SAM on Medical Images: A Comprehensive Study on Three Prompt Modes
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Abstract (arXiv)
The Segment Anything Model (SAM) made an eye-catching debut recently and inspired many researchers to explore its potential and limitation in terms of zero-shot generalization capability. As the first promptable foundation model for segmentation tasks, it was trained on a large dataset with an unprecedented number of images and annotations. This large-scale dataset and its promptable nature endow the model with strong zero-shot generalization. Although the SAM has shown competitive performance on several datasets, we still want to investigate its zero-shot generalization on medical images. As we know, the acquisition of medical image annotation usually requires a lot of effort from professional practitioners. Therefore, if there exists a foundation model that can give high-quality mask prediction simply based on a few point prompts, this model will undoubtedly become the game changer for medical image analysis. To evaluate whether SAM has the potential to become the foundation model for medical image segmentation tasks, we collected more than 12 public medical image datasets that cover various organs and modalities. We also explore what kind of prompt can lead to the best zero-shot performance with different modalities. Furthermore, we find that a pattern shows that the perturbation of the box size will significantly change the prediction accuracy. Finally, Extensive experiments show that the predicted mask quality varied a lot among different datasets. And providing proper prompts, such as bounding boxes, to the SAM will significantly increase its performance.
Key facts. Cited by 82 papers in the map (data through 14 Oct 2026). Builds on 23 of its 36 references that are in the map. First posted on arXiv 28 Apr 2023.
Builds on
23 of 36 references.
References · 23
- 2023Segment Anythingcited by 8,234
- 2019Kvasir-SEG: A Segmented Polyp Datasetcited by 589
- 2023Segment Everything Everywhere All at Oncecited by 548
- 2019The Liver Tumor Segmentation Benchmark (LiTS)cited by 509
- 2020PraNet: Parallel Reverse Attention Network for Polyp Segmentationcited by 460
- 2023Segment Anything Model for Medical Image Analysis: an Experimental Studycited by 291
- 2023Inpaint Anything: Segment Anything Meets Image Inpaintingcited by 233
- 2016A Benchmark for Endoluminal Scene Segmentation of Colonoscopy Imagescited by 221
- 2023Segment Anything Model (SAM) for Digital Pathology: Assess Zero-shot Segmentation on Whole Slide Imagingcited by 161
- 2023Segment Anything Is Not Always Perfect: An Investigation of SAM on Different Real-world Applicationscited by 121
- 2023Can SAM Segment Anything? When SAM Meets Camouflaged Object Detectioncited by 100
- 2023Anything-3D: Towards Single-view Anything Reconstruction in the Wildcited by 92
11 more
- 2023Segment Anything in 3D with Radiance Fieldscited by 62
- 2023SAM.MD: Zero-shot medical image segmentation capabilities of the Segment Anything Modelcited by 61
- 2023Can SAM Segment Polyps?cited by 59
- 2023When SAM Meets Medical Images: An Investigation of Segment Anything Model (SAM) on Multi-phase Liver Tumor Segmentationcited by 52
- 2021COVID-19 Infection Localization and Severity Grading from Chest X-ray Imagescited by 46
- 2023SAMM (Segment Any Medical Model): A 3D Slicer Integration to SAMcited by 31
- 2022FUSeg: The Foot Ulcer Segmentation Challengecited by 22
- 2023Learnable Ophthalmology SAMcited by 21
- 2023Can SAM Count Anything? An Empirical Study on SAM Countingcited by 18
- 2023Any-to-Any Style Transfer: Making Picasso and Da Vinci Collaboratecited by 17
- 2023The Segment Anything foundation model achieves favorable brain tumor autosegmentation accuracy on MRI to support radiotherapy treatment planningcited by 15
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Citing papers per year: 2023: 32; 2024: 32; 2025: 13; 2026: 5.
