Cheap Lunch for Medical Image Segmentation by Fine-tuning SAM on Few Exemplars
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Abstract (arXiv)
The Segment Anything Model (SAM) has demonstrated remarkable capabilities of scaled-up segmentation models, enabling zero-shot generalization across a variety of domains. By leveraging large-scale foundational models as pre-trained models, it is a natural progression to fine-tune SAM for specific domains to further enhance performances. However, the adoption of foundational models in the medical domain presents a challenge due to the difficulty and expense of labeling sufficient data for adaptation within hospital systems. In this paper, we introduce an efficient and practical approach for fine-tuning SAM using a limited number of exemplars, making it suitable for such scenarios. Our approach combines two established techniques from the literature: an exemplar-guided synthesis module and the widely recognized Low-Rank Adaptation (LoRA) fine-tuning strategy, serving as data-level and model-level attempts respectively. Interestingly, our empirical findings suggest that SAM can be effectively aligned within the medical domain even with few labeled data. We validate our approach through experiments on brain tumor segmentation (BraTS) and multi-organ CT segmentation (Synapse). The comprehensive results underscore the feasibility and effectiveness of such an approach, paving the way for the practical application of SAM in the medical domain.
Key facts. Cited by 21 papers in the map (data through 14 Oct 2026). Builds on 15 of its 21 references that are in the map. First posted on arXiv 27 Aug 2023.
Builds on
15 of 21 references.
References · 15
- 2017Attention Is All You Needcited by 60,361
- 2020Language Models are Few-Shot Learnerscited by 32,419
- 2021LoRA: Low-Rank Adaptation of Large Language Modelscited by 14,380
- 2023Segment Anythingcited by 8,234
- 2022PaLM: Scaling Language Modeling with Pathwayscited by 5,326
- 2021On the Opportunities and Risks of Foundation Modelscited by 4,033
- 2021TransUNet: Transformers Make Strong Encoders for Medical Image Segmentationcited by 1,558
- 2018Attention U-Net: Learning Where to Look for the Pancreascited by 1,435
- 2018Identifying the Best Machine Learning Algorithms for Brain Tumor Segmentation, Progression Assessment, and Overall Survival Prediction in the BRATS Challengecited by 511
- 2023Segment Anything in High Qualitycited by 376
- 2020Contrastive learning of global and local features for medical image segmentation with limited annotationscited by 309
- 2023Customized Segment Anything Model for Medical Image Segmentationcited by 280
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Citing papers per year: 2023: 4; 2024: 10; 2025: 6; 2026: 1.
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- 2024Segment Anything Model for Medical Image Segmentation: Current Applications and Future Directionscited by 97
- 2023MA-SAM: Modality-agnostic SAM Adaptation for 3D Medical Image Segmentationcited by 82
- 2024Foundation Model for Advancing Healthcare: Challenges, Opportunities, and Future Directionscited by 77
- 2024A Survey on LoRA of Large Language Modelscited by 67
- 2024Unleashing the Potential of SAM for Medical Adaptation via Hierarchical Decodingcited by 48
- 2024Image Segmentation in Foundation Model Era: A Surveycited by 35
- 2024How to build the best medical image segmentation algorithm using foundation models: a comprehensive empirical study with Segment Anything Modelcited by 32
- 2024Foundation Models for Biomedical Image Segmentation: A Surveycited by 28
- 2024Generative Enhancement for 3D Medical Imagescited by 14
- 2025Recent Advances in Medical Imaging Segmentation: A Surveycited by 8
- 2023Large Scale Foundation Models for Intelligent Manufacturing Applications: A Surveycited by 6
- 2025Few-Shot Adaptation of Training-Free Foundation Model for 3D Medical Image Segmentationcited by 5
9 more
- 2024Beyond Pixel-Wise Supervision for Medical Image Segmentation: From Traditional Models to Foundation Modelscited by 4
- 2025PGP-SAM: Prototype-Guided Prompt Learning for Efficient Few-Shot Medical Image Segmentationcited by 4
- 2023Zero-Shot Digital Rock Image Segmentation with a Fine-Tuned Segment Anything Modelcited by 2
- 2024Semantic Segmentation Refiner for Ultrasound Applications with Zero-Shot Foundation Modelscited by 2
- 2025PG-SAM: Prior-Guided SAM with Medical for Multi-organ Segmentationcited by 2
- 2025Generalist Models in Medical Image Segmentation: A Survey and Performance Comparison with Task-Specific Approachescited by 2
- 2023GMISeg: General Medical Image Segmentation without Re-Trainingcited by 0
- 2025Brain Imaging Foundation Models, Are We There Yet? A Systematic Review of Foundation Models for Brain Imaging and Biomedical Researchcited by 0
- 2026A Few Cases Are All You Need: An Empirical Study of Annotation-Efficient LoRA Fine-Tuning of MedSAM3cited by 0
