# VesSAM: Efficient Multi-Prompting for Segmenting Complex Vessel

arXiv: https://arxiv.org/abs/2511.00981 · HTML: https://mlsanity.com/paper/2511.00981/

## Key facts

- Cited by 3 papers in the map (data through 14 Oct 2026).
- Builds on 35 of its 45 references that are in the map.
- First posted on arXiv 2 Nov 2025.

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

- [Attention Is All You Need](https://mlsanity.com/paper/1706.03762/) (2017)
- [Deep Residual Learning for Image Recognition](https://mlsanity.com/paper/1512.03385/) (2015)
- [BERT: Pre-training of Deep Bidirectional Transformers for Language Understanding](https://mlsanity.com/paper/1810.04805/) (2018)
- [Learning Transferable Visual Models From Natural Language Supervision](https://mlsanity.com/paper/2103.00020/) (2021)
- [An Image is Worth 16x16 Words: Transformers for Image Recognition at Scale](https://mlsanity.com/paper/2010.11929/) (2020)
- [U-Net: Convolutional Networks for Biomedical Image Segmentation](https://mlsanity.com/paper/1505.04597/) (2015)
- [High-Resolution Image Synthesis with Latent Diffusion Models](https://mlsanity.com/paper/2112.10752/) (2021)
- [GPT-4 Technical Report](https://mlsanity.com/paper/2303.08774/) (2023)
- [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)
- [Swin Transformer: Hierarchical Vision Transformer using Shifted Windows](https://mlsanity.com/paper/2103.14030/) (2021)
- [Segment Anything](https://mlsanity.com/paper/2304.02643/) (2023)
- [Visual Instruction Tuning](https://mlsanity.com/paper/2304.08485/) (2023)
- [Densely Connected Convolutional Networks](https://mlsanity.com/paper/1608.06993/) (2016)
- [BLIP: Bootstrapping Language-Image Pre-training for Unified Vision-Language Understanding and Generation](https://mlsanity.com/paper/2201.12086/) (2022)
- [Zero-Shot Text-to-Image Generation](https://mlsanity.com/paper/2102.12092/) (2021)
- [Grounding DINO: Marrying DINO with Grounded Pre-Training for Open-Set Object Detection](https://mlsanity.com/paper/2303.05499/) (2023)
- [BioBERT: a pre-trained biomedical language representation model for biomedical text mining](https://mlsanity.com/paper/1901.08746/) (2019)
- [Visual Prompt Tuning](https://mlsanity.com/paper/2203.12119/) (2022)
- [TransUNet: Transformers Make Strong Encoders for Medical Image Segmentation](https://mlsanity.com/paper/2102.04306/) (2021)
- [ChatGLM: A Family of Large Language Models from GLM-130B to GLM-4 All Tools](https://mlsanity.com/paper/2406.12793/) (2024)
- [The Dawn of LMMs: Preliminary Explorations with GPT-4V(ision)](https://mlsanity.com/paper/2309.17421/) (2023)
- [Parameter-Efficient Fine-Tuning for Large Models: A Comprehensive Survey](https://mlsanity.com/paper/2403.14608/) (2024)
- [Vision Transformer Adapter for Dense Predictions](https://mlsanity.com/paper/2205.08534/) (2022)
- [Customized Segment Anything Model for Medical Image Segmentation](https://mlsanity.com/paper/2304.13785/) (2023)
- [Segment Anything in Medical Images](https://mlsanity.com/paper/2304.12306/) (2023)
- [Medical SAM 2: Segment medical images as video via Segment Anything Model 2](https://mlsanity.com/paper/2408.00874/) (2024)
- [SAM-Med2D](https://mlsanity.com/paper/2308.16184/) (2023)
- [SAM-Med3D: Towards General-purpose Segmentation Models for Volumetric Medical Images](https://mlsanity.com/paper/2310.15161/) (2023)
- [Contrastive Learning for Label-Efficient Semantic Segmentation](https://mlsanity.com/paper/2012.06985/) (2020)

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

- [From Reconstruction to Decision: A Post-Encoder Plug-in Adapter for Curvilinear Segmentation](https://mlsanity.com/paper/2606.23486/) (2026)
- [Modeling Clinical Workflow for SYNTAX Scoring from Coronary Angiography Videos](https://mlsanity.com/paper/2609.23553/) (2026)
- [Topology-Aware Parameter-Efficient Adaptation for Cross-Dataset Retinal Vessel Segmentation](https://mlsanity.com/paper/2609.26189/) (2026)

## Abstract (arXiv)

Accurate vessel segmentation is critical for clinical applications such as disease diagnosis and surgical planning, yet remains challenging due to thin, branching structures and low texture contrast. While foundation models like the Segment Anything Model (SAM) have shown promise in generic segmentation, they perform sub-optimally on vascular structures. In this work, we present VesSAM, a powerful and efficient framework tailored for 2D vessel segmentation. VesSAM integrates (1) a convolutional adapter to enhance local texture features, (2) a multi-prompt encoder that fuses anatomical prompts, including skeletons, bifurcation points, and segment midpoints, via hierarchical cross-attention, and (3) a lightweight mask decoder to reduce jagged artifacts. We also introduce an automated pipeline to generate structured multi-prompt annotations, and curate a diverse benchmark dataset spanning 8 datasets across 5 imaging modalities. Experimental results demonstrate that VesSAM consistently outperforms state-of-the-art PEFT-based SAM variants by over 10% Dice and 13% IoU, and achieves competitive performance compared to fully fine-tuned methods, with significantly fewer parameters. VesSAM also generalizes well to out-of-distribution (OoD) settings, outperforming all baselines in average OoD Dice and IoU.