# Efficient Universal Models for Medical Image Segmentation via Weakly Supervised In-Context Learning

arXiv: https://arxiv.org/abs/2510.05899 · HTML: https://mlsanity.com/paper/2510.05899/

## Key facts

- Cited by 1 papers in the map (data through 14 Oct 2026).
- Builds on 13 of its 20 references that are in the map.
- First posted on arXiv 7 Oct 2025.

## Builds on (most cited first, 13 of 13)

- [Segment Anything](https://mlsanity.com/paper/2304.02643/) (2023)
- [TotalSegmentator: robust segmentation of 104 anatomical structures in CT images](https://mlsanity.com/paper/2208.05868/) (2022)
- [AMOS: A Large-Scale Abdominal Multi-Organ Benchmark for Versatile Medical Image Segmentation](https://mlsanity.com/paper/2206.08023/) (2022)
- [SegGPT: Segmenting Everything In Context](https://mlsanity.com/paper/2304.03284/) (2023)
- [SAM-Med3D: Towards General-purpose Segmentation Models for Volumetric Medical Images](https://mlsanity.com/paper/2310.15161/) (2023)
- [UniverSeg: Universal Medical Image Segmentation](https://mlsanity.com/paper/2304.06131/) (2023)
- [nnInteractive: Redefining 3D Promptable Segmentation](https://mlsanity.com/paper/2503.08373/) (2025)
- [Neuralizer: General Neuroimage Analysis without Re-Training](https://mlsanity.com/paper/2305.02644/) (2023)
- [Rethinking Abdominal Organ Segmentation (RAOS) in the clinical scenario: A robustness evaluation benchmark with challenging cases](https://mlsanity.com/paper/2406.13674/) (2024)
- [Read Like a Radiologist: Efficient Vision-Language Model for 3D Medical Imaging Interpretation](https://mlsanity.com/paper/2412.13558/) (2024)
- [A Chebyshev Confidence Guided Source-Free Domain Adaptation Framework for Medical Image Segmentation](https://mlsanity.com/paper/2310.18087/) (2023)
- [Medverse: A Universal Model for Full-Resolution 3D Medical Image Segmentation, Transformation and Enhancement](https://mlsanity.com/paper/2509.09232/) (2025)
- [Towards Robust In-Context Learning for Medical Image Segmentation via Data Synthesis](https://mlsanity.com/paper/2509.19711/) (2025)

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

- [UniMedSeg: Unified In-Context Learning for Multi-Paradigm 2D/3D Medical Image Segmentation](https://mlsanity.com/paper/2607.12896/) (2026)

## Abstract (arXiv)

Universal models for medical image segmentation, such as interactive and in-context learning (ICL) models, offer strong generalization but require extensive annotations. Interactive models need repeated user prompts for each image, while ICL relies on dense, pixel-level labels. To address this, we propose Weakly Supervised In-Context Learning (WS-ICL), a new ICL paradigm that leverages weak prompts (e.g., bounding boxes or points) instead of dense labels for context. This approach significantly reduces annotation effort by eliminating the need for fine-grained masks and repeated user prompting for all images. We evaluated the proposed WS-ICL model on three held-out benchmarks. Experimental results demonstrate that WS-ICL achieves performance comparable to regular ICL models at a significantly lower annotation cost. In addition, WS-ICL is highly competitive even under the interactive paradigm. These findings establish WS-ICL as a promising step toward more efficient and unified universal models for medical image segmentation. Our code and model are publicly available at https://github.com/jiesihu/Weak-ICL.