- 2026A Few Cases Are All You Need: An Empirical Study of Annotation-Efficient LoRA Fine-Tuning of MedSAM319 Aug 2026
- 2025Brain Imaging Foundation Models, Are We There Yet? A Systematic Review of Foundation Models for Brain Imaging and Biomedical Research16 Jun 2025
- 2025Generalist Models in Medical Image Segmentation: A Survey and Performance Comparison with Task-Specific Approaches12 Jun 2025
- 2025Recent Advances in Medical Imaging Segmentation: A Survey14 May 2025
- 2025PG-SAM: Prior-Guided SAM with Medical for Multi-organ Segmentation23 Mar 2025
- 2025Few-Shot Adaptation of Training-Free Foundation Model for 3D Medical Image Segmentation15 Jan 2025
- 2025PGP-SAM: Prototype-Guided Prompt Learning for Efficient Few-Shot Medical Image Segmentation12 Jan 2025
- 2024Image Segmentation in Foundation Model Era: A Survey23 Aug 2024
- 2024A Survey on LoRA of Large Language Models8 Jul 2024
- 2024Semantic Segmentation Refiner for Ultrasound Applications with Zero-Shot Foundation Models25 Apr 2024
- 2024Beyond Pixel-Wise Supervision for Medical Image Segmentation: From Traditional Models to Foundation Models20 Apr 2024
- 2024How to build the best medical image segmentation algorithm using foundation models: a comprehensive empirical study with Segment Anything Model15 Apr 2024
9 more
- 2024Foundation Model for Advancing Healthcare: Challenges, Opportunities, and Future Directions4 Apr 2024
- 2024Unleashing the Potential of SAM for Medical Adaptation via Hierarchical Decoding27 Mar 2024
- 2024Generative Enhancement for 3D Medical Images19 Mar 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
- 2023Large Scale Foundation Models for Intelligent Manufacturing Applications: A Survey11 Dec 2023
- 2023GMISeg: General Medical Image Segmentation without Re-Training21 Nov 2023
- 2023Zero-Shot Digital Rock Image Segmentation with a Fine-Tuned Segment Anything Model17 Nov 2023
- 2023MA-SAM: Modality-agnostic SAM Adaptation for 3D Medical Image Segmentation16 Sep 2023
- 2024Image Segmentation in Foundation Model Era: A Surveycited by 35
- 2024Generative Enhancement for 3D Medical Imagescited by 14
- 2024Image Segmentation in Foundation Model Era: A Survey23 Aug 2024
- 2024Generative Enhancement for 3D Medical Images19 Mar 2024
- 2024Segment Anything Model for Medical Image Segmentation: Current Applications and Future Directionscited by 97
- 2023MA-SAM: Modality-agnostic SAM Adaptation for 3D Medical Image Segmentationcited by 82
- 2024Foundation Model for Advancing Healthcare: Challenges, Opportunities, and Future Directionscited by 77
- 2024A Survey on LoRA of Large Language Modelscited by 67
- 2024Unleashing the Potential of SAM for Medical Adaptation via Hierarchical Decodingcited by 48
- 2024How to build the best medical image segmentation algorithm using foundation models: a comprehensive empirical study with Segment Anything Modelcited by 32
- 2024Foundation Models for Biomedical Image Segmentation: A Surveycited by 28
- 2025Recent Advances in Medical Imaging Segmentation: A Surveycited by 8
- 2023Large Scale Foundation Models for Intelligent Manufacturing Applications: A Surveycited by 6
- 2025Few-Shot Adaptation of Training-Free Foundation Model for 3D Medical Image Segmentationcited by 5
- 2024Beyond Pixel-Wise Supervision for Medical Image Segmentation: From Traditional Models to Foundation Modelscited by 4
- 2025PGP-SAM: Prototype-Guided Prompt Learning for Efficient Few-Shot Medical Image Segmentationcited by 4
12 most cited of 19 All 19 (JSON)
- 2026A Few Cases Are All You Need: An Empirical Study of Annotation-Efficient LoRA Fine-Tuning of MedSAM319 Aug 2026
- 2025Brain Imaging Foundation Models, Are We There Yet? A Systematic Review of Foundation Models for Brain Imaging and Biomedical Research16 Jun 2025
- 2025Generalist Models in Medical Image Segmentation: A Survey and Performance Comparison with Task-Specific Approaches12 Jun 2025
- 2025Recent Advances in Medical Imaging Segmentation: A Survey14 May 2025
- 2025PG-SAM: Prior-Guided SAM with Medical for Multi-organ Segmentation23 Mar 2025
- 2025Few-Shot Adaptation of Training-Free Foundation Model for 3D Medical Image Segmentation15 Jan 2025
- 2025PGP-SAM: Prototype-Guided Prompt Learning for Efficient Few-Shot Medical Image Segmentation12 Jan 2025
- 2024A Survey on LoRA of Large Language Models8 Jul 2024
- 2024Semantic Segmentation Refiner for Ultrasound Applications with Zero-Shot Foundation Models25 Apr 2024
- 2024Beyond Pixel-Wise Supervision for Medical Image Segmentation: From Traditional Models to Foundation Models20 Apr 2024
- 2024How to build the best medical image segmentation algorithm using foundation models: a comprehensive empirical study with Segment Anything Model15 Apr 2024
- 2024Foundation Model for Advancing Healthcare: Challenges, Opportunities, and Future Directions4 Apr 2024
12 newest of 19 All 19 (JSON)