# Towards a Comprehensive, Efficient and Promptable Anatomic Structure Segmentation Model using 3D Whole-body CT Scans

arXiv: https://arxiv.org/abs/2403.15063 · HTML: https://mlsanity.com/paper/2403.15063/

## Key facts

- Cited by 10 papers in the map (data through 14 Oct 2026).
- Builds on 53 of its 81 references that are in the map.
- First posted on arXiv 22 Mar 2024.

## Builds on (most cited first, 30 of 53)

- [BERT: Pre-training of Deep Bidirectional Transformers for Language Understanding](https://mlsanity.com/paper/1810.04805/) (2018)
- [Learning Transferable Visual Models From Natural Language Supervision](https://mlsanity.com/paper/2103.00020/) (2021)
- [Language Models are Few-Shot Learners](https://mlsanity.com/paper/2005.14165/) (2020)
- [An Image is Worth 16x16 Words: Transformers for Image Recognition at Scale](https://mlsanity.com/paper/2010.11929/) (2020)
- [PyTorch: An Imperative Style, High-Performance Deep Learning Library](https://mlsanity.com/paper/1912.01703/) (2019)
- [U-Net: Convolutional Networks for Biomedical Image Segmentation](https://mlsanity.com/paper/1505.04597/) (2015)
- [LoRA: Low-Rank Adaptation of Large Language Models](https://mlsanity.com/paper/2106.09685/) (2021)
- [Segment Anything](https://mlsanity.com/paper/2304.02643/) (2023)
- [DINOv2: Learning Robust Visual Features without Supervision](https://mlsanity.com/paper/2304.07193/) (2023)
- [Emerging Properties in Self-Supervised Vision Transformers](https://mlsanity.com/paper/2104.14294/) (2021)
- [Hierarchical Text-Conditional Image Generation with CLIP Latents](https://mlsanity.com/paper/2204.06125/) (2022)
- [Fully Convolutional Networks for Semantic Segmentation](https://mlsanity.com/paper/1411.4038/) (2014)
- [Masked-attention Mask Transformer for Universal Image Segmentation](https://mlsanity.com/paper/2112.01527/) (2021)
- [V-Net: Fully Convolutional Neural Networks for Volumetric Medical Image Segmentation](https://mlsanity.com/paper/1606.04797/) (2016)
- [Fourier Features Let Networks Learn High Frequency Functions in Low Dimensional Domains](https://mlsanity.com/paper/2006.10739/) (2020)
- [3D U-Net: Learning Dense Volumetric Segmentation from Sparse Annotation](https://mlsanity.com/paper/1606.06650/) (2016)
- [Semantic Image Synthesis with Spatially-Adaptive Normalization](https://mlsanity.com/paper/1903.07291/) (2019)
- [Instance Normalization: The Missing Ingredient for Fast Stylization](https://mlsanity.com/paper/1607.08022/) (2016)
- [UNETR: Transformers for 3D Medical Image Segmentation](https://mlsanity.com/paper/2103.10504/) (2021)
- [TotalSegmentator: robust segmentation of 104 anatomical structures in CT images](https://mlsanity.com/paper/2208.05868/) (2022)
- [Segment Everything Everywhere All at Once](https://mlsanity.com/paper/2304.06718/) (2023)
- [Medical SAM Adapter: Adapting Segment Anything Model for Medical Image Segmentation](https://mlsanity.com/paper/2304.12620/) (2023)
- [Self-Supervised Pre-Training of Swin Transformers for 3D Medical Image Analysis](https://mlsanity.com/paper/2111.14791/) (2021)
- [Segment Anything Model for Medical Image Analysis: an Experimental Study](https://mlsanity.com/paper/2304.10517/) (2023)
- [Customized Segment Anything Model for Medical Image Segmentation](https://mlsanity.com/paper/2304.13785/) (2023)
- [Deep Convolutional Neural Networks for Computer-Aided Detection: CNN Architectures, Dataset Characteristics and Transfer Learning](https://mlsanity.com/paper/1602.03409/) (2016)
- [SegGPT: Segmenting Everything In Context](https://mlsanity.com/paper/2304.03284/) (2023)
- [nnFormer: Interleaved Transformer for Volumetric Segmentation](https://mlsanity.com/paper/2109.03201/) (2021)
- [Reviving Iterative Training with Mask Guidance for Interactive Segmentation](https://mlsanity.com/paper/2102.06583/) (2021)
- [Segment Anything Model (SAM) for Digital Pathology: Assess Zero-shot Segmentation on Whole Slide Imaging](https://mlsanity.com/paper/2304.04155/) (2023)

