ViRefSAM: Visual Reference-Guided Segment Anything Model for Remote Sensing Segmentation

The Segment Anything Model (SAM), with its prompt-driven paradigm, exhibits strong generalization in generic segmentation tasks. However, applying SAM to remote sensing (RS) images still faces two major challenges. First, manually constructing precise prompts for each image (e.g., points or boxes) is labor-intensive and inefficient, especially in RS scenarios with dense small objects or spatially fragmented distributions. Second, SAM lacks domain adaptability, as it is pre-trained primarily on natural images and struggles to capture RS-specific semantics and spatial characteristics, especially when segmenting novel or unseen classes. To address these issues, inspired by few-shot learning, we propose ViRefSAM, a novel framework that guides SAM utilizing only a few annotated reference images that contain class-specific objects. Without requiring manual prompts, ViRefSAM enables automatic segmentation of class-consistent objects across RS images. Specifically, ViRefSAM introduces two key components while keeping SAM's original architecture intact: (1) a Visual Contextual Prompt Encoder that extracts class-specific semantic clues from reference images and generates object-aware prompts via contextual interaction with target images; and (2) a Dynamic Target Alignment Adapter, integrated into SAM's image encoder, which mitigates the domain gap by injecting class-specific semantics into target image features, enabling SAM to dynamically focus on task-relevant regions. Extensive experiments on three few-shot segmentation benchmarks, including iSAID-5$^i$, LoveDA-2$^i$, and COCO-20$^i$, demonstrate that ViRefSAM enables accurate and automatic segmentation of unseen classes by leveraging only a few reference images and consistently outperforms existing few-shot segmentation methods across diverse datasets.

No time to train! Training-Free Reference-Based Instance Segmentation

The performance of image segmentation models has historically been constrained by the high cost of collecting large-scale annotated data. The Segment Anything Model (SAM) alleviates this original problem through a promptable, semantics-agnostic, segmentation paradigm and yet still requires manual visual-prompts or complex domain-dependent prompt-generation rules to process a new image. Towards reducing this new burden, our work investigates the task of object segmentation when provided with, alternatively, only a small set of reference images. Our key insight is to leverage strong semantic priors, as learned by foundation models, to identify corresponding regions between a reference and a target image. We find that correspondences enable automatic generation of instance-level segmentation masks for downstream tasks and instantiate our ideas via a multi-stage, training-free method incorporating (1) memory bank construction; (2) representation aggregation and (3) semantic-aware feature matching. Our experiments show significant improvements on segmentation metrics, leading to state-of-the-art performance on COCO FSOD (36.8% nAP), PASCAL VOC Few-Shot (71.2% nAP50) and outperforming existing training-free approaches on the Cross-Domain FSOD benchmark (22.4% nAP).

General Methods Make Great Domain-specific Foundation Models: A Case-study on Fetal Ultrasound

With access to large-scale, unlabeled medical datasets, researchers are confronted with two questions: Should they attempt to pretrain a custom foundation model on this medical data, or use transfer-learning from an existing generalist model? And, if a custom model is pretrained, are novel methods required? In this paper we explore these questions by conducting a case-study, in which we train a foundation model on a large regional fetal ultrasound dataset of 2M images. By selecting the well-established DINOv2 method for pretraining, we achieve state-of-the-art results on three fetal ultrasound datasets, covering data from different countries, classification, segmentation, and few-shot tasks. We compare against a series of models pretrained on natural images, ultrasound images, and supervised baselines. Our results demonstrate two key insights: (i) Pretraining on custom data is worth it, even if smaller models are trained on less data, as scaling in natural image pretraining does not translate to ultrasound performance. (ii) Well-tuned methods from computer vision are making it feasible to train custom foundation models for a given medical domain, requiring no hyperparameter tuning and little methodological adaptation. Given these findings, we argue that a bias towards methodological innovation should be avoided when developing domain specific foundation models under common computational resource constraints.

SynPo: Boosting Training-Free Few-Shot Medical Segmentation via High-Quality Negative Prompts

The advent of Large Vision Models (LVMs) offers new opportunities for few-shot medical image segmentation. However, existing training-free methods based on LVMs fail to effectively utilize negative prompts, leading to poor performance on low-contrast medical images. To address this issue, we propose SynPo, a training-free few-shot method based on LVMs (e.g., SAM), with the core insight: improving the quality of negative prompts. To select point prompts in a more reliable confidence map, we design a novel Confidence Map Synergy Module by combining the strengths of DINOv2 and SAM. Based on the confidence map, we select the top-k pixels as the positive points set and choose the negative points set using a Gaussian distribution, followed by independent K-means clustering for both sets. Then, these selected points are leveraged as high-quality prompts for SAM to get the segmentation results. Extensive experiments demonstrate that SynPo achieves performance comparable to state-of-the-art training-based few-shot methods.

Concentrate on Weakness: Mining Hard Prototypes for Few-Shot Medical Image Segmentation

Few-Shot Medical Image Segmentation (FSMIS) has been widely used to train a model that can perform segmentation from only a few annotated images. However, most existing prototype-based FSMIS methods generate multiple prototypes from the support image solely by random sampling or local averaging, which can cause particularly severe boundary blurring due to the tendency for normal features accounting for the majority of features of a specific category. Consequently, we propose to focus more attention to those weaker features that are crucial for clear segmentation boundary. Specifically, we design a Support Self-Prediction (SSP) module to identify such weak features by comparing true support mask with one predicted by global support prototype. Then, a Hard Prototypes Generation (HPG) module is employed to generate multiple hard prototypes based on these weak features. Subsequently, a Multiple Similarity Maps Fusion (MSMF) module is devised to generate final segmenting mask in a dual-path fashion to mitigate the imbalance between foreground and background in medical images. Furthermore, we introduce a boundary loss to further constraint the edge of segmentation. Extensive experiments on three publicly available medical image datasets demonstrate that our method achieves state-of-the-art performance. Code is available at https://github.com/jcjiang99/CoW.

