# Adapting Foundation Models for Annotation-Efficient Adnexal Mass Segmentation in Cine Images

arXiv: https://arxiv.org/abs/2604.08045 · HTML: https://mlsanity.com/paper/2604.08045/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 7 of its 28 references that are in the map.
- First posted on arXiv 9 Apr 2026.

## Builds on (most cited first, 7 of 7)

- [U-Net: Convolutional Networks for Biomedical Image Segmentation](https://mlsanity.com/paper/1505.04597/) (2015)
- [Emerging Properties in Self-Supervised Vision Transformers](https://mlsanity.com/paper/2104.14294/) (2021)
- [Vision Transformers for Dense Prediction](https://mlsanity.com/paper/2103.13413/) (2021)
- [RefineNet: Multi-Path Refinement Networks for High-Resolution Semantic Segmentation](https://mlsanity.com/paper/1611.06612/) (2016)
- [FCNs in the Wild: Pixel-level Adversarial and Constraint-based Adaptation](https://mlsanity.com/paper/1612.02649/) (2016)
- [Accurate Weakly-Supervised Deep Lesion Segmentation using Large-Scale Clinical Annotations: Slice-Propagated 3D Mask Generation from 2D RECIST](https://mlsanity.com/paper/1807.01172/) (2018)
- [Adnexal Mass Segmentation with Ultrasound Data Synthesis](https://mlsanity.com/paper/2209.12305/) (2022)

## Abstract (arXiv)

Adnexal mass evaluation via ultrasound is a challenging clinical task, often hindered by subjective interpretation and significant inter-observer variability. While automated segmentation is a foundational step for quantitative risk assessment, traditional fully supervised convolutional architectures frequently require large amounts of pixel-level annotations and struggle with domain shifts common in medical imaging. In this work, we propose a label-efficient segmentation framework that leverages the robust semantic priors of a pretrained DINOv3 foundational vision transformer backbone. By integrating this backbone with a Dense Prediction Transformer (DPT)-style decoder, our model hierarchically reassembles multi-scale features to combine global semantic representations with fine-grained spatial details. Evaluated on a clinical dataset of 7,777 annotated frames from 112 patients, our method achieves state-of-the-art performance compared to established fully supervised baselines, including U-Net, U-Net++, DeepLabV3, and MAnet. Specifically, we obtain a Dice score of 0.945 and improved boundary adherence, reducing the 95th-percentile Hausdorff Distance by 11.4% relative to the strongest convolutional baseline. Furthermore, we conduct an extensive efficiency analysis demonstrating that our DINOv3-based approach retains significantly higher performance under data starvation regimes, maintaining strong results even when trained on only 25% of the data. These results suggest that leveraging large-scale self-supervised foundations provides a promising and data-efficient solution for medical image segmentation in data-constrained clinical environments. Project Repository: https://github.com/FrancescaFati/MESA