Daily Papers

Interactive image segmentation enables annotators to efficiently perform pixel-level annotation for segmentation tasks. However, the existing interactive segmentation pipeline suffers from inefficient computations of interactive models because of the following two issues. First, annotators' later click is based on models' feedback of annotators' former click. This serial interaction is unable to utilize model's parallelism capabilities. Second, in each interaction step, the model handles the invariant image along with the sparse variable clicks, resulting in a process that's highly repetitive and redundant. For efficient computations, we propose a method named InterFormer that follows a new pipeline to address these issues. InterFormer extracts and preprocesses the computationally time-consuming part i.e. image processing from the existing process. Specifically, InterFormer employs a large vision transformer (ViT) on high-performance devices to preprocess images in parallel, and then uses a lightweight module called interactive multi-head self attention (I-MSA) for interactive segmentation. Furthermore, the I-MSA module's deployment on low-power devices extends the practical application of interactive segmentation. The I-MSA module utilizes the preprocessed features to efficiently response to the annotator inputs in real-time. The experiments on several datasets demonstrate the effectiveness of InterFormer, which outperforms previous interactive segmentation models in terms of computational efficiency and segmentation quality, achieve real-time high-quality interactive segmentation on CPU-only devices. The code is available at https://github.com/YouHuang67/InterFormer.

The goal of interactive image segmentation is to delineate specific regions within an image via visual or language prompts. Low-latency and high-quality interactive segmentation with diverse prompts remain challenging for existing specialist and generalist models. Specialist models, with their limited prompts and task-specific designs, experience high latency because the image must be recomputed every time the prompt is updated, due to the joint encoding of image and visual prompts. Generalist models, exemplified by the Segment Anything Model (SAM), have recently excelled in prompt diversity and efficiency, lifting image segmentation to the foundation model era. However, for high-quality segmentations, SAM still lags behind state-of-the-art specialist models despite SAM being trained with x100 more segmentation masks. In this work, we delve deep into the architectural differences between the two types of models. We observe that dense representation and fusion of visual prompts are the key design choices contributing to the high segmentation quality of specialist models. In light of this, we reintroduce this dense design into the generalist models, to facilitate the development of generalist models with high segmentation quality. To densely represent diverse visual prompts, we propose to use a dense map to capture five types: clicks, boxes, polygons, scribbles, and masks. Thus, we propose SegNext, a next-generation interactive segmentation approach offering low latency, high quality, and diverse prompt support. Our method outperforms current state-of-the-art methods on HQSeg-44K and DAVIS, both quantitatively and qualitatively.

Click-based interactive image segmentation aims at extracting objects with a limited user clicking. A hierarchical backbone is the de-facto architecture for current methods. Recently, the plain, non-hierarchical Vision Transformer (ViT) has emerged as a competitive backbone for dense prediction tasks. This design allows the original ViT to be a foundation model that can be finetuned for downstream tasks without redesigning a hierarchical backbone for pretraining. Although this design is simple and has been proven effective, it has not yet been explored for interactive image segmentation. To fill this gap, we propose SimpleClick, the first interactive segmentation method that leverages a plain backbone. Based on the plain backbone, we introduce a symmetric patch embedding layer that encodes clicks into the backbone with minor modifications to the backbone itself. With the plain backbone pretrained as a masked autoencoder (MAE), SimpleClick achieves state-of-the-art performance. Remarkably, our method achieves 4.15 NoC@90 on SBD, improving 21.8% over the previous best result. Extensive evaluation on medical images demonstrates the generalizability of our method. We further develop an extremely tiny ViT backbone for SimpleClick and provide a detailed computational analysis, highlighting its suitability as a practical annotation tool.

Existing automatic 3D image segmentation methods usually fail to meet the clinic use. Many studies have explored an interactive strategy to improve the image segmentation performance by iteratively incorporating user hints. However, the dynamic process for successive interactions is largely ignored. We here propose to model the dynamic process of iterative interactive image segmentation as a Markov decision process (MDP) and solve it with reinforcement learning (RL). Unfortunately, it is intractable to use single-agent RL for voxel-wise prediction due to the large exploration space. To reduce the exploration space to a tractable size, we treat each voxel as an agent with a shared voxel-level behavior strategy so that it can be solved with multi-agent reinforcement learning. An additional advantage of this multi-agent model is to capture the dependency among voxels for segmentation task. Meanwhile, to enrich the information of previous segmentations, we reserve the prediction uncertainty in the state space of MDP and derive an adjustment action space leading to a more precise and finer segmentation. In addition, to improve the efficiency of exploration, we design a relative cross-entropy gain-based reward to update the policy in a constrained direction. Experimental results on various medical datasets have shown that our method significantly outperforms existing state-of-the-art methods, with the advantage of fewer interactions and a faster convergence.

Interactive segmentation has recently been explored to effectively and efficiently harvest high-quality segmentation masks by iteratively incorporating user hints. While iterative in nature, most existing interactive segmentation methods tend to ignore the dynamics of successive interactions and take each interaction independently. We here propose to model iterative interactive image segmentation with a Markov decision process (MDP) and solve it with reinforcement learning (RL) where each voxel is treated as an agent. Considering the large exploration space for voxel-wise prediction and the dependence among neighboring voxels for the segmentation tasks, multi-agent reinforcement learning is adopted, where the voxel-level policy is shared among agents. Considering that boundary voxels are more important for segmentation, we further introduce a boundary-aware reward, which consists of a global reward in the form of relative cross-entropy gain, to update the policy in a constrained direction, and a boundary reward in the form of relative weight, to emphasize the correctness of boundary predictions. To combine the advantages of different types of interactions, i.e., simple and efficient for point-clicking, and stable and robust for scribbles, we propose a supervoxel-clicking based interaction design. Experimental results on four benchmark datasets have shown that the proposed method significantly outperforms the state-of-the-arts, with the advantage of fewer interactions, higher accuracy, and enhanced robustness.

The Segment Anything Model (SAM) has set a new standard in interactive image segmentation, offering robust performance across various tasks. However, its significant computational requirements limit its deployment in real-time or resource-constrained environments. To address these challenges, we propose a novel knowledge distillation approach, KD SAM, which incorporates both encoder and decoder optimization through a combination of Mean Squared Error (MSE) and Perceptual Loss. This dual-loss framework captures structural and semantic features, enabling the student model to maintain high segmentation accuracy while reducing computational complexity. Based on the model evaluation on datasets, including Kvasir-SEG, ISIC 2017, Fetal Head Ultrasound, and Breast Ultrasound, we demonstrate that KD SAM achieves comparable or superior performance to the baseline models, with significantly fewer parameters. KD SAM effectively balances segmentation accuracy and computational efficiency, making it well-suited for real-time medical image segmentation applications in resource-constrained environments.