Generalist Models in Medical Image Segmentation: A Survey and Performance Comparison with Task-Specific Approaches

Following the successful paradigm shift of large language models, leveraging pre-training on a massive corpus of data and fine-tuning on different downstream tasks, generalist models have made their foray into computer vision. The introduction of Segment Anything Model (SAM) set a milestone on segmentation of natural images, inspiring the design of a multitude of architectures for medical image segmentation. In this survey we offer a comprehensive and in-depth investigation on generalist models for medical image segmentation. We start with an introduction on the fundamentals concepts underpinning their development. Then, we provide a taxonomy on the different declinations of SAM in terms of zero-shot, few-shot, fine-tuning, adapters, on the recent SAM 2, on other innovative models trained on images alone, and others trained on both text and images. We thoroughly analyze their performances at the level of both primary research and best-in-literature, followed by a rigorous comparison with the state-of-the-art task-specific models. We emphasize the need to address challenges in terms of compliance with regulatory frameworks, privacy and security laws, budget, and trustworthy artificial intelligence (AI). Finally, we share our perspective on future directions concerning synthetic data, early fusion, lessons learnt from generalist models in natural language processing, agentic AI and physical AI, and clinical translation.

SANSA: Unleashing the Hidden Semantics in SAM2 for Few-Shot Segmentation

Few-shot segmentation aims to segment unseen object categories from just a handful of annotated examples. This requires mechanisms that can both identify semantically related objects across images and accurately produce segmentation masks. We note that Segment Anything 2 (SAM2), with its prompt-and-propagate mechanism, offers both strong segmentation capabilities and a built-in feature matching process. However, we show that its representations are entangled with task-specific cues optimized for object tracking, which impairs its use for tasks requiring higher level semantic understanding. Our key insight is that, despite its class-agnostic pretraining, SAM2 already encodes rich semantic structure in its features. We propose SANSA (Semantically AligNed Segment Anything 2), a framework that makes this latent structure explicit, and repurposes SAM2 for few-shot segmentation through minimal task-specific modifications. SANSA achieves state-of-the-art performance on few-shot segmentation benchmarks specifically designed to assess generalization, outperforms generalist methods in the popular in-context setting, supports various prompts flexible interaction via points, boxes, or scribbles, and remains significantly faster and more compact than prior approaches. Code is available at https://github.com/ClaudiaCuttano/SANSA.

SaSi: A Self-augmented and Self-interpreted Deep Learning Approach for Few-shot Cryo-ET Particle Detection

Cryo-electron tomography (cryo-ET) has emerged as a powerful technique for imaging macromolecular complexes in their near-native states. However, the localization of 3D particles in cellular environments still presents a significant challenge due to low signal-to-noise ratios and missing wedge artifacts. Deep learning approaches have shown great potential, but they need huge amounts of data, which can be a challenge in cryo-ET scenarios where labeled data is often scarce. In this paper, we propose a novel Self-augmented and Self-interpreted (SaSi) deep learning approach towards few-shot particle detection in 3D cryo-ET images. Our method builds upon self-augmentation techniques to further boost data utilization and introduces a self-interpreted segmentation strategy for alleviating dependency on labeled data, hence improving generalization and robustness. As demonstrated by experiments conducted on both simulated and real-world cryo-ET datasets, the SaSi approach significantly outperforms existing state-of-the-art methods for particle localization. This research increases understanding of how to detect particles with very few labels in cryo-ET and thus sets a new benchmark for few-shot learning in structural biology.

ProMi: An Efficient Prototype-Mixture Baseline for Few-Shot Segmentation with Bounding-Box Annotations

In robotics applications, few-shot segmentation is crucial because it allows robots to perform complex tasks with minimal training data, facilitating their adaptation to diverse, real-world environments. However, pixel-level annotations of even small amount of images is highly time-consuming and costly. In this paper, we present a novel few-shot binary segmentation method based on bounding-box annotations instead of pixel-level labels. We introduce, ProMi, an efficient prototype-mixture-based method that treats the background class as a mixture of distributions. Our approach is simple, training-free, and effective, accommodating coarse annotations with ease. Compared to existing baselines, ProMi achieves the best results across different datasets with significant gains, demonstrating its effectiveness. Furthermore, we present qualitative experiments tailored to real-world mobile robot tasks, demonstrating the applicability of our approach in such scenarios. Our code: https://github.com/ThalesGroup/promi.

Recent Advances in Medical Imaging Segmentation: A Survey

Medical imaging is a cornerstone of modern healthcare, driving advancements in diagnosis, treatment planning, and patient care. Among its various tasks, segmentation remains one of the most challenging problem due to factors such as data accessibility, annotation complexity, structural variability, variation in medical imaging modalities, and privacy constraints. Despite recent progress, achieving robust generalization and domain adaptation remains a significant hurdle, particularly given the resource-intensive nature of some proposed models and their reliance on domain expertise. This survey explores cutting-edge advancements in medical image segmentation, focusing on methodologies such as Generative AI, Few-Shot Learning, Foundation Models, and Universal Models. These approaches offer promising solutions to longstanding challenges. We provide a comprehensive overview of the theoretical foundations, state-of-the-art techniques, and recent applications of these methods. Finally, we discuss inherent limitations, unresolved issues, and future research directions aimed at enhancing the practicality and accessibility of segmentation models in medical imaging. We are maintaining a \href{https://github.com/faresbougourzi/Awesome-DL-for-Medical-Imaging-Segmentation}{GitHub Repository} to continue tracking and updating innovations in this field.