Vision Foundation Models in Medical Image Analysis: Advances and Challenges

The rapid development of Vision Foundation Models (VFMs), particularly Vision Transformers (ViT) and Segment Anything Model (SAM), has sparked significant advances in the field of medical image analysis. These models have demonstrated exceptional capabilities in capturing long-range dependencies and achieving high generalization in segmentation tasks. However, adapting these large models to medical image analysis presents several challenges, including domain differences between medical and natural images, the need for efficient model adaptation strategies, and the limitations of small-scale medical datasets. This paper reviews the state-of-the-art research on the adaptation of VFMs to medical image segmentation, focusing on the challenges of domain adaptation, model compression, and federated learning. We discuss the latest developments in adapter-based improvements, knowledge distillation techniques, and multi-scale contextual feature modeling, and propose future directions to overcome these bottlenecks. Our analysis highlights the potential of VFMs, along with emerging methodologies such as federated learning and model compression, to revolutionize medical image analysis and enhance clinical applications. The goal of this work is to provide a comprehensive overview of current approaches and suggest key areas for future research that can drive the next wave of innovation in medical image segmentation.