ProMISe: Promptable Medical Image Segmentation using SAM

With the proposal of the Segment Anything Model (SAM), fine-tuning SAM for medical image segmentation (MIS) has become popular. However, due to the large size of the SAM model and the significant ___domain gap between natural and medical images, fine-tuning-based strategies are costly with potential risk of instability, feature damage and catastrophic forgetting. Furthermore, some methods of transferring SAM to a ___domain-specific MIS through fine-tuning strategies disable the model's prompting capability, severely limiting its utilization scenarios. In this paper, we propose an Auto-Prompting Module (APM), which provides SAM-based foundation model with Euclidean adaptive prompts in the target ___domain. Our experiments demonstrate that such adaptive prompts significantly improve SAM's non-fine-tuned performance in MIS. In addition, we propose a novel non-invasive method called Incremental Pattern Shifting (IPS) to adapt SAM to specific medical domains. Experimental results show that the IPS enables SAM to achieve state-of-the-art or competitive performance in MIS without the need for fine-tuning. By coupling these two methods, we propose ProMISe, an end-to-end non-fine-tuned framework for Promptable Medical Image Segmentation. Our experiments demonstrate that both using our methods individually or in combination achieves satisfactory performance in low-cost pattern shifting, with all of SAM's parameters frozen.