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- 2023On the Challenges and Perspectives of Foundation Models for Medical Image Analysiscited by 135
- 2023SAM-Med2Dcited by 124
- 2023SAM-Med3D: Towards General-purpose Segmentation Models for Volumetric Medical Imagescited by 107
- 2023SurgicalSAM: Efficient Class Promptable Surgical Instrument Segmentationcited by 104
- 2024Segment Anything Model for Medical Image Segmentation: Current Applications and Future Directionscited by 97
- 2023Weakly-Supervised Concealed Object Segmentation with SAM-based Pseudo Labeling and Multi-scale Feature Groupingcited by 92
- 2023MA-SAM: Modality-agnostic SAM Adaptation for 3D Medical Image Segmentationcited by 82
- 20233DSAM-adapter: Holistic adaptation of SAM from 2D to 3D for promptable tumor segmentationcited by 70
- 2023A Comprehensive Survey on Segment Anything Model for Vision and Beyondcited by 64
- 2024Unleashing the Potential of SAM for Medical Adaptation via Hierarchical Decodingcited by 48
- 2023Annotation-free Audio-Visual Segmentationcited by 46
- 2023Are Natural Domain Foundation Models Useful for Medical Image Classification?cited by 46
38 more
- 2023A Survey on Segment Anything Model (SAM): Vision Foundation Model Meets Prompt Engineeringcited by 45
- 2024MedCLIP-SAMv2: Towards Universal Text-Driven Medical Image Segmentationcited by 39
- 2023Explain Any Concept: Segment Anything Meets Concept-Based Explanationcited by 37
- 2024Image Segmentation in Foundation Model Era: A Surveycited by 35
- 2023Artificial General Intelligence for Medical Imaging Analysiscited by 32
- 2024Foundation Models for Biomedical Image Segmentation: A Surveycited by 28
- 2023Deep Interactive Segmentation of Medical Images: A Systematic Review and Taxonomycited by 27
- 2024Data-Centric Foundation Models in Computational Healthcare: A Surveycited by 27
- 2024APSeg: Auto-Prompt Network for Cross-Domain Few-Shot Semantic Segmentationcited by 26
- 2023Towards Segment Anything Model (SAM) for Medical Image Segmentation: A Surveycited by 21
- 2024Interactive 3D Medical Image Segmentation with SAM 2cited by 17
- 2024SegmentAnyBone: A Universal Model that Segments Any Bone at Any Location on MRIcited by 14
- 2024Biomedical SAM 2: Segment Anything in Biomedical Images and Videoscited by 14
- 2023mathrmSAMMed: A medical image annotation framework based on large vision modelcited by 13
- 2023False Negative/Positive Control for SAM on Noisy Medical Imagescited by 12
- 2024SAM Fewshot Finetuning for Anatomical Segmentation in Medical Imagescited by 12
- 2023Temporally-Extended Prompts Optimization for SAM in Interactive Medical Image Segmentationcited by 9
- 2025Visual Instruction Pretraining for Domain-Specific Foundation Modelscited by 9
- 2023Enhancing the Reliability of Segment Anything Model for Auto-Prompting Medical Image Segmentation with Uncertainty Rectificationcited by 8
- 2023SurgicalPart-SAM: Part-to-Whole Collaborative Prompting for Surgical Instrument Segmentationcited by 8
- 2024RevSAM2: Prompt SAM2 for Medical Image Segmentation via Reverse-Propagation without Fine-tuningcited by 7
- 2024Curriculum Prompting Foundation Models for Medical Image Segmentationcited by 6
- 2024Swin-LiteMedSAM: A Lightweight Box-Based Segment Anything Model for Large-Scale Medical Image Datasetscited by 6
- 2025Bringing SAM to new heights: Leveraging elevation data for tree crown segmentation from drone imagerycited by 6
- 2023SAM-OCTA: Prompting Segment-Anything for OCTA Image Segmentationcited by 5
- 2023Assessing Test-time Variability for Interactive 3D Medical Image Segmentation with Diverse Point Promptscited by 5
- 2023AdapterShadow: Adapting Segment Anything Model for Shadow Detectioncited by 5
- 2024TV-SAM: Increasing Zero-Shot Segmentation Performance on Multimodal Medical Images Using GPT-4 Generated Descriptive Prompts Without Human Annotationcited by 5
- 2024A Federated Learning-Friendly Approach for Parameter-Efficient Fine-Tuning of SAM in 3D Segmentationcited by 5
- 2024SEG-SAM: Semantic-Guided SAM for Unified Medical Image Segmentationcited by 5
- 2025TextSAM-EUS: Text Prompt Learning for SAM to Accurately Segment Pancreatic Tumor in Endoscopic Ultrasoundcited by 5
- 2023Industrial Segment Anything -- a Case Study in Aircraft Manufacturing, Intralogistics, Maintenance, Repair, and Overhaulcited by 4
