Abstract:Accurate magnetic resonance imaging (MRI) segmentation is crucial for clinical decision-making, but remains labor-intensive when performed manually. Convolutional neural network (CNN)-based methods can be accurate and efficient, but often generalize poorly to MRI's variable contrast, intensity inhomogeneity, and protocols. Although the transformer-based Segment Anything Model (SAM) has demonstrated remarkable generalizability in natural images, existing adaptations often treat MRI as another imaging modality, overlooking these modality-specific challenges. We present SAMRI, an MRI-specialized SAM trained and validated on 1.1 million labeled MR slices spanning whole-body organs and pathologies. We demonstrate that SAM can be effectively adapted to MRI by simply fine-tuning its mask decoder using a two-stage strategy, reducing training time by 94% and trainable parameters by 96% versus full-model retraining. Across diverse MRI segmentation tasks, SAMRI achieves a mean Dice of 0.87, delivering state-of-the-art accuracy across anatomical regions and robust generalization on unseen structures, particularly small and clinically important structures.



Abstract:Promptable segmentation foundation models have emerged as a transformative approach to addressing the diverse needs in medical images, but most existing models require expensive computing, posing a big barrier to their adoption in clinical practice. In this work, we organized the first international competition dedicated to promptable medical image segmentation, featuring a large-scale dataset spanning nine common imaging modalities from over 20 different institutions. The top teams developed lightweight segmentation foundation models and implemented an efficient inference pipeline that substantially reduced computational requirements while maintaining state-of-the-art segmentation accuracy. Moreover, the post-challenge phase advanced the algorithms through the design of performance booster and reproducibility tasks, resulting in improved algorithms and validated reproducibility of the winning solution. Furthermore, the best-performing algorithms have been incorporated into the open-source software with a user-friendly interface to facilitate clinical adoption. The data and code are publicly available to foster the further development of medical image segmentation foundation models and pave the way for impactful real-world applications.