Segment Anything (SAM) has recently pushed the boundaries of segmentation by demonstrating zero-shot generalization and flexible prompting after training on over one billion masks. Despite this, its mask prediction accuracy often falls short of the precision required in real-world applications. While several refinement modules have been proposed to boost SAM's segmentation quality, achieving highly accurate object delineation within a single, unified framework remains an open challenge. Furthermore, interactive image matting, which aims to generate fine-grained alpha mattes guided by diverse user hints, has not yet been explored in the context of SAM. Insights from recent studies highlight strong correlations between segmentation and matting, suggesting the feasibility of a unified model capable of both tasks. In this paper, we introduce Segment And Matte Anything (SAMA), a lightweight extension of SAM that delivers high-quality interactive image segmentation and matting with minimal extra parameters. Our Multi-View Localization Encoder (MVLE) captures detailed features from local views, while the Localization Adapter (Local-Adapter) refines mask outputs by recovering subtle boundary details. We also incorporate two prediction heads for each task into the architecture to generate segmentation and matting masks, simultaneously. Trained on a diverse dataset aggregated from publicly available sources, SAMA achieves state-of-the-art performance across multiple segmentation and matting benchmarks, showcasing its adaptability and effectiveness in a wide range of downstream tasks.

Interactive Medical Image Segmentation (IMIS) has long been constrained by the limited availability of large-scale, diverse, and densely annotated datasets, which hinders model generalization and consistent evaluation across different models. In this paper, we introduce the IMed-361M benchmark dataset, a significant advancement in general IMIS research. First, we collect and standardize over 6.4 million medical images and their corresponding ground truth masks from multiple data sources. Then, leveraging the strong object recognition capabilities of a vision foundational model, we automatically generated dense interactive masks for each image and ensured their quality through rigorous quality control and granularity management. Unlike previous datasets, which are limited by specific modalities or sparse annotations, IMed-361M spans 14 modalities and 204 segmentation targets, totaling 361 million masks-an average of 56 masks per image. Finally, we developed an IMIS baseline network on this dataset that supports high-quality mask generation through interactive inputs, including clicks, bounding boxes, text prompts, and their combinations. We evaluate its performance on medical image segmentation tasks from multiple perspectives, demonstrating superior accuracy and scalability compared to existing interactive segmentation models. To facilitate research on foundational models in medical computer vision, we release the IMed-361M and model at https://github.com/uni-medical/IMIS-Bench.

Medical image segmentation is evolving from task-specific models toward generalizable frameworks. Recent research leverages Multi-modal Large Language Models (MLLMs) as autonomous agents, employing reinforcement learning with verifiable reward (RLVR) to orchestrate specialized tools like the Segment Anything Model (SAM). However, these approaches often rely on single-turn, rigid interaction strategies and lack process-level supervision during training, which hinders their ability to fully exploit the dynamic potential of interactive tools and leads to redundant actions. To bridge this gap, we propose MedSAM-Agent, a framework that reformulates interactive segmentation as a multi-step autonomous decision-making process. First, we introduce a hybrid prompting strategy for expert-curated trajectory generation, enabling the model to internalize human-like decision heuristics and adaptive refinement strategies. Furthermore, we develop a two-stage training pipeline that integrates multi-turn, end-to-end outcome verification with a clinical-fidelity process reward design to promote interaction parsimony and decision efficiency. Extensive experiments across 6 medical modalities and 21 datasets demonstrate that MedSAM-Agent achieves state-of-the-art performance, effectively unifying autonomous medical reasoning with robust, iterative optimization. Code is available https://github.com/CUHK-AIM-Group/MedSAM-Agent{here}.

Precise delineation of meningiomas is crucial for effective radiotherapy (RT) planning, directly influencing treatment efficacy and preservation of adjacent healthy tissues. While automated deep learning approaches have demonstrated considerable potential, achieving consistently accurate clinical segmentation remains challenging due to tumor heterogeneity. Interactive Medical Image Segmentation (IMIS) addresses this challenge by integrating advanced AI techniques with clinical input. However, generic segmentation tools, despite widespread applicability, often lack the specificity required for clinically critical and disease-specific tasks like meningioma RT planning. To overcome these limitations, we introduce Interactive-MEN-RT, a dedicated IMIS tool specifically developed for clinician-assisted 3D meningioma segmentation in RT workflows. The system incorporates multiple clinically relevant interaction methods, including point annotations, bounding boxes, lasso tools, and scribbles, enhancing usability and clinical precision. In our evaluation involving 500 contrast-enhanced T1-weighted MRI scans from the BraTS 2025 Meningioma RT Segmentation Challenge, Interactive-MEN-RT demonstrated substantial improvement compared to other segmentation methods, achieving Dice similarity coefficients of up to 77.6\% and Intersection over Union scores of 64.8\%. These results emphasize the need for clinically tailored segmentation solutions in critical applications such as meningioma RT planning. The code is publicly available at: https://github.com/snuh-rad-aicon/Interactive-MEN-RT

Precise image segmentation provides clinical study with meaningful and well-structured information. Despite the remarkable progress achieved in medical image segmentation, there is still an absence of foundation segmentation model that can segment a wide range of anatomical categories with easy user interaction. In this paper, we propose a universal and interactive volumetric medical image segmentation model, named SegVol. By training on 90k unlabeled Computed Tomography (CT) volumes and 6k labeled CTs, this foundation model supports the segmentation of over 200 anatomical categories using semantic and spatial prompts. Extensive experiments verify that SegVol outperforms the state of the art by a large margin on multiple segmentation benchmarks. Notably, on three challenging lesion datasets, our method achieves around 20% higher Dice score than nnU-Net. The model and data are publicly available at: https://github.com/BAAI-DCAI/SegVol.

Interactive egocentric medical image segmentation (IEMIS) plays an important role in smart-glasses-assisted medical image review, segmenting the medical targets a clinician refers to from their egocentric view. Once it succeeds, the object-level visual evidence it provides strengthens the review and underpins fine-grained analysis and clinical decision-making. However, the instruction and the video both come from the user's egocentric perspective, which poses two challenges. (1) Semantic ambiguity leaves the model unable to confirm the user-intended target. (2) Visual variability makes the segmentation jump from frame to frame. In this paper, we propose EgoMed-Agent, a multi-agent system that understands the target from the human perspective through two workflows. (1) The Target Confirmation Workflow grounds the instruction against candidate targets with a reliability score, confirming the target when the grounding is reliable and asking the user to clarify when it is not, thereby confirming the segmentation target. (2) The Localization-Guided Propagation Workflow couples mask propagation with per-frame target localization, using the localized target to correct the propagated mask whenever the two diverge, so the segmentation stays on the target across the egocentric video. Extensive experiments show that EgoMed-Agent reaches 71.34\% average Dice, far above the best text-prompted baseline (11.70\%). Our code is available at https://github.com/wdyyyyyy/EgoMed-Agent{our project page}.