- 2023Exploring SAM Ablations for Enhancing Medical Segmentation in Radiology and Pathologycited by 4
- 2024SAVE: Segment Audio-Visual Easy way using Segment Anything Modelcited by 4
- 2024MCP-MedSAM: A Powerful Lightweight Medical Segment Anything Model Trained with a Single GPU in Just One Daycited by 4
- 2025Rethinking Few-Shot Medical Image Segmentation by SAM2: A Training-Free Framework with Augmentative Prompting and Dynamic Matchingcited by 4
- 2025Assessing SAM for Tree Crown Instance Segmentation from Drone Imagerycited by 4
- 2023Empirical Analysis of a Segmentation Foundation Model in Prostate Imagingcited by 3
50 most cited of 82 All 82 (JSON)
- 2026Quantifying Volumetric Risk: Class-Aware Asymmetric Weighted Conformal Prediction for 3D Medical Image Segmentation7 Oct 2026
- 2026When Adaptation Hurts: Connecting Representational Drift to OOD Failures in MedSAM Fine-Tuning21 Aug 2026
- 2026Learning from Noisy Prompts: Saliency-Guided Prompt Distillation for Robust Segmentation with SAM25 Apr 2026
- 2026Prompting Foundation Models for Zero-Shot Ship Instance Segmentation in SAR Imagery20 Apr 2026
- 2026Prompting with the human-touch: evaluating model-sensitivity of foundation models for musculoskeletal CT segmentation11 Mar 2026
- 2025OFL-SAM2: Prompt SAM2 with Online Few-shot Learner for Efficient Medical Image Segmentation31 Dec 2025
- 2025Granular Computing-driven SAM: From Coarse-to-Fine Guidance for Prompt-Free Segmentation24 Nov 2025
- 2025Continual Alignment for SAM: Rethinking Foundation Models for Medical Image Segmentation in Continual Learning21 Nov 2025
- 2025Visual Instruction Pretraining for Domain-Specific Foundation Models22 Sep 2025
- 2025SAM-DCE: Addressing Token Uniformity and Semantic Over-Smoothing in Medical Segmentation21 Sep 2025
- 2025TextSAM-EUS: Text Prompt Learning for SAM to Accurately Segment Pancreatic Tumor in Endoscopic Ultrasound24 Jul 2025
- 2025Prompt Mechanisms in Medical Imaging: A Comprehensive Survey28 Jun 2025
38 more
- 2025SAM-aware Test-time Adaptation for Universal Medical Image Segmentation5 Jun 2025
- 2025Bringing SAM to new heights: Leveraging elevation data for tree crown segmentation from drone imagery5 Jun 2025
- 2025MAIS: Memory-Attention for Interactive Segmentation12 May 2025
- 2025Assessing SAM for Tree Crown Instance Segmentation from Drone Imagery26 Mar 2025
- 2025SALT: Parameter-Efficient Fine-Tuning via Singular Value Adaptation with Low-Rank Transformation20 Mar 2025
- 2025Rethinking Few-Shot Medical Image Segmentation by SAM2: A Training-Free Framework with Augmentative Prompting and Dynamic Matching5 Mar 2025
- 2024SEG-SAM: Semantic-Guided SAM for Unified Medical Image Segmentation17 Dec 2024
- 2024MCP-MedSAM: A Powerful Lightweight Medical Segment Anything Model Trained with a Single GPU in Just One Day8 Dec 2024
- 2024Adaptive Interactive Segmentation for Multimodal Medical Imaging via Selection Engine29 Nov 2024
- 2024Foundation AI Model for Medical Image Segmentation5 Nov 2024
- 2024EP-SAM: Weakly Supervised Histopathology Segmentation via Enhanced Prompt with Segment Anything17 Oct 2024
- 2024Fundus to Fluorescein Angiography Video Generation as a Retinal Generative Foundation Model17 Oct 2024
- 2024Universal Medical Image Representation Learning with Compositional Decoders30 Sep 2024
- 2024MedCLIP-SAMv2: Towards Universal Text-Driven Medical Image Segmentation28 Sep 2024
- 2024Swin-LiteMedSAM: A Lightweight Box-Based Segment Anything Model for Large-Scale Medical Image Datasets11 Sep 2024
- 2024RevSAM2: Prompt SAM2 for Medical Image Segmentation via Reverse-Propagation without Fine-tuning6 Sep 2024
- 2024A Novel Hybrid Parameter-Efficient Fine-Tuning Approach for Hippocampus Segmentation and Alzheimer's Disease Diagnosis2 Sep 2024
- 2024Curriculum Prompting Foundation Models for Medical Image Segmentation1 Sep 2024
- 2024Image Segmentation in Foundation Model Era: A Survey23 Aug 2024
- 2024Biomedical SAM 2: Segment Anything in Biomedical Images and Videos6 Aug 2024
- 2024Interactive 3D Medical Image Segmentation with SAM 25 Aug 2024
- 2024A Federated Learning-Friendly Approach for Parameter-Efficient Fine-Tuning of SAM in 3D Segmentation31 Jul 2024
- 2024SAM Fewshot Finetuning for Anatomical Segmentation in Medical Images5 Jul 2024
