# Fully Automated SAM for Single-source Domain Generalization in Medical Image Segmentation

arXiv: https://arxiv.org/abs/2507.17281 · HTML: https://mlsanity.com/paper/2507.17281/

## Key facts

- Cited by 1 papers in the map (data through 14 Oct 2026).
- Builds on 35 of its 44 references that are in the map.
- First posted on arXiv 23 Jul 2025.

## Builds on (most cited first, 30 of 35)

- [Deep Residual Learning for Image Recognition](https://mlsanity.com/paper/1512.03385/) (2015)
- [Segment Anything](https://mlsanity.com/paper/2304.02643/) (2023)
- [CutMix: Regularization Strategy to Train Strong Classifiers with Localizable Features](https://mlsanity.com/paper/1905.04899/) (2019)
- [Domain Generalization: A Survey](https://mlsanity.com/paper/2103.02503/) (2021)
- [Domain Generalization with MixStyle](https://mlsanity.com/paper/2104.02008/) (2021)
- [Self-Challenging Improves Cross-Domain Generalization](https://mlsanity.com/paper/2007.02454/) (2020)
- [Segment Anything in Medical Images](https://mlsanity.com/paper/2304.12306/) (2023)
- [Robust and Generalizable Visual Representation Learning via Random Convolutions](https://mlsanity.com/paper/2007.13003/) (2020)
- [Uncertainty Modeling for Out-of-Distribution Generalization](https://mlsanity.com/paper/2202.03958/) (2022)
- [Shape-aware Meta-learning for Generalizing Prostate MRI Segmentation to Unseen Domains](https://mlsanity.com/paper/2007.02035/) (2020)
- [Exact Feature Distribution Matching for Arbitrary Style Transfer and Domain Generalization](https://mlsanity.com/paper/2203.07740/) (2022)
- [Causality-inspired Single-source Domain Generalization for Medical Image Segmentation](https://mlsanity.com/paper/2111.12525/) (2021)
- [Segment Anything Model for Medical Image Segmentation: Current Applications and Future Directions](https://mlsanity.com/paper/2401.03495/) (2024)
- [Semantic-Aware Domain Generalized Segmentation](https://mlsanity.com/paper/2204.00822/) (2022)
- [A Comprehensive Survey on Segment Anything Model for Vision and Beyond](https://mlsanity.com/paper/2305.08196/) (2023)
- [Generalizable Cross-modality Medical Image Segmentation via Style Augmentation and Dual Normalization](https://mlsanity.com/paper/2112.11177/) (2021)
- [Rethinking Data Augmentation for Single-source Domain Generalization in Medical Image Segmentation](https://mlsanity.com/paper/2211.14805/) (2022)
- [Realistic Adversarial Data Augmentation for MR Image Segmentation](https://mlsanity.com/paper/2006.13322/) (2020)
- [Deep Symmetric Adaptation Network for Cross-modality Medical Image Segmentation](https://mlsanity.com/paper/2101.06853/) (2021)
- [SkinSAM: Empowering Skin Cancer Segmentation with Segment Anything Model](https://mlsanity.com/paper/2304.13973/) (2023)
- [Towards a glaucoma risk index based on simulated hemodynamics from fundus images](https://mlsanity.com/paper/1805.10273/) (2018)
- [MEGANet: Multi-Scale Edge-Guided Attention Network for Weak Boundary Polyp Segmentation](https://mlsanity.com/paper/2309.03329/) (2023)
- [MaxStyle: Adversarial Style Composition for Robust Medical Image Segmentation](https://mlsanity.com/paper/2206.01737/) (2022)
- [DeSAM: Decoupled Segment Anything Model for Generalizable Medical Image Segmentation](https://mlsanity.com/paper/2306.00499/) (2023)
- [Frequency-mixed Single-source Domain Generalization for Medical Image Segmentation](https://mlsanity.com/paper/2307.09005/) (2023)
- [False Negative/Positive Control for SAM on Noisy Medical Images](https://mlsanity.com/paper/2308.10382/) (2023)
- [ASPS: Augmented Segment Anything Model for Polyp Segmentation](https://mlsanity.com/paper/2407.00718/) (2024)
- [WeakSAM: Segment Anything Meets Weakly-supervised Instance-level Recognition](https://mlsanity.com/paper/2402.14812/) (2024)
- [Text-Region Matching for Multi-Label Image Recognition with Missing Labels](https://mlsanity.com/paper/2407.18520/) (2024)
- [Semantic-Aware Dual Contrastive Learning for Multi-label Image Classification](https://mlsanity.com/paper/2307.09715/) (2023)

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

- [Enhancing MedSAM with a Lightweight Box Predictor for Medical Image Segmentation](https://mlsanity.com/paper/2606.04705/) (2026)

## Abstract (arXiv)

Although SAM-based single-source domain generalization models for medical image segmentation can mitigate the impact of domain shift on the model in cross-domain scenarios, these models still face two major challenges. First, the segmentation of SAM is highly dependent on domain-specific expert-annotated prompts, which prevents SAM from achieving fully automated medical image segmentation and therefore limits its application in clinical settings. Second, providing poor prompts (such as bounding boxes that are too small or too large) to the SAM prompt encoder can mislead SAM into generating incorrect mask results. Therefore, we propose the FA-SAM, a single-source domain generalization framework for medical image segmentation that achieves fully automated SAM. FA-SAM introduces two key innovations: an Auto-prompted Generation Model (AGM) branch equipped with a Shallow Feature Uncertainty Modeling (SUFM) module, and an Image-Prompt Embedding Fusion (IPEF) module integrated into the SAM mask decoder. Specifically, AGM models the uncertainty distribution of shallow features through the SUFM module to generate bounding box prompts for the target domain, enabling fully automated segmentation with SAM. The IPEF module integrates multiscale information from SAM image embeddings and prompt embeddings to capture global and local details of the target object, enabling SAM to mitigate the impact of poor prompts. Extensive experiments on publicly available prostate and fundus vessel datasets validate the effectiveness of FA-SAM and highlight its potential to address the above challenges.