Generating accurate sounds for complex audio-visual scenes is challenging, especially in the presence of multiple objects and sound sources. In this paper, we propose an {\em interactive object-aware audio generation} model that grounds sound generation in user-selected visual objects within images. Our method integrates object-centric learning into a conditional latent diffusion model, which learns to associate image regions with their corresponding sounds through multi-modal attention. At test time, our model employs image segmentation to allow users to interactively generate sounds at the {\em object} level. We theoretically validate that our attention mechanism functionally approximates test-time segmentation masks, ensuring the generated audio aligns with selected objects. Quantitative and qualitative evaluations show that our model outperforms baselines, achieving better alignment between objects and their associated sounds. Project page: https://tinglok.netlify.app/files/avobject/

We present ENSAM (Equivariant, Normalized, Segment Anything Model), a lightweight and promptable model for universal 3D medical image segmentation. ENSAM combines a SegResNet-based encoder with a prompt encoder and mask decoder in a U-Net-style architecture, using latent cross-attention, relative positional encoding, normalized attention, and the Muon optimizer for training. ENSAM is designed to achieve good performance under limited data and computational budgets, and is trained from scratch on under 5,000 volumes from multiple modalities (CT, MRI, PET, ultrasound, microscopy) on a single 32 GB GPU in 6 hours. As part of the CVPR 2025 Foundation Models for Interactive 3D Biomedical Image Segmentation Challenge, ENSAM was evaluated on hidden test set with multimodal 3D medical images, obtaining a DSC AUC of 2.404, NSD AUC of 2.266, final DSC of 0.627, and final NSD of 0.597, outperforming two previously published baseline models (VISTA3D, SAM-Med3D) and matching the third (SegVol), surpassing its performance in final DSC but trailing behind in the other three metrics. In the coreset track of the challenge, ENSAM ranks 5th of 10 overall and best among the approaches not utilizing pretrained weights. Ablation studies confirm that our use of relative positional encodings and the Muon optimizer each substantially speed up convergence and improve segmentation quality.

Segmentation of anatomical structures and pathological regions in medical images is essential for modern clinical diagnosis, disease research, and treatment planning. While significant advancements have been made in deep learning-based segmentation techniques, many of these methods still suffer from limitations in data efficiency, generalizability, and interactivity. As a result, developing precise segmentation methods that require fewer labeled datasets remains a critical challenge in medical image analysis. Recently, the introduction of foundation models like CLIP and Segment-Anything-Model (SAM), with robust cross-domain representations, has paved the way for interactive and universal image segmentation. However, further exploration of these models for data-efficient segmentation in medical imaging is still needed and highly relevant. In this paper, we introduce MedCLIP-SAMv2, a novel framework that integrates the CLIP and SAM models to perform segmentation on clinical scans using text prompts, in both zero-shot and weakly supervised settings. Our approach includes fine-tuning the BiomedCLIP model with a new Decoupled Hard Negative Noise Contrastive Estimation (DHN-NCE) loss, and leveraging the Multi-modal Information Bottleneck (M2IB) to create visual prompts for generating segmentation masks from SAM in the zero-shot setting. We also investigate using zero-shot segmentation labels within a weakly supervised paradigm to enhance segmentation quality further. Extensive testing across four diverse segmentation tasks and medical imaging modalities (breast tumor ultrasound, brain tumor MRI, lung X-ray, and lung CT) demonstrates the high accuracy of our proposed framework. Our code is available at https://github.com/HealthX-Lab/MedCLIP-SAMv2.

Medical image segmentation of anatomical structures and pathology is crucial in modern clinical diagnosis, disease study, and treatment planning. To date, great progress has been made in deep learning-based segmentation techniques, but most methods still lack data efficiency, generalizability, and interactability. Consequently, the development of new, precise segmentation methods that demand fewer labeled datasets is of utmost importance in medical image analysis. Recently, the emergence of foundation models, such as CLIP and Segment-Anything-Model (SAM), with comprehensive cross-domain representation opened the door for interactive and universal image segmentation. However, exploration of these models for data-efficient medical image segmentation is still limited, but is highly necessary. In this paper, we propose a novel framework, called MedCLIP-SAM that combines CLIP and SAM models to generate segmentation of clinical scans using text prompts in both zero-shot and weakly supervised settings. To achieve this, we employed a new Decoupled Hard Negative Noise Contrastive Estimation (DHN-NCE) loss to fine-tune the BiomedCLIP model and the recent gScoreCAM to generate prompts to obtain segmentation masks from SAM in a zero-shot setting. Additionally, we explored the use of zero-shot segmentation labels in a weakly supervised paradigm to improve the segmentation quality further. By extensively testing three diverse segmentation tasks and medical image modalities (breast tumor ultrasound, brain tumor MRI, and lung X-ray), our proposed framework has demonstrated excellent accuracy. Code is available at https://github.com/HealthX-Lab/MedCLIP-SAM.

Accurate semantic segmentation for histopathology image is crucial for quantitative tissue analysis and downstream clinical modeling. Recent segmentation foundation models have improved generalization through large-scale pretraining, yet remain poorly aligned with pathology because they treat segmentation as a static visual prediction task. Here we present VISTA-PATH, an interactive, class-aware pathology segmentation foundation model designed to resolve heterogeneous structures, incorporate expert feedback, and produce pixel-level segmentation that are directly meaningful for clinical interpretation. VISTA-PATH jointly conditions segmentation on visual context, semantic tissue descriptions, and optional expert-provided spatial prompts, enabling precise multi-class segmentation across heterogeneous pathology images. To support this paradigm, we curate VISTA-PATH Data, a large-scale pathology segmentation corpus comprising over 1.6 million image-mask-text triplets spanning 9 organs and 93 tissue classes. Across extensive held-out and external benchmarks, VISTA-PATH consistently outperforms existing segmentation foundation models. Importantly, VISTA-PATH supports dynamic human-in-the-loop refinement by propagating sparse, patch-level bounding-box annotation feedback into whole-slide segmentation. Finally, we show that the high-fidelity, class-aware segmentation produced by VISTA-PATH is a preferred model for computational pathology. It improve tissue microenvironment analysis through proposed Tumor Interaction Score (TIS), which exhibits strong and significant associations with patient survival. Together, these results establish VISTA-PATH as a foundation model that elevates pathology image segmentation from a static prediction to an interactive and clinically grounded representation for digital pathology. Source code and demo can be found at https://github.com/zhihuanglab/VISTA-PATH.

Semantic medical image segmentation is a crucial part of both scientific research and clinical care. With enough labelled data, deep learning models can be trained to accurately automate specific medical image segmentation tasks. However, manually segmenting images to create training data is highly labor intensive. In this paper, we present ScribblePrompt, an interactive segmentation framework for medical imaging that enables human annotators to segment unseen structures using scribbles, clicks, and bounding boxes. Scribbles are an intuitive and effective form of user interaction for complex tasks, however most existing methods focus on click-based interactions. We introduce algorithms for simulating realistic scribbles that enable training models that are amenable to multiple types of interaction. To achieve generalization to new tasks, we train on a diverse collection of 65 open-access biomedical datasets -- using both real and synthetic labels. We test ScribblePrompt on multiple network architectures and unseen datasets, and demonstrate that it can be used in real-time on a single CPU. We evaluate ScribblePrompt using manually-collected scribbles, simulated interactions, and a user study. ScribblePrompt outperforms existing methods in all our evaluations. In the user study, ScribblePrompt reduced annotation time by 28% while improving Dice by 15% compared to existing methods. We showcase ScribblePrompt in an online demo and provide code at https://scribbleprompt.csail.mit.edu

LLaVA-Interactive is a research prototype for multimodal human-AI interaction. The system can have multi-turn dialogues with human users by taking multimodal user inputs and generating multimodal responses. Importantly, LLaVA-Interactive goes beyond language prompt, where visual prompt is enabled to align human intents in the interaction. The development of LLaVA-Interactive is extremely cost-efficient as the system combines three multimodal skills of pre-built AI models without additional model training: visual chat of LLaVA, image segmentation from SEEM, as well as image generation and editing from GLIGEN. A diverse set of application scenarios is presented to demonstrate the promises of LLaVA-Interactive and to inspire future research in multimodal interactive systems.