## Built on by (most cited first, 10 of 10)

- [AbdomenAtlas: A Large-Scale, Detailed-Annotated, & Multi-Center Dataset for Efficient Transfer Learning and Open Algorithmic Benchmarking](https://mlsanity.com/paper/2407.16697/) (2024)
- [Large-scale and Fine-grained Vision-language Pre-training for Enhanced CT Image Understanding](https://mlsanity.com/paper/2501.14548/) (2025)
- [CAT: Coordinating Anatomical-Textual Prompts for Multi-Organ and Tumor Segmentation](https://mlsanity.com/paper/2406.07085/) (2024)
- [CRISP-SAM2: SAM2 with Cross-Modal Interaction and Semantic Prompting for Multi-Organ Segmentation](https://mlsanity.com/paper/2506.23121/) (2025)
- [Unleashing the Potential of Vision-Language Pre-Training for 3D Zero-Shot Lesion Segmentation via Mask-Attribute Alignment](https://mlsanity.com/paper/2410.15744/) (2024)
- [Atlas is Your Perfect Context: One-Shot Customization for Generalizable Foundational Medical Image Segmentation](https://mlsanity.com/paper/2512.18176/) (2025)
- [TGC-Net: A Structure-Aware and Semantically-Aligned Framework for Text-Guided Medical Image Segmentation](https://mlsanity.com/paper/2512.21135/) (2025)
- [3D Modality-Aware Pre-training for Vision-Language Model in MRI Multi-organ Abnormality Detection](https://mlsanity.com/paper/2602.23652/) (2026)
- [Prompting with the human-touch: evaluating model-sensitivity of foundation models for musculoskeletal CT segmentation](https://mlsanity.com/paper/2603.10541/) (2026)
- [Super-Generalist: Towards Comprehensive and Accurate Medical Image Understanding via Generalist-Specialist Synergy](https://mlsanity.com/paper/2607.09135/) (2026)

## Abstract (arXiv)

Segment anything model (SAM) demonstrates strong generalization ability on natural image segmentation. However, its direct adaptation in medical image segmentation tasks shows significant performance drops. It also requires an excessive number of prompt points to obtain a reasonable accuracy. Although quite a few studies explore adapting SAM into medical image volumes, the efficiency of 2D adaptation methods is unsatisfactory and 3D adaptation methods are only capable of segmenting specific organs/tumors. In this work, we propose a comprehensive and scalable 3D SAM model for whole-body CT segmentation, named CT-SAM3D. Instead of adapting SAM, we propose a 3D promptable segmentation model using a (nearly) fully labeled CT dataset. To train CT-SAM3D effectively, ensuring the model's accurate responses to higher-dimensional spatial prompts is crucial, and 3D patch-wise training is required due to GPU memory constraints. Therefore, we propose two key technical developments: 1) a progressively and spatially aligned prompt encoding method to effectively encode click prompts in local 3D space; and 2) a cross-patch prompt scheme to capture more 3D spatial context, which is beneficial for reducing the editing workloads when interactively prompting on large organs. CT-SAM3D is trained using a curated dataset of 1204 CT scans containing 107 whole-body anatomies and extensively validated using five datasets, achieving significantly better results against all previous SAM-derived models. Code, data, and our 3D interactive segmentation tool with quasi-real-time responses are available at https://github.com/alibaba-damo-academy/ct-sam3d.