Foundation Models for Biomedical Image Segmentation: A Survey
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Abstract (arXiv)
Recent advancements in biomedical image analysis have been significantly driven by the Segment Anything Model (SAM). This transformative technology, originally developed for general-purpose computer vision, has found rapid application in medical image processing. Within the last year, marked by over 100 publications, SAM has demonstrated its prowess in zero-shot learning adaptations for medical imaging. The fundamental premise of SAM lies in its capability to segment or identify objects in images without prior knowledge of the object type or imaging modality. This approach aligns well with tasks achievable by the human visual system, though its application in non-biological vision contexts remains more theoretically challenging. A notable feature of SAM is its ability to adjust segmentation according to a specified resolution scale or area of interest, akin to semantic priming. This adaptability has spurred a wave of creativity and innovation in applying SAM to medical imaging. Our review focuses on the period from April 1, 2023, to September 30, 2023, a critical first six months post-initial publication. We examine the adaptations and integrations of SAM necessary to address longstanding clinical challenges, particularly in the context of 33 open datasets covered in our analysis. While SAM approaches or achieves state-of-the-art performance in numerous applications, it falls short in certain areas, such as segmentation of the carotid artery, adrenal glands, optic nerve, and mandible bone. Our survey delves into the innovative techniques where SAM's foundational approach excels and explores the core concepts in translating and applying these models effectively in diverse medical imaging scenarios.
Key facts. Cited by 28 papers in the map (data through 7 Oct 2026). Builds on 85 of its 170 references that are in the map. First posted on arXiv 15 Jan 2024.
Builds on
85 of 170 references.
References · 85
- 2020An Image is Worth 16x16 Words: Transformers for Image Recognition at Scalecited by 29,915
- 2021TransUNet: Transformers Make Strong Encoders for Medical Image Segmentationcited by 1,552
- 2023Segment Everything Everywhere All at Oncecited by 546
- 2021The RSNA-ASNR-MICCAI BraTS 2021 Benchmark on Brain Tumor Segmentation and Radiogenomic Classificationcited by 507
- 2023Medical SAM Adapter: Adapting Segment Anything Model for Medical Image Segmentationcited by 485
- 2022AMOS: A Large-Scale Abdominal Multi-Organ Benchmark for Versatile Medical Image Segmentationcited by 347
- 2023Customized Segment Anything Model for Medical Image Segmentationcited by 277
- 2023Segment Anything in Medical Imagescited by 226
- 2023CLIP-Driven Universal Model for Organ Segmentation and Tumor Detectioncited by 224
- 2023Segment and Track Anythingcited by 193
- 2022Medical Image Segmentation Review: The success of U-Netcited by 190
- 2021nnFormer: Interleaved Transformer for Volumetric Segmentationcited by 179
38 more
- 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
- 2023CellViT: Vision Transformers for Precise Cell Segmentation and Classificationcited by 108
- 2020MosMedData: Chest CT Scans With COVID-19 Related Findings Datasetcited by 103
- 2023The KiTS21 Challenge: Automatic segmentation of kidneys, renal tumors, and renal cysts in corticomedullary-phase CTcited by 101
- 20223D UX-Net: A Large Kernel Volumetric ConvNet Modernizing Hierarchical Transformer for Medical Image Segmentationcited by 94
- 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
- 2023SAM on Medical Images: A Comprehensive Study on Three Prompt Modescited by 81
- 2023SAM Struggles in Concealed Scenes -- Empirical Study on Segment Anythingcited by 75
- 2023AutoSAM: Adapting SAM to Medical Images by Overloading the Prompt Encodercited by 70
