and pathology images. The results underscore SAM's inconsistency, particularly in medical images where objects may have ambiguous boundaries and varying scales. For instance, SAM demonstrates competent performance in scenarios with clear object delineations but struggles in complex cases such as tumor segmentation where boundaries are subtle.

Adaptations and Enhancements

Acknowledging SAM's limitations in direct applications, the paper explores adaptations that could enhance its medical applicability. These include:

  • Fine-Tuning Approaches: Several methods are explored, focusing on updating minimal parameters rather than comprehensive retraining. This includes strategies like prompt-specific adjustments and employing transformer blocks to adapt SAM efficiently to medical image characteristics.
  • Prompt Strategy Optimization: The investigation extends into strategic prompt utilization to cope with SAM’s sensitivity to input prompts. Techniques such as leveraging point and box prompts are evaluated, revealing that box prompts often yield superior results.
  • Automated and Hybrid Prompting: Innovations to transform SAM into a fully automated system through auxiliary networks are explored. Such methods aim to reduce the dependency on manual interaction, thus improving efficiency in a clinical context.

Challenges and Implications

Despite these advancements, substantial challenges persist. The paper highlights areas such as the need for large-scale domain-specific medical datasets and the potential integration of additional clinical knowledge to improve context-specific segmentation reliability. Furthermore, transitioning SAM’s capabilities from 2D to 3D imaging is another critical frontier, which offers significant promise given the volumetric nature of many medical imaging tasks.

Conclusion and Future Directions

Zhang et al. emphasize that while SAM’s current performance may not outshine specialized models in all respects, its foundational strength and adaptability suggest a pivotal role in the future landscape of medical image segmentation. The discussion illuminates promising pathways towards integrating SAM within medical workflows, enhancing not just segmentation tasks but overall clinical decision support systems.

This assessment encapsulates the SAM's state within medical segmentation, fostering a nuanced understanding of its potential roles and forthcoming innovations in medical AI applications.

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Authors (2)
  1. Yichi Zhang (184 papers)
  2. Rushi Jiao (4 papers)
Citations (17)