Image segmentation plays an essential role in medicine for both diagnostic and interventional tasks. Segmentation approaches are either manual, semi-automated or fully-automated. Manual segmentation offers full control over the quality of the results, but is tedious, time consuming and prone to operator bias. Fully automated methods require no human effort, but often deliver sub-optimal results without providing users with the means to make corrections. Semi-automated approaches keep users in control of the results by providing means for interaction, but the main challenge is to offer a good trade-off between precision and required interaction. In this paper we present a deep learning (DL) based semi-automated segmentation approach that aims to be a "smart" interactive tool for region of interest delineation in medical images. We demonstrate its use for segmenting multiple organs on computed tomography (CT) of the abdomen. Our approach solves some of the most pressing clinical challenges: (i) it requires only one to a few user clicks to deliver excellent 2D segmentations in a fast and reliable fashion; (ii) it can generalize to previously unseen structures and "corner cases"; (iii) it delivers results that can be corrected quickly in a smart and intuitive way up to an arbitrary degree of precision chosen by the user and (iv) ensures high accuracy. We present our approach and compare it to other techniques and previous work to show the advantages brought by our method.

Medical image segmentation is vital for clinical diagnosis and quantitative analysis, yet remains challenging due to the heterogeneity of imaging modalities and the high cost of pixel-level annotations. Although general interactive segmentation models like SAM have achieved remarkable progress, their transfer to medical imaging still faces two key bottlenecks: (i) the lack of adaptive mechanisms for modality- and anatomy-specific tasks, which limits generalization in out-of-distribution medical scenarios; and (ii) current medical adaptation methods fine-tune on large, heterogeneous datasets without selection, leading to noisy supervision, higher cost, and negative transfer. To address these issues, we propose SegMoTE, an efficient and adaptive framework for medical image segmentation. SegMoTE preserves SAM's original prompt interface, efficient inference, and zero-shot generalization while introducing only a small number of learnable parameters to dynamically adapt across modalities and tasks. In addition, we design a progressive prompt tokenization mechanism that enables fully automatic segmentation, significantly reducing annotation dependence. Trained on MedSeg-HQ, a curated dataset less than 1% of existing large-scale datasets, SegMoTE achieves SOTA performance across diverse imaging modalities and anatomical tasks. It represents the first efficient, robust, and scalable adaptation of general segmentation models to the medical domain under extremely low annotation cost, advancing the practical deployment of foundation vision models in clinical applications.

In this paper, we present PRISM, a Promptable and Robust Interactive Segmentation Model, aiming for precise segmentation of 3D medical images. PRISM accepts various visual inputs, including points, boxes, and scribbles as sparse prompts, as well as masks as dense prompts. Specifically, PRISM is designed with four principles to achieve robustness: (1) Iterative learning. The model produces segmentations by using visual prompts from previous iterations to achieve progressive improvement. (2) Confidence learning. PRISM employs multiple segmentation heads per input image, each generating a continuous map and a confidence score to optimize predictions. (3) Corrective learning. Following each segmentation iteration, PRISM employs a shallow corrective refinement network to reassign mislabeled voxels. (4) Hybrid design. PRISM integrates hybrid encoders to better capture both the local and global information. Comprehensive validation of PRISM is conducted using four public datasets for tumor segmentation in the colon, pancreas, liver, and kidney, highlighting challenges caused by anatomical variations and ambiguous boundaries in accurate tumor identification. Compared to state-of-the-art methods, both with and without prompt engineering, PRISM significantly improves performance, achieving results that are close to human levels. The code is publicly available at https://github.com/MedICL-VU/PRISM.

Promptable segmentation foundation models such as SAM3 have demonstrated strong generalization capabilities through interactive and concept-based prompting. However, their direct applicability to medical image segmentation remains limited by severe domain shifts, the absence of privileged spatial prompts, and the need to reason over complex anatomical and volumetric structures. Here we present Medical SAM3, a foundation model for universal prompt-driven medical image segmentation, obtained by fully fine-tuning SAM3 on large-scale, heterogeneous 2D and 3D medical imaging datasets with paired segmentation masks and text prompts. Through a systematic analysis of vanilla SAM3, we observe that its performance degrades substantially on medical data, with its apparent competitiveness largely relying on strong geometric priors such as ground-truth-derived bounding boxes. These findings motivate full model adaptation beyond prompt engineering alone. By fine-tuning SAM3's model parameters on 33 datasets spanning 10 medical imaging modalities, Medical SAM3 acquires robust domain-specific representations while preserving prompt-driven flexibility. Extensive experiments across organs, imaging modalities, and dimensionalities demonstrate consistent and significant performance gains, particularly in challenging scenarios characterized by semantic ambiguity, complex morphology, and long-range 3D context. Our results establish Medical SAM3 as a universal, text-guided segmentation foundation model for medical imaging and highlight the importance of holistic model adaptation for achieving robust prompt-driven segmentation under severe domain shift. Code and model will be made available at https://github.com/AIM-Research-Lab/Medical-SAM3.

Accurate medical image segmentation is essential for clinical diagnosis and treatment planning. While recent interactive foundation models (e.g., nnInteractive) enhance generalization through large-scale multimodal pretraining, they still depend on precise prompts and often perform below expectations in contexts that are underrepresented in their training data. We present AtlasSegFM, an atlas-guided framework that customizes available foundation models to clinical contexts with a single annotated example. The core innovations are: 1) a pipeline that provides context-aware prompts for foundation models via registration between a context atlas and query images, and 2) a test-time adapter to fuse predictions from both atlas registration and the foundation model. Extensive experiments across public and in-house datasets spanning multiple modalities and organs demonstrate that AtlasSegFM consistently improves segmentation, particularly for small, delicate structures. AtlasSegFM provides a lightweight, deployable solution one-shot customization of foundation models in real-world clinical workflows. The code will be made publicly available.

Medical image segmentation is an important analysis task in clinical practice and research. Deep learning has massively advanced the field, but current approaches are mostly based on models trained for a specific task. Training such models or adapting them to a new condition is costly due to the need for (manually) labeled data. The emergence of vision foundation models, especially Segment Anything, offers a path to universal segmentation for medical images, overcoming these issues. Here, we study how to improve Segment Anything for medical images by comparing different finetuning strategies on a large and diverse dataset. We evaluate the finetuned models on a wide range of interactive and (automatic) semantic segmentation tasks. We find that the performance can be clearly improved for interactive segmentation. However, semantic segmentation does not benefit from pretraining on medical images. Our best model, MedicoSAM, is publicly available at https://github.com/computational-cell-analytics/medico-sam. We show that it is compatible with existing tools for data annotation and believe that it will be of great practical value.