- 2024SAVE: Segment Audio-Visual Easy way using Segment Anything Model2 Jul 2024
- 2024Segment Anything Model for automated image data annotation: empirical studies using text prompts from Grounding DINO27 Jun 2024
- 2024APSeg: Auto-Prompt Network for Cross-Domain Few-Shot Semantic Segmentation12 Jun 2024
- 2024Semantic Segmentation Refiner for Ultrasound Applications with Zero-Shot Foundation Models25 Apr 2024
- 2024Performance Evaluation of Segment Anything Model with Variational Prompting for Application to Non-Visible Spectrum Imagery18 Apr 2024
- 2024Unleashing the Potential of SAM for Medical Adaptation via Hierarchical Decoding27 Mar 2024
- 2024Segment Any Medical Model Extended26 Mar 2024
- 2024Anytime, Anywhere, Anyone: Investigating the Feasibility of Segment Anything Model for Crowd-Sourcing Medical Image Annotations22 Mar 2024
- 2024ProMISe: Promptable Medical Image Segmentation using SAM7 Mar 2024
- 2024TV-SAM: Increasing Zero-Shot Segmentation Performance on Multimodal Medical Images Using GPT-4 Generated Descriptive Prompts Without Human Annotation24 Feb 2024
- 2024Exploring the Transferability of a Foundation Model for Fundus Images: Application to Hypertensive Retinopathy27 Jan 2024
- 2024SegmentAnyBone: A Universal Model that Segments Any Bone at Any Location on MRI23 Jan 2024
- 2024Foundation Models for Biomedical Image Segmentation: A Survey15 Jan 2024
- 2024Segment Anything Model for Medical Image Segmentation: Current Applications and Future Directions7 Jan 2024
- 2024Data-Centric Foundation Models in Computational Healthcare: A Survey4 Jan 2024
50 newest of 82 All 82 (JSON)
- 2024Image Segmentation in Foundation Model Era: A Surveycited by 35
- 2024Image Segmentation in Foundation Model Era: A Survey23 Aug 2024
- 2023On the Challenges and Perspectives of Foundation Models for Medical Image Analysiscited by 135
- 2023SAM-Med2Dcited by 124
- 2023SAM-Med3D: Towards General-purpose Segmentation Models for Volumetric Medical Imagescited by 107
- 2023SurgicalSAM: Efficient Class Promptable Surgical Instrument Segmentationcited by 104
- 2024Segment Anything Model for Medical Image Segmentation: Current Applications and Future Directionscited by 97
- 2023Weakly-Supervised Concealed Object Segmentation with SAM-based Pseudo Labeling and Multi-scale Feature Groupingcited by 92
- 2023MA-SAM: Modality-agnostic SAM Adaptation for 3D Medical Image Segmentationcited by 82
- 20233DSAM-adapter: Holistic adaptation of SAM from 2D to 3D for promptable tumor segmentationcited by 70
- 2023A Comprehensive Survey on Segment Anything Model for Vision and Beyondcited by 64
- 2024Unleashing the Potential of SAM for Medical Adaptation via Hierarchical Decodingcited by 48
- 2023Annotation-free Audio-Visual Segmentationcited by 46
- 2023Are Natural Domain Foundation Models Useful for Medical Image Classification?cited by 46
12 most cited of 81 All 81 (JSON)
- 2026Quantifying Volumetric Risk: Class-Aware Asymmetric Weighted Conformal Prediction for 3D Medical Image Segmentation7 Oct 2026
- 2026When Adaptation Hurts: Connecting Representational Drift to OOD Failures in MedSAM Fine-Tuning21 Aug 2026
- 2026Learning from Noisy Prompts: Saliency-Guided Prompt Distillation for Robust Segmentation with SAM25 Apr 2026
- 2026Prompting Foundation Models for Zero-Shot Ship Instance Segmentation in SAR Imagery20 Apr 2026
- 2026Prompting with the human-touch: evaluating model-sensitivity of foundation models for musculoskeletal CT segmentation11 Mar 2026
- 2025OFL-SAM2: Prompt SAM2 with Online Few-shot Learner for Efficient Medical Image Segmentation31 Dec 2025
- 2025Granular Computing-driven SAM: From Coarse-to-Fine Guidance for Prompt-Free Segmentation24 Nov 2025
- 2025Continual Alignment for SAM: Rethinking Foundation Models for Medical Image Segmentation in Continual Learning21 Nov 2025
- 2025Visual Instruction Pretraining for Domain-Specific Foundation Models22 Sep 2025
- 2025SAM-DCE: Addressing Token Uniformity and Semantic Over-Smoothing in Medical Segmentation21 Sep 2025
- 2025TextSAM-EUS: Text Prompt Learning for SAM to Accurately Segment Pancreatic Tumor in Endoscopic Ultrasound24 Jul 2025
- 2025Prompt Mechanisms in Medical Imaging: A Comprehensive Survey28 Jun 2025
12 newest of 81 All 81 (JSON)