- 20233DSAM-adapter: Holistic adaptation of SAM from 2D to 3D for promptable tumor segmentationcited by 70
- 2023Polyp-SAM: Transfer SAM for Polyp Segmentationcited by 64
- 2021A multi-centre polyp detection and segmentation dataset for generalisability assessmentcited by 63
- 2023SAM.MD: Zero-shot medical image segmentation capabilities of the Segment Anything Modelcited by 61
- 2023Can SAM Segment Polyps?cited by 59
- 2023PathAsst: A Generative Foundation AI Assistant Towards Artificial General Intelligence of Pathologycited by 57
- 2023Input Augmentation with SAM: Boosting Medical Image Segmentation with Segmentation Foundation Modelcited by 56
- 2023SAM Fails to Segment Anything? -- SAM-Adapter: Adapting SAM in Underperformed Scenes: Camouflage, Shadow, Medical Image Segmentation, and Morecited by 53
- 2023How to Efficiently Adapt Large Segmentation Model(SAM) to Medical Imagescited by 53
- 2023When SAM Meets Medical Images: An Investigation of Segment Anything Model (SAM) on Multi-phase Liver Tumor Segmentationcited by 52
- 2023The ASNR-MICCAI Brain Tumor Segmentation (BraTS) Challenge 2023: Intracranial Meningiomacited by 51
- 2023The Brain Tumor Segmentation (BraTS) Challenge 2023: Glioma Segmentation in Sub-Saharan Africa Patient Population (BraTS-Africa)cited by 51
- 2023The Brain Tumor Segmentation (BraTS) Challenge 2023: Focus on Pediatrics (CBTN-CONNECT-DIPGR-ASNR-MICCAI BraTS-PEDs)cited by 49
- 2023Computer-Vision Benchmark Segment-Anything Model (SAM) in Medical Images: Accuracy in 12 Datasetscited by 45
- 2023Beyond Adapting SAM: Towards End-to-End Ultrasound Image Segmentation via Auto Promptingcited by 40
- 2023Segment Anything Model for Medical Images?cited by 39
- 2023SAMAug: Point Prompt Augmentation for Segment Anything Modelcited by 38
- 2023AdaptiveSAM: Towards Efficient Tuning of SAM for Surgical Scene Segmentationcited by 37
- 2023The Brain Tumor Segmentation (BraTS-METS) Challenge 2023: Brain Metastasis Segmentation on Pre-treatment MRIcited by 35
- 2023SAM3D: Segment Anything Model in Volumetric Medical Imagescited by 34
- 2023SkinSAM: Empowering Skin Cancer Segmentation with Segment Anything Modelcited by 32
- 2023All-in-SAM: from Weak Annotation to Pixel-wise Nuclei Segmentation with Prompt-based Finetuningcited by 32
- 2023SAMM (Segment Any Medical Model): A 3D Slicer Integration to SAMcited by 31
- 2023SAM Meets Robotic Surgery: An Empirical Study on Generalization, Robustness and Adaptationcited by 30
- 2019Automated Design of Deep Learning Methods for Biomedical Image Segmentationcited by 27
- 2022Assessing generalisability of deep learning-based polyp detection and segmentation methods through a computer vision challengecited by 27
- 2023DeSAM: Decoupled Segment Anything Model for Generalizable Medical Image Segmentationcited by 26
50 most cited of 85 All 85 (JSON)
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Citing papers per year: 2024: 8; 2025: 18; 2026: 2.
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- 2024BiomedParse: a biomedical foundation model for image parsing of everything everywhere all at oncecited by 107
- 2024How to build the best medical image segmentation algorithm using foundation models: a comprehensive empirical study with Segment Anything Modelcited by 32
- 2024S-SAM: SVD-based Fine-Tuning of Segment Anything Model for Medical Image Segmentationcited by 11
- 2025Vision Foundation Models in Medical Image Analysis: Advances and Challengescited by 9
- 2025Surgical Scene Understanding in the Era of Foundation AI Models: A Comprehensive Reviewcited by 8
- 2024On the Workflows and Smells of Leaderboard Operations (LBOps): An Exploratory Study of Foundation Model Leaderboardscited by 6
- 2025MedicoSAM: Robust Improvement of SAM for Medical Imagingcited by 6
- 2024MIST: A Simple and Scalable End-To-End 3D Medical Imaging Segmentation Frameworkcited by 5
- 2024Evaluating Cell AI Foundation Models in Kidney Pathology with Human-in-the-Loop Enrichmentcited by 5