The anatomical structure segmentation of the spine and adjacent structures from computed tomography (CT) images is a key step for spinal disease diagnosis and treatment. However, the segmentation of CT images is impeded by low contrast and complex vertebral boundaries. Although advanced models such as the Segment Anything Model (SAM) have shown promise in various segmentation tasks, their performance in spinal CT imaging is limited by high annotation requirements and poor domain adaptability. To address these limitations, we propose SpinalSAM-R1, a multimodal vision-language interactive system that integrates a fine-tuned SAM with DeepSeek-R1, for spine CT image segmentation. Specifically, our SpinalSAM-R1 introduces an anatomy-guided attention mechanism to improve spine segmentation performance, and a semantics-driven interaction protocol powered by DeepSeek-R1, enabling natural language-guided refinement. The SpinalSAM-R1 is fine-tuned using Low-Rank Adaptation (LoRA) for efficient adaptation. We validate our SpinalSAM-R1 on the spine anatomical structure with CT images. Experimental results suggest that our method achieves superior segmentation performance. Meanwhile, we develop a PyQt5-based interactive software, which supports point, box, and text-based prompts. The system supports 11 clinical operations with 94.3\% parsing accuracy and sub-800 ms response times. The software is released on https://github.com/6jm233333/spinalsam-r1.

Automatic medical image segmentation has made great progress benefit from the development of deep learning. However, most existing methods are based on convolutional neural networks (CNNs), which fail to build long-range dependencies and global context connections due to the limitation of receptive field in convolution operation. Inspired by the success of Transformer in modeling the long-range contextual information, some researchers have expended considerable efforts in designing the robust variants of Transformer-based U-Net. Moreover, the patch division used in vision transformers usually ignores the pixel-level intrinsic structural features inside each patch. To alleviate these problems, we propose a novel deep medical image segmentation framework called Dual Swin Transformer U-Net (DS-TransUNet), which might be the first attempt to concurrently incorporate the advantages of hierarchical Swin Transformer into both encoder and decoder of the standard U-shaped architecture to enhance the semantic segmentation quality of varying medical images. Unlike many prior Transformer-based solutions, the proposed DS-TransUNet first adopts dual-scale encoder subnetworks based on Swin Transformer to extract the coarse and fine-grained feature representations of different semantic scales. As the core component for our DS-TransUNet, a well-designed Transformer Interactive Fusion (TIF) module is proposed to effectively establish global dependencies between features of different scales through the self-attention mechanism. Furthermore, we also introduce the Swin Transformer block into decoder to further explore the long-range contextual information during the up-sampling process. Extensive experiments across four typical tasks for medical image segmentation demonstrate the effectiveness of DS-TransUNet, and show that our approach significantly outperforms the state-of-the-art methods.

The remarkable capabilities of the Segment Anything Model (SAM) for tackling image segmentation tasks in an intuitive and interactive manner has sparked interest in the design of effective visual prompts. Such interest has led to the creation of automated point prompt selection strategies, typically motivated from a feature extraction perspective. However, there is still very little understanding of how appropriate these automated visual prompting strategies are, particularly when compared to humans, across diverse image domains. Additionally, the performance benefits of including such automated visual prompting strategies within the finetuning process of SAM also remains unexplored, as does the effect of interpretable factors like distance between the prompt points on segmentation performance. To bridge these gaps, we leverage a recently released visual prompting dataset, PointPrompt, and introduce a number of benchmarking tasks that provide an array of opportunities to improve the understanding of the way human prompts differ from automated ones and what underlying factors make for effective visual prompts. We demonstrate that the resulting segmentation scores obtained by humans are approximately 29% higher than those given by automated strategies and identify potential features that are indicative of prompting performance with R^2 scores over 0.5. Additionally, we demonstrate that performance when using automated methods can be improved by up to 68% via a finetuning approach. Overall, our experiments not only showcase the existing gap between human prompts and automated methods, but also highlight potential avenues through which this gap can be leveraged to improve effective visual prompt design. Further details along with the dataset links and codes are available at https://github.com/olivesgatech/PointPrompt

The Segment Anything Model (SAM) represents a state-of-the-art research advancement in natural image segmentation, achieving impressive results with input prompts such as points and bounding boxes. However, our evaluation and recent research indicate that directly applying the pretrained SAM to medical image segmentation does not yield satisfactory performance. This limitation primarily arises from significant domain gap between natural images and medical images. To bridge this gap, we introduce SAM-Med2D, the most comprehensive studies on applying SAM to medical 2D images. Specifically, we first collect and curate approximately 4.6M images and 19.7M masks from public and private datasets, constructing a large-scale medical image segmentation dataset encompassing various modalities and objects. Then, we comprehensively fine-tune SAM on this dataset and turn it into SAM-Med2D. Unlike previous methods that only adopt bounding box or point prompts as interactive segmentation approach, we adapt SAM to medical image segmentation through more comprehensive prompts involving bounding boxes, points, and masks. We additionally fine-tune the encoder and decoder of the original SAM to obtain a well-performed SAM-Med2D, leading to the most comprehensive fine-tuning strategies to date. Finally, we conducted a comprehensive evaluation and analysis to investigate the performance of SAM-Med2D in medical image segmentation across various modalities, anatomical structures, and organs. Concurrently, we validated the generalization capability of SAM-Med2D on 9 datasets from MICCAI 2023 challenge. Overall, our approach demonstrated significantly superior performance and generalization capability compared to SAM.

The Segment Anything Model (SAM) has established itself as a powerful zero-shot image segmentation model, employing interactive prompts such as points to generate masks. This paper presents SAM-PT, a method extending SAM's capability to tracking and segmenting anything in dynamic videos. SAM-PT leverages robust and sparse point selection and propagation techniques for mask generation, demonstrating that a SAM-based segmentation tracker can yield strong zero-shot performance across popular video object segmentation benchmarks, including DAVIS, YouTube-VOS, and MOSE. Compared to traditional object-centric mask propagation strategies, we uniquely use point propagation to exploit local structure information that is agnostic to object semantics. We highlight the merits of point-based tracking through direct evaluation on the zero-shot open-world Unidentified Video Objects (UVO) benchmark. To further enhance our approach, we utilize K-Medoids clustering for point initialization and track both positive and negative points to clearly distinguish the target object. We also employ multiple mask decoding passes for mask refinement and devise a point re-initialization strategy to improve tracking accuracy. Our code integrates different point trackers and video segmentation benchmarks and will be released at https://github.com/SysCV/sam-pt.

