# MAUP: Training-free Multi-center Adaptive Uncertainty-aware Prompting for Cross-domain Few-shot Medical Image Segmentation

arXiv: https://arxiv.org/abs/2508.03511 · HTML: https://mlsanity.com/paper/2508.03511/

## Key facts

- Cited by 8 papers in the map (data through 14 Oct 2026).
- Builds on 19 of its 32 references that are in the map.
- First posted on arXiv 5 Aug 2025.

## Builds on (most cited first, 19 of 19)

- [Segment Anything](https://mlsanity.com/paper/2304.02643/) (2023)
- [DINOv2: Learning Robust Visual Features without Supervision](https://mlsanity.com/paper/2304.07193/) (2023)
- [PANet: Few-Shot Image Semantic Segmentation with Prototype Alignment](https://mlsanity.com/paper/1908.06391/) (2019)
- [CHAOS Challenge -- Combined (CT-MR) Healthy Abdominal Organ Segmentation](https://mlsanity.com/paper/2001.06535/) (2020)
- [Medical Image Segmentation Review: The success of U-Net](https://mlsanity.com/paper/2211.14830/) (2022)
- [On the Challenges and Perspectives of Foundation Models for Medical Image Analysis](https://mlsanity.com/paper/2306.05705/) (2023)
- [Multivariate mixture model for myocardium segmentation combining multi-source images](https://mlsanity.com/paper/1612.08820/) (2016)
- [Self-Supervision with Superpixels: Training Few-shot Medical Image Segmentation without Annotation](https://mlsanity.com/paper/2007.09886/) (2020)
- [UNETR++: Delving into Efficient and Accurate 3D Medical Image Segmentation](https://mlsanity.com/paper/2212.04497/) (2022)
- [Mine yOur owN Anatomy: Revisiting Medical Image Segmentation with Extremely Limited Labels](https://mlsanity.com/paper/2209.13476/) (2022)
- [Cross-Domain Few-Shot Segmentation via Iterative Support-Query Correspondence Mining](https://mlsanity.com/paper/2401.08407/) (2024)
- [Few-Shot Medical Image Segmentation via a Region-enhanced Prototypical Transformer](https://mlsanity.com/paper/2309.04825/) (2023)
- [M4oE: A Foundation Model for Medical Multimodal Image Segmentation with Mixture of Experts](https://mlsanity.com/paper/2405.09446/) (2024)
- [Learnable Prompting SAM-induced Knowledge Distillation for Semi-supervised Medical Image Segmentation](https://mlsanity.com/paper/2412.13742/) (2024)
- [SelfReg-UNet: Self-Regularized UNet for Medical Image Segmentation](https://mlsanity.com/paper/2406.14896/) (2024)
- [FAMNet: Frequency-aware Matching Network for Cross-domain Few-shot Medical Image Segmentation](https://mlsanity.com/paper/2412.09319/) (2024)
- [Prototype Correlation Matching and Class-Relation Reasoning for Few-Shot Medical Image Segmentation](https://mlsanity.com/paper/2406.05054/) (2024)
- [Partition-A-Medical-Image: Extracting Multiple Representative Sub-regions for Few-shot Medical Image Segmentation](https://mlsanity.com/paper/2309.11172/) (2023)
- [RobustEMD: Domain Robust Matching for Cross-domain Few-shot Medical Image Segmentation](https://mlsanity.com/paper/2410.01110/) (2024)

## Built on by (most cited first, 8 of 8)

- [Atlas is Your Perfect Context: One-Shot Customization for Generalizable Foundational Medical Image Segmentation](https://mlsanity.com/paper/2512.18176/) (2025)
- [Contrastive Graph Modeling for Cross-Domain Few-Shot Medical Image Segmentation](https://mlsanity.com/paper/2512.21683/) (2025)
- [Training-free Cross-domain Few-shot Segmentation via Robust Semantic Representation and Matching](https://mlsanity.com/paper/2606.24297/) (2026)
- [Mask to Concept: Auto-Promptable SAM3 via Efficient Test-Time Concept Embedding Search for Few-Shot Annotation](https://mlsanity.com/paper/2606.26711/) (2026)
- [Prototype Memory-Guided Training-Free Anomaly Classification and Localization in Prenatal Ultrasound](https://mlsanity.com/paper/2607.00744/) (2026)
- [RAP: Retrieve, Adapt, and Prompt-Fit for Training-Free Few-Shot Medical Image Segmentation](https://mlsanity.com/paper/2603.27705/) (2026)
- [Geometry-aware Prototype Learning for Cross-domain Few-shot Medical Image Segmentation](https://mlsanity.com/paper/2605.10885/) (2026)
- [From Few-Shot Segmentation to Clinician-in-the-Loop Medical Image Analysis](https://mlsanity.com/paper/2609.10001/) (2026)

## Abstract (arXiv)

Cross-domain Few-shot Medical Image Segmentation (CD-FSMIS) is a potential solution for segmenting medical images with limited annotation using knowledge from other domains. The significant performance of current CD-FSMIS models relies on the heavily training procedure over other source medical domains, which degrades the universality and ease of model deployment. With the development of large visual models of natural images, we propose a training-free CD-FSMIS model that introduces the Multi-center Adaptive Uncertainty-aware Prompting (MAUP) strategy for adapting the foundation model Segment Anything Model (SAM), which is trained with natural images, into the CD-FSMIS task. To be specific, MAUP consists of three key innovations: (1) K-means clustering based multi-center prompts generation for comprehensive spatial coverage, (2) uncertainty-aware prompts selection that focuses on the challenging regions, and (3) adaptive prompt optimization that can dynamically adjust according to the target region complexity. With the pre-trained DINOv2 feature encoder, MAUP achieves precise segmentation results across three medical datasets without any additional training compared with several conventional CD-FSMIS models and training-free FSMIS model. The source code is available at: https://github.com/YazhouZhu19/MAUP.