- 2025Adaptation of Foundation Models for Medical Image Analysis: Strategies, Challenges, and Future Directionscited by 3
- 2026SkinCLIP-VL: Consistency-Aware Vision-Language Learning for Multimodal Skin Cancer Diagnosiscited by 3
- 2024UnSeGArmaNet: Unsupervised Image Segmentation using Graph Neural Networks with Convolutional ARMA Filterscited by 2
16 more
- 2025Foundation Model for Whole-Heart Segmentation: Leveraging Student-Teacher Learning in Multi-Modal Medical Imagingcited by 2
- 2025Fine-grained Multi-class Nuclei Segmentation with Molecular-empowered All-in-SAM Modelcited by 2
- 2025Universal and Transferable Attacks on Pathology Foundation Modelscited by 2
- 2025Diffusion-Driven Generation of Minimally Preprocessed Brain MRIcited by 2
- 2024Blackbox Adaptation for Medical Image Segmentationcited by 1
- 2025SAMRI: Segment Any MRIcited by 1
- 2025Mitigating Pretraining-Induced Attention Asymmetry in 2D+ Electron Microscopy Image Segmentationcited by 0
- 2025Brain Imaging Foundation Models, Are We There Yet? A Systematic Review of Foundation Models for Brain Imaging and Biomedical Researchcited by 0
- 2025Weakly Supervised Object Segmentation by Background Conditional Divergencecited by 0
- 2025MedSAM-CA: A CNN-Augmented ViT with Attention-Enhanced Multi-Scale Fusion for Medical Image Segmentationcited by 0
- 2025F3-Net: Foundation Model for Full Abnormality Segmentation of Medical Images with Flexible Input Modality Requirementcited by 0
- 2025E-BayesSAM: Efficient Bayesian Adaptation of SAM with Self-Optimizing KAN-Based Interpretation for Uncertainty-Aware Ultrasonic Segmentationcited by 0
- 2025DuPLUS: Dual-Prompt Vision-Language Framework for Universal Medical Image Segmentation and Prognosiscited by 0
- 2025Fine-tuning Segment Anything for Real-Time Tumor Tracking in Cine-MRIcited by 0
- 2025PPBoost: Progressive Prompt Boosting for Text-Driven Medical Image Segmentationcited by 0
- 2026Toward Clinically Ready Foundation Models in Medical Image Analysis: Adaptation Mechanisms and Deployment Trade-offscited by 0
- 2026SkinCLIP-VL: Consistency-Aware Vision-Language Learning for Multimodal Skin Cancer Diagnosis22 Mar 2026
- 2026Toward Clinically Ready Foundation Models in Medical Image Analysis: Adaptation Mechanisms and Deployment Trade-offs15 Mar 2026
- 2025PPBoost: Progressive Prompt Boosting for Text-Driven Medical Image Segmentation26 Nov 2025
- 2025Adaptation of Foundation Models for Medical Image Analysis: Strategies, Challenges, and Future Directions3 Nov 2025
- 2025SAMRI: Segment Any MRI30 Oct 2025
- 2025Diffusion-Driven Generation of Minimally Preprocessed Brain MRI29 Oct 2025
- 2025Fine-tuning Segment Anything for Real-Time Tumor Tracking in Cine-MRI29 Oct 2025
- 2025Universal and Transferable Attacks on Pathology Foundation Models18 Oct 2025
- 2025DuPLUS: Dual-Prompt Vision-Language Framework for Universal Medical Image Segmentation and Prognosis3 Oct 2025
- 2025E-BayesSAM: Efficient Bayesian Adaptation of SAM with Self-Optimizing KAN-Based Interpretation for Uncertainty-Aware Ultrasonic Segmentation24 Aug 2025
- 2025Fine-grained Multi-class Nuclei Segmentation with Molecular-empowered All-in-SAM Model21 Aug 2025
- 2025F3-Net: Foundation Model for Full Abnormality Segmentation of Medical Images with Flexible Input Modality Requirement11 Jul 2025
16 more
- 2025MedSAM-CA: A CNN-Augmented ViT with Attention-Enhanced Multi-Scale Fusion for Medical Image Segmentation30 Jun 2025
- 2025Weakly Supervised Object Segmentation by Background Conditional Divergence25 Jun 2025
- 2025Brain Imaging Foundation Models, Are We There Yet? A Systematic Review of Foundation Models for Brain Imaging and Biomedical Research16 Jun 2025
- 2025Mitigating Pretraining-Induced Attention Asymmetry in 2D+ Electron Microscopy Image Segmentation20 May 2025
- 2025Foundation Model for Whole-Heart Segmentation: Leveraging Student-Teacher Learning in Multi-Modal Medical Imaging24 Mar 2025