Multimodal representation learning models have demonstrated successful operation across complex tasks, and the integration of vision-language models (VLMs) has further enabled embedding models with instruction-following capabilities. However, existing embedding models lack visual-interactive capabilities to specify regions of interest from users (e.g., point, bounding box, mask), which have been explored in generative models to broaden their human-interactive applicability. Equipping embedding models with visual interactions not only would unlock new applications with localized grounding of user intent, which remains unexplored, but also enable the models to learn entity-level information within images to complement their global representations for conventional embedding tasks. In this paper, we propose a novel Visual-InteRactive Text-Image Universal Embedder (VIRTUE) that extends the capabilities of the segmentation model and the vision-language model to the realm of representation learning. In VIRTUE, the segmentation model can process visual prompts that pinpoint specific regions within an image, thereby enabling the embedder to handle complex and ambiguous scenarios more precisely. To evaluate the visual-interaction ability of VIRTUE, we introduce a large-scale Segmentation-and-Scene Caption Retrieval (SCaR) benchmark comprising 1M samples that aims to retrieve the text caption by jointly considering the entity with a specific object and image scene. VIRTUE consistently achieves a state-of-the-art performance with significant improvements across 36 universal MMEB (3.1%-8.5%) and five visual-interactive SCaR (15.2%-20.3%) tasks.

Multi-modality image fusion and segmentation play a vital role in autonomous driving and robotic operation. Early efforts focus on boosting the performance for only one task, e.g., fusion or segmentation, making it hard to reach~`Best of Both Worlds'. To overcome this issue, in this paper, we propose a Multi-interactive Feature learning architecture for image fusion and Segmentation, namely SegMiF, and exploit dual-task correlation to promote the performance of both tasks. The SegMiF is of a cascade structure, containing a fusion sub-network and a commonly used segmentation sub-network. By slickly bridging intermediate features between two components, the knowledge learned from the segmentation task can effectively assist the fusion task. Also, the benefited fusion network supports the segmentation one to perform more pretentiously. Besides, a hierarchical interactive attention block is established to ensure fine-grained mapping of all the vital information between two tasks, so that the modality/semantic features can be fully mutual-interactive. In addition, a dynamic weight factor is introduced to automatically adjust the corresponding weights of each task, which can balance the interactive feature correspondence and break through the limitation of laborious tuning. Furthermore, we construct a smart multi-wave binocular imaging system and collect a full-time multi-modality benchmark with 15 annotated pixel-level categories for image fusion and segmentation. Extensive experiments on several public datasets and our benchmark demonstrate that the proposed method outputs visually appealing fused images and perform averagely 7.66% higher segmentation mIoU in the real-world scene than the state-of-the-art approaches. The source code and benchmark are available at https://github.com/JinyuanLiu-CV/SegMiF.

Multimodal Large Language Models (MLLMs) have demonstrated strong image-level visual understanding and reasoning, yet their pixel-level perception across both images and videos remains limited. Foundation segmentation models such as the SAM series produce high-quality masks, but they rely on low-level visual prompts and cannot natively interpret complex conversational instructions. Existing segmentation MLLMs narrow this gap, but are usually specialized for either images or videos and rarely support both textual and visual prompts in one interface. We introduce X2SAM, a unified segmentation MLLM that extends any-segmentation capabilities from images to videos. Given conversational instructions and visual prompts, X2SAM couples an LLM with a Mask Memory module that stores guided vision features for temporally consistent video mask generation. The same formulation supports generic, open-vocabulary, referring, reasoning, grounded conversation generation, interactive, and visual grounded segmentation across image and video inputs. We further introduce the Video Visual Grounded (V-VGD) segmentation benchmark, which evaluates whether a model can segment object tracks in videos from interactive visual prompts. With a unified joint training strategy over heterogeneous image and video datasets, X2SAM delivers strong video segmentation performance, remains competitive on image segmentation benchmarks, and preserves general image and video chat ability.

Medical researchers and clinicians often need to perform novel segmentation tasks on a set of related images. Existing methods for segmenting a new dataset are either interactive, requiring substantial human effort for each image, or require an existing set of previously labeled images. We introduce a system, MultiverSeg, that enables practitioners to rapidly segment an entire new dataset without requiring access to any existing labeled data from that task or domain. Along with the image to segment, the model takes user interactions such as clicks, bounding boxes or scribbles as input, and predicts a segmentation. As the user segments more images, those images and segmentations become additional inputs to the model, providing context. As the context set of labeled images grows, the number of interactions required to segment each new image decreases. We demonstrate that MultiverSeg enables users to interactively segment new datasets efficiently, by amortizing the number of interactions per image to achieve an accurate segmentation. Compared to using a state-of-the-art interactive segmentation method, MultiverSeg reduced the total number of clicks by 36% and scribble steps by 25% to achieve 90% Dice on sets of images from unseen tasks. We release code and model weights at https://multiverseg.csail.mit.edu

Interactive Segmentation (IS) segments specific objects or parts in the image according to user input. Current IS pipelines fall into two categories: single-granularity output and multi-granularity output. The latter aims to alleviate the spatial ambiguity present in the former. However, the multi-granularity output pipeline suffers from limited interaction flexibility and produces redundant results. In this work, we introduce Granularity-Controllable Interactive Segmentation (GraCo), a novel approach that allows precise control of prediction granularity by introducing additional parameters to input. This enhances the customization of the interactive system and eliminates redundancy while resolving ambiguity. Nevertheless, the exorbitant cost of annotating multi-granularity masks and the lack of available datasets with granularity annotations make it difficult for models to acquire the necessary guidance to control output granularity. To address this problem, we design an any-granularity mask generator that exploits the semantic property of the pre-trained IS model to automatically generate abundant mask-granularity pairs without requiring additional manual annotation. Based on these pairs, we propose a granularity-controllable learning strategy that efficiently imparts the granularity controllability to the IS model. Extensive experiments on intricate scenarios at object and part levels demonstrate that our GraCo has significant advantages over previous methods. This highlights the potential of GraCo to be a flexible annotation tool, capable of adapting to diverse segmentation scenarios. The project page: https://zhao-yian.github.io/GraCo.

Most state-of-the-art instance segmentation methods rely on large amounts of pixel-precise ground-truth annotations for training, which are expensive to create. Interactive segmentation networks help generate such annotations based on an image and the corresponding user interactions such as clicks. Existing methods for this task can only process a single instance at a time and each user interaction requires a full forward pass through the entire deep network. We introduce a more efficient approach, called DynaMITe, in which we represent user interactions as spatio-temporal queries to a Transformer decoder with a potential to segment multiple object instances in a single iteration. Our architecture also alleviates any need to re-compute image features during refinement, and requires fewer interactions for segmenting multiple instances in a single image when compared to other methods. DynaMITe achieves state-of-the-art results on multiple existing interactive segmentation benchmarks, and also on the new multi-instance benchmark that we propose in this paper.

Interactive segmentation enables users to segment as needed by providing cues of objects, which introduces human-computer interaction for many fields, such as image editing and medical image analysis. Typically, massive and expansive pixel-level annotations are spent to train deep models by object-oriented interactions with manually labeled object masks. In this work, we reveal that informative interactions can be made by simulation with semantic-consistent yet diverse region exploration in an unsupervised paradigm. Concretely, we introduce a Multi-granularity Interaction Simulation (MIS) approach to open up a promising direction for unsupervised interactive segmentation. Drawing on the high-quality dense features produced by recent self-supervised models, we propose to gradually merge patches or regions with similar features to form more extensive regions and thus, every merged region serves as a semantic-meaningful multi-granularity proposal. By randomly sampling these proposals and simulating possible interactions based on them, we provide meaningful interaction at multiple granularities to teach the model to understand interactions. Our MIS significantly outperforms non-deep learning unsupervised methods and is even comparable with some previous deep-supervised methods without any annotation.

Click-based interactive segmentation (IS) aims to extract the target objects under user interaction. For this task, most of the current deep learning (DL)-based methods mainly follow the general pipelines of semantic segmentation. Albeit achieving promising performance, they do not fully and explicitly utilize and propagate the click information, inevitably leading to unsatisfactory segmentation results, even at clicked points. Against this issue, in this paper, we propose to formulate the IS task as a Gaussian process (GP)-based pixel-wise binary classification model on each image. To solve this model, we utilize amortized variational inference to approximate the intractable GP posterior in a data-driven manner and then decouple the approximated GP posterior into double space forms for efficient sampling with linear complexity. Then, we correspondingly construct a GP classification framework, named GPCIS, which is integrated with the deep kernel learning mechanism for more flexibility. The main specificities of the proposed GPCIS lie in: 1) Under the explicit guidance of the derived GP posterior, the information contained in clicks can be finely propagated to the entire image and then boost the segmentation; 2) The accuracy of predictions at clicks has good theoretical support. These merits of GPCIS as well as its good generality and high efficiency are substantiated by comprehensive experiments on several benchmarks, as compared with representative methods both quantitatively and qualitatively.

Recent Large Vision Language Models (LVLMs) demonstrate promising capabilities in unifying visual understanding and generative modeling, enabling both accurate content understanding and flexible editing. However, current approaches treat "what to see" and "how to edit" separately: they either perform isolated object segmentation or utilize segmentation masks merely as conditional prompts for local edit generation tasks, often relying on multiple disjointed models. To bridge these gaps, we introduce FOCUS, a unified LVLM that integrates segmentation-aware perception and controllable object-centric generation within an end-to-end framework. FOCUS employs a dual-branch visual encoder to simultaneously capture global semantic context and fine-grained spatial details. In addition, we leverage a MoVQGAN-based visual tokenizer to produce discrete visual tokens that enhance generation quality. To enable accurate and controllable image editing, we propose a progressive multi-stage training pipeline, where segmentation masks are jointly optimized and used as spatial condition prompts to guide the diffusion decoder. This strategy aligns visual encoding, segmentation, and generation modules, effectively bridging segmentation-aware perception with fine-grained visual synthesis. Extensive experiments across three core tasks, including multimodal understanding, referring segmentation accuracy, and controllable image generation, demonstrate that FOCUS achieves strong performance by jointly optimizing visual perception and generative capabilities.

In this paper, we focus on image inpainting task, aiming at recovering the missing area of an incomplete image given the context information. Recent development in deep generative models enables an efficient end-to-end framework for image synthesis and inpainting tasks, but existing methods based on generative models don't exploit the segmentation information to constrain the object shapes, which usually lead to blurry results on the boundary. To tackle this problem, we propose to introduce the semantic segmentation information, which disentangles the inter-class difference and intra-class variation for image inpainting. This leads to much clearer recovered boundary between semantically different regions and better texture within semantically consistent segments. Our model factorizes the image inpainting process into segmentation prediction (SP-Net) and segmentation guidance (SG-Net) as two steps, which predict the segmentation labels in the missing area first, and then generate segmentation guided inpainting results. Experiments on multiple public datasets show that our approach outperforms existing methods in optimizing the image inpainting quality, and the interactive segmentation guidance provides possibilities for multi-modal predictions of image inpainting.

Segment Anything Model (SAM) is a foundation model for interactive segmentation, and it has catalyzed major advances in generative AI, computational photography, and medical imaging. This model takes in an arbitrary user input and provides segmentation masks of the corresponding objects. It is our goal to develop a version of SAM that is appropriate for use in a photography app. The original SAM model has a few challenges in this setting. First, original SAM a 600 million parameter based on ViT-H, and its high computational cost and large model size that are not suitable for todays mobile hardware. We address this by proposing the SqueezeSAM model architecture, which is 50x faster and 100x smaller than SAM. Next, when a user takes a photo on their phone, it might not occur to them to click on the image and get a mask. Our solution is to use salient object detection to generate the first few clicks. This produces an initial segmentation mask that the user can interactively edit. Finally, when a user clicks on an object, they typically expect all related pieces of the object to be segmented. For instance, if a user clicks on a person t-shirt in a photo, they expect the whole person to be segmented, but SAM typically segments just the t-shirt. We address this with a new data augmentation scheme, and the end result is that if the user clicks on a person holding a basketball, the person and the basketball are all segmented together.

Large language models (LLMs) have recently demonstrated their potential in clinical applications, providing valuable medical knowledge and advice. For example, a large dialog LLM like ChatGPT has successfully passed part of the US medical licensing exam. However, LLMs currently have difficulty processing images, making it challenging to interpret information from medical images, which are rich in information that supports clinical decisions. On the other hand, computer-aided diagnosis (CAD) networks for medical images have seen significant success in the medical field by using advanced deep-learning algorithms to support clinical decision-making. This paper presents a method for integrating LLMs into medical-image CAD networks. The proposed framework uses LLMs to enhance the output of multiple CAD networks, such as diagnosis networks, lesion segmentation networks, and report generation networks, by summarizing and reorganizing the information presented in natural language text format. The goal is to merge the strengths of LLMs' medical domain knowledge and logical reasoning with the vision understanding capability of existing medical-image CAD models to create a more user-friendly and understandable system for patients compared to conventional CAD systems. In the future, LLM's medical knowledge can be also used to improve the performance of vision-based medical-image CAD models.

The emergence of Segment Anything (SAM) sparked research interest in the field of interactive segmentation, especially in the context of image editing tasks and speeding up data annotation. Unlike common semantic segmentation, interactive segmentation methods allow users to directly influence their output through prompts (e.g. clicks). However, click patterns in real-world interactive segmentation scenarios remain largely unexplored. Most methods rely on the assumption that users would click in the center of the largest erroneous area. Nevertheless, recent studies show that this is not always the case. Thus, methods may have poor performance in real-world deployment despite high metrics in a baseline benchmark. To accurately simulate real-user clicks, we conducted a large crowdsourcing study of click patterns in an interactive segmentation scenario and collected 475K real-user clicks. Drawing on ideas from saliency tasks, we develop a clickability model that enables sampling clicks, which closely resemble actual user inputs. Using our model and dataset, we propose RClicks benchmark for a comprehensive comparison of existing interactive segmentation methods on realistic clicks. Specifically, we evaluate not only the average quality of methods, but also the robustness w.r.t. click patterns. According to our benchmark, in real-world usage interactive segmentation models may perform worse than it has been reported in the baseline benchmark, and most of the methods are not robust. We believe that RClicks is a significant step towards creating interactive segmentation methods that provide the best user experience in real-world cases.

