# Generalizing Segmentation Foundation Model Under Sim-to-real Domain-shift for Guidewire Segmentation in X-ray Fluoroscopy

arXiv: https://arxiv.org/abs/2410.07460 · HTML: https://mlsanity.com/paper/2410.07460/

## Key facts

- Cited by 1 papers in the map (data through 14 Oct 2026).
- Builds on 40 of its 56 references that are in the map.
- First posted on arXiv 9 Oct 2024.

## Builds on (most cited first, 30 of 40)

- [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)
- [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)
- [Momentum Contrast for Unsupervised Visual Representation Learning](https://mlsanity.com/paper/1911.05722/) (2019)
- [Masked Autoencoders Are Scalable Vision Learners](https://mlsanity.com/paper/2111.06377/) (2021)
- [Overcoming catastrophic forgetting in neural networks](https://mlsanity.com/paper/1612.00796/) (2016)
- [V-Net: Fully Convolutional Neural Networks for Volumetric Medical Image Segmentation](https://mlsanity.com/paper/1606.04797/) (2016)
- [FixMatch: Simplifying Semi-Supervised Learning with Consistency and Confidence](https://mlsanity.com/paper/2001.07685/) (2020)
- [3D U-Net: Learning Dense Volumetric Segmentation from Sparse Annotation](https://mlsanity.com/paper/1606.06650/) (2016)
- [Multimodal Unsupervised Image-to-Image Translation](https://mlsanity.com/paper/1804.04732/) (2018)
- [Unsupervised Image-to-Image Translation Networks](https://mlsanity.com/paper/1703.00848/) (2017)
- [Pseudo-Labeling and Confirmation Bias in Deep Semi-Supervised Learning](https://mlsanity.com/paper/1908.02983/) (2019)
- [Medical SAM Adapter: Adapting Segment Anything Model for Medical Image Segmentation](https://mlsanity.com/paper/2304.12620/) (2023)
- [End-to-End Semi-Supervised Object Detection with Soft Teacher](https://mlsanity.com/paper/2106.09018/) (2021)
- [Customized Segment Anything Model for Medical Image Segmentation](https://mlsanity.com/paper/2304.13785/) (2023)
- [Source Data-absent Unsupervised Domain Adaptation through Hypothesis Transfer and Labeling Transfer](https://mlsanity.com/paper/2012.07297/) (2020)
- [MedNeXt: Transformer-driven Scaling of ConvNets for Medical Image Segmentation](https://mlsanity.com/paper/2303.09975/) (2023)
- [A Review of Single-Source Deep Unsupervised Visual Domain Adaptation](https://mlsanity.com/paper/2009.00155/) (2020)
- [HoMM: Higher-order Moment Matching for Unsupervised Domain Adaptation](https://mlsanity.com/paper/1912.11976/) (2019)
- [Adversarial Style Mining for One-Shot Unsupervised Domain Adaptation](https://mlsanity.com/paper/2004.06042/) (2020)
- [SAM Fails to Segment Anything? -- SAM-Adapter: Adapting SAM in Underperformed Scenes: Camouflage, Shadow, Medical Image Segmentation, and More](https://mlsanity.com/paper/2304.09148/) (2023)
- [Revisiting Realistic Test-Time Training: Sequential Inference and Adaptation by Anchored Clustering](https://mlsanity.com/paper/2206.02721/) (2022)
- [One-shot Unsupervised Domain Adaptation with Personalized Diffusion Models](https://mlsanity.com/paper/2303.18080/) (2023)
- [Towards Real-World Test-Time Adaptation: Tri-Net Self-Training with Balanced Normalization](https://mlsanity.com/paper/2309.14949/) (2023)
- [Improving the Generalization of Segmentation Foundation Model under Distribution Shift via Weakly Supervised Adaptation](https://mlsanity.com/paper/2312.03502/) (2023)
- [RCPS: Rectified Contrastive Pseudo Supervision for Semi-Supervised Medical Image Segmentation](https://mlsanity.com/paper/2301.05500/) (2023)
- [Addressing Appearance Change in Outdoor Robotics with Adversarial Domain Adaptation](https://mlsanity.com/paper/1703.01461/) (2017)

## Built on by (most cited first, 1 of 1)

- [Advancing Embodied Intelligence in Robotic-Assisted Endovascular Procedures: A Systematic Review of AI Solutions](https://mlsanity.com/paper/2504.15327/) (2025)

## Abstract (arXiv)

Guidewire segmentation during endovascular interventions holds the potential to significantly enhance procedural accuracy, improving visualization and providing critical feedback that can support both physicians and robotic systems in navigating complex vascular pathways. Unlike supervised segmentation networks, which need many expensive expert-annotated labels, sim-to-real domain adaptation approaches utilize synthetic data from simulations, offering a cost-effective solution. The success of models like Segment-Anything (SAM) has driven advancements in image segmentation foundation models with strong zero/few-shot generalization through prompt engineering. However, they struggle with medical images like X-ray fluoroscopy and the domain-shifts of the data. Given the challenges of acquiring annotation and the accessibility of labeled simulation data, we propose a sim-to-real domain adaption framework with a coarse-to-fine strategy to adapt SAM to X-ray fluoroscopy guidewire segmentation without any annotation on the target domain. We first generate the pseudo-labels by utilizing a simple source image style transfer technique that preserves the guidewire structure. Then, we develop a weakly supervised self-training architecture to fine-tune an end-to-end student SAM with the coarse labels by imposing consistency regularization and supervision from the teacher SAM network. We validate the effectiveness of the proposed method on a publicly available Cardiac dataset and an in-house Neurovascular dataset, where our method surpasses both pre-trained SAM and many state-of-the-art domain adaptation techniques by a large margin. Our code will be made public on GitHub soon.