- 2025Vision Foundation Models in Medical Image Analysis: Advances and Challenges20 Feb 2025
- 2025Surgical Scene Understanding in the Era of Foundation AI Models: A Comprehensive Review16 Feb 2025
- 2025MedicoSAM: Robust Improvement of SAM for Medical Imaging20 Jan 2025
- 2024Evaluating Cell AI Foundation Models in Kidney Pathology with Human-in-the-Loop Enrichment31 Oct 2024
- 2024UnSeGArmaNet: Unsupervised Image Segmentation using Graph Neural Networks with Convolutional ARMA Filters8 Oct 2024
- 2024S-SAM: SVD-based Fine-Tuning of Segment Anything Model for Medical Image Segmentation12 Aug 2024
- 2024MIST: A Simple and Scalable End-To-End 3D Medical Imaging Segmentation Framework31 Jul 2024
- 2024On the Workflows and Smells of Leaderboard Operations (LBOps): An Exploratory Study of Foundation Model Leaderboards4 Jul 2024
- 2024BiomedParse: a biomedical foundation model for image parsing of everything everywhere all at once21 May 2024
- 2024Blackbox Adaptation for Medical Image Segmentation17 May 2024
- 2024How to build the best medical image segmentation algorithm using foundation models: a comprehensive empirical study with Segment Anything Model15 Apr 2024
- 2024BiomedParse: a biomedical foundation model for image parsing of everything everywhere all at oncecited by 107
- 2024How to build the best medical image segmentation algorithm using foundation models: a comprehensive empirical study with Segment Anything Modelcited by 32
- 2024S-SAM: SVD-based Fine-Tuning of Segment Anything Model for Medical Image Segmentationcited by 11
- 2025Vision Foundation Models in Medical Image Analysis: Advances and Challengescited by 9
- 2025Surgical Scene Understanding in the Era of Foundation AI Models: A Comprehensive Reviewcited by 8
- 2024On the Workflows and Smells of Leaderboard Operations (LBOps): An Exploratory Study of Foundation Model Leaderboardscited by 6
- 2025MedicoSAM: Robust Improvement of SAM for Medical Imagingcited by 6
- 2024MIST: A Simple and Scalable End-To-End 3D Medical Imaging Segmentation Frameworkcited by 5
- 2024Evaluating Cell AI Foundation Models in Kidney Pathology with Human-in-the-Loop Enrichmentcited by 5
- 2025Adaptation of Foundation Models for Medical Image Analysis: Strategies, Challenges, and Future Directionscited by 3
- 2024UnSeGArmaNet: Unsupervised Image Segmentation using Graph Neural Networks with Convolutional ARMA Filterscited by 2
- 2025Foundation Model for Whole-Heart Segmentation: Leveraging Student-Teacher Learning in Multi-Modal Medical Imagingcited by 2
12 most cited of 26 All 26 (JSON)
- 2026Toward Clinically Ready Foundation Models in Medical Image Analysis: Adaptation Mechanisms and Deployment Trade-offs15 Mar 2026
- 2025PPBoost: Progressive Prompt Boosting for Text-Driven Medical Image Segmentation26 Nov 2025
- 2025Adaptation of Foundation Models for Medical Image Analysis: Strategies, Challenges, and Future Directions3 Nov 2025
- 2025SAMRI: Segment Any MRI30 Oct 2025
- 2025Fine-tuning Segment Anything for Real-Time Tumor Tracking in Cine-MRI29 Oct 2025
- 2025Universal and Transferable Attacks on Pathology Foundation Models18 Oct 2025
- 2025DuPLUS: Dual-Prompt Vision-Language Framework for Universal Medical Image Segmentation and Prognosis3 Oct 2025
- 2025E-BayesSAM: Efficient Bayesian Adaptation of SAM with Self-Optimizing KAN-Based Interpretation for Uncertainty-Aware Ultrasonic Segmentation24 Aug 2025
- 2025Fine-grained Multi-class Nuclei Segmentation with Molecular-empowered All-in-SAM Model21 Aug 2025
- 2025F3-Net: Foundation Model for Full Abnormality Segmentation of Medical Images with Flexible Input Modality Requirement11 Jul 2025
- 2025MedSAM-CA: A CNN-Augmented ViT with Attention-Enhanced Multi-Scale Fusion for Medical Image Segmentation30 Jun 2025
- 2025Weakly Supervised Object Segmentation by Background Conditional Divergence25 Jun 2025
12 newest of 26 All 26 (JSON)