Recent approaches attempt to adapt powerful interactive segmentation models, such as SAM, to interactive matting and fine-tune the models based on synthetic matting datasets. However, models trained on synthetic data fail to generalize to complex and occlusion scenes. We address this challenge by proposing a new matting dataset based on the COCO dataset, namely COCO-Matting. Specifically, the construction of our COCO-Matting includes accessory fusion and mask-to-matte, which selects real-world complex images from COCO and converts semantic segmentation masks to matting labels. The built COCO-Matting comprises an extensive collection of 38,251 human instance-level alpha mattes in complex natural scenarios. Furthermore, existing SAM-based matting methods extract intermediate features and masks from a frozen SAM and only train a lightweight matting decoder by end-to-end matting losses, which do not fully exploit the potential of the pre-trained SAM. Thus, we propose SEMat which revamps the network architecture and training objectives. For network architecture, the proposed feature-aligned transformer learns to extract fine-grained edge and transparency features. The proposed matte-aligned decoder aims to segment matting-specific objects and convert coarse masks into high-precision mattes. For training objectives, the proposed regularization and trimap loss aim to retain the prior from the pre-trained model and push the matting logits extracted from the mask decoder to contain trimap-based semantic information. Extensive experiments across seven diverse datasets demonstrate the superior performance of our method, proving its efficacy in interactive natural image matting. We open-source our code, models, and dataset at https://github.com/XiaRho/SEMat.

Accurate and efficient 3D segmentation is essential for both clinical and research applications. While foundation models like SAM have revolutionized interactive segmentation, their 2D design and domain shift limitations make them ill-suited for 3D medical images. Current adaptations address some of these challenges but remain limited, either lacking volumetric awareness, offering restricted interactivity, or supporting only a small set of structures and modalities. Usability also remains a challenge, as current tools are rarely integrated into established imaging platforms and often rely on cumbersome web-based interfaces with restricted functionality. We introduce nnInteractive, the first comprehensive 3D interactive open-set segmentation method. It supports diverse prompts-including points, scribbles, boxes, and a novel lasso prompt-while leveraging intuitive 2D interactions to generate full 3D segmentations. Trained on 120+ diverse volumetric 3D datasets (CT, MRI, PET, 3D Microscopy, etc.), nnInteractive sets a new state-of-the-art in accuracy, adaptability, and usability. Crucially, it is the first method integrated into widely used image viewers (e.g., Napari, MITK), ensuring broad accessibility for real-world clinical and research applications. Extensive benchmarking demonstrates that nnInteractive far surpasses existing methods, setting a new standard for AI-driven interactive 3D segmentation. nnInteractive is publicly available: https://github.com/MIC-DKFZ/napari-nninteractive (Napari plugin), https://www.mitk.org/MITK-nnInteractive (MITK integration), https://github.com/MIC-DKFZ/nnInteractive (Python backend).

Reconstructing object deformation from a single image remains a significant challenge in computer vision and graphics. Existing methods typically rely on multi-view video to recover deformation, limiting their applicability under constrained scenarios. To address this, we propose DeformSplat, a novel framework that effectively guides 3D Gaussian deformation from only a single image. Our method introduces two main technical contributions. First, we present Gaussian-to-Pixel Matching which bridges the domain gap between 3D Gaussian representations and 2D pixel observations. This enables robust deformation guidance from sparse visual cues. Second, we propose Rigid Part Segmentation consisting of initialization and refinement. This segmentation explicitly identifies rigid regions, crucial for maintaining geometric coherence during deformation. By combining these two techniques, our approach can reconstruct consistent deformations from a single image. Extensive experiments demonstrate that our approach significantly outperforms existing methods and naturally extends to various applications,such as frame interpolation and interactive object manipulation.

As consumer Virtual Reality (VR) and Mixed Reality (MR) technologies gain momentum, there's a growing focus on the development of engagements with 3D virtual content. Unfortunately, traditional techniques for content creation, editing, and interaction within these virtual spaces are fraught with difficulties. They tend to be not only engineering-intensive but also require extensive expertise, which adds to the frustration and inefficiency in virtual object manipulation. Our proposed VR-GS system represents a leap forward in human-centered 3D content interaction, offering a seamless and intuitive user experience. By developing a physical dynamics-aware interactive Gaussian Splatting in a Virtual Reality setting, and constructing a highly efficient two-level embedding strategy alongside deformable body simulations, VR-GS ensures real-time execution with highly realistic dynamic responses. The components of our Virtual Reality system are designed for high efficiency and effectiveness, starting from detailed scene reconstruction and object segmentation, advancing through multi-view image in-painting, and extending to interactive physics-based editing. The system also incorporates real-time deformation embedding and dynamic shadow casting, ensuring a comprehensive and engaging virtual experience.Our project page is available at: https://yingjiang96.github.io/VR-GS/.

In this work, we address various segmentation tasks, each traditionally tackled by distinct or partially unified models. We propose OMG-Seg, One Model that is Good enough to efficiently and effectively handle all the segmentation tasks, including image semantic, instance, and panoptic segmentation, as well as their video counterparts, open vocabulary settings, prompt-driven, interactive segmentation like SAM, and video object segmentation. To our knowledge, this is the first model to handle all these tasks in one model and achieve satisfactory performance. We show that OMG-Seg, a transformer-based encoder-decoder architecture with task-specific queries and outputs, can support over ten distinct segmentation tasks and yet significantly reduce computational and parameter overhead across various tasks and datasets. We rigorously evaluate the inter-task influences and correlations during co-training. Code and models are available at https://github.com/lxtGH/OMG-Seg.

We present Set-of-Mark (SoM), a new visual prompting method, to unleash the visual grounding abilities of large multimodal models (LMMs), such as GPT-4V. As illustrated in Fig. 1 (right), we employ off-the-shelf interactive segmentation models, such as SAM, to partition an image into regions at different levels of granularity, and overlay these regions with a set of marks e.g., alphanumerics, masks, boxes. Using the marked image as input, GPT-4V can answer the questions that require visual grounding. We perform a comprehensive empirical study to validate the effectiveness of SoM on a wide range of fine-grained vision and multimodal tasks. For example, our experiments show that GPT-4V with SoM outperforms the state-of-the-art fully-finetuned referring segmentation model on RefCOCOg in a zero-shot setting.

The Segment Anything Model (SAM) family has become a widely adopted vision foundation model, but its ability to control segmentation granularity remains limited. Users often need to refine results manually - by adding more prompts or selecting from pre-generated masks - to achieve the desired level of detail. This process can be ambiguous, as the same prompt may correspond to several plausible masks, and collecting dense annotations across all granularities is prohibitively expensive, making supervised solutions infeasible. To address this limitation, we introduce UnSAMv2, which enables segment anything at any granularity without human annotations. UnSAMv2 extends the divide-and-conquer strategy of UnSAM by discovering abundant mask-granularity pairs and introducing a novel granularity control embedding that enables precise, continuous control over segmentation scale. Remarkably, with only 6K unlabeled images and 0.02% additional parameters, UnSAMv2 substantially enhances SAM-2, achieving segment anything at any granularity across interactive, whole-image, and video segmentation tasks. Evaluated on over 11 benchmarks, UnSAMv2 improves NoC_{90} (5.69 