# SAM-DA: Decoder Adapter for Efficient Medical Domain Adaptation

arXiv: https://arxiv.org/abs/2501.06836 · HTML: https://mlsanity.com/paper/2501.06836/

## Key facts

- Cited by 3 papers in the map (data through 14 Oct 2026).
- Builds on 39 of its 54 references that are in the map.
- First posted on arXiv 12 Jan 2025.

## Builds on (most cited first, 30 of 39)

- [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)
- [LLaMA: Open and Efficient Foundation Language Models](https://mlsanity.com/paper/2302.13971/) (2023)
- [DINOv2: Learning Robust Visual Features without Supervision](https://mlsanity.com/paper/2304.07193/) (2023)
- [Parameter-Efficient Transfer Learning for NLP](https://mlsanity.com/paper/1902.00751/) (2019)
- [Prefix-Tuning: Optimizing Continuous Prompts for Generation](https://mlsanity.com/paper/2101.00190/) (2021)
- [The Power of Scale for Parameter-Efficient Prompt Tuning](https://mlsanity.com/paper/2104.08691/) (2021)
- [V-Net: Fully Convolutional Neural Networks for Volumetric Medical Image Segmentation](https://mlsanity.com/paper/1606.04797/) (2016)
- [Learning to Prompt for Vision-Language Models](https://mlsanity.com/paper/2109.01134/) (2021)
- [Towards a Unified View of Parameter-Efficient Transfer Learning](https://mlsanity.com/paper/2110.04366/) (2021)
- [AdapterFusion: Non-Destructive Task Composition for Transfer Learning](https://mlsanity.com/paper/2005.00247/) (2020)
- [LLaMA-Adapter: Efficient Fine-tuning of Language Models with Zero-init Attention](https://mlsanity.com/paper/2303.16199/) (2023)
- [GPT Understands, Too](https://mlsanity.com/paper/2103.10385/) (2021)
- [Taskonomy: Disentangling Task Transfer Learning](https://mlsanity.com/paper/1804.08328/) (2018)
- [Vision Transformer Adapter for Dense Predictions](https://mlsanity.com/paper/2205.08534/) (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)
- [Segment Anything in High Quality](https://mlsanity.com/paper/2306.01567/) (2023)
- [Transfusion: Understanding Transfer Learning for Medical Imaging](https://mlsanity.com/paper/1902.07208/) (2019)
- [Parameter-efficient Multi-task Fine-tuning for Transformers via Shared Hypernetworks](https://mlsanity.com/paper/2106.04489/) (2021)
- [Customized Segment Anything Model for Medical Image Segmentation](https://mlsanity.com/paper/2304.13785/) (2023)
- [Parameter-Efficient Fine-Tuning Methods for Pretrained Language Models: A Critical Review and Assessment](https://mlsanity.com/paper/2312.12148/) (2023)
- [Segment Anything in Medical Images](https://mlsanity.com/paper/2304.12306/) (2023)
- [Universal Source-Free Domain Adaptation](https://mlsanity.com/paper/2004.04393/) (2020)
- [MIC: Masked Image Consistency for Context-Enhanced Domain Adaptation](https://mlsanity.com/paper/2212.01322/) (2022)
- [FSS-1000: A 1000-Class Dataset for Few-Shot Segmentation](https://mlsanity.com/paper/1907.12347/) (2019)
- [Exploring Versatile Generative Language Model Via Parameter-Efficient Transfer Learning](https://mlsanity.com/paper/2004.03829/) (2020)
- [Shape-aware Meta-learning for Generalizing Prostate MRI Segmentation to Unseen Domains](https://mlsanity.com/paper/2007.02035/) (2020)
- [MS-Net: Multi-Site Network for Improving Prostate Segmentation with Heterogeneous MRI Data](https://mlsanity.com/paper/2002.03366/) (2020)
- [Standardized Assessment of Automatic Segmentation of White Matter Hyperintensities and Results of the WMH Segmentation Challenge](https://mlsanity.com/paper/1904.00682/) (2019)

## Built on by (most cited first, 3 of 3)

- [RobustMedSAM: Degradation-Resilient Medical Image Segmentation via Robust Foundation Model Adaptation](https://mlsanity.com/paper/2604.09814/) (2026)
- [Hierarchical Prototype-Memory Adaptation of SAM for Surgical Instrument Segmentation](https://mlsanity.com/paper/2608.24541/) (2026)
- [ReG-SAM: Reference Graph-Driven SAM for 2D Foundational Vessel Segmentation](https://mlsanity.com/paper/2609.31160/) (2026)

## Abstract (arXiv)

This paper addresses the domain adaptation challenge for semantic segmentation in medical imaging. Despite the impressive performance of recent foundational segmentation models like SAM on natural images, they struggle with medical domain images. Beyond this, recent approaches that perform end-to-end fine-tuning of models are simply not computationally tractable. To address this, we propose a novel SAM adapter approach that minimizes the number of trainable parameters while achieving comparable performances to full fine-tuning. The proposed SAM adapter is strategically placed in the mask decoder, offering excellent and broad generalization capabilities and improved segmentation across both fully supervised and test-time domain adaptation tasks. Extensive validation on four datasets showcases the adapter's efficacy, outperforming existing methods while training less than 1% of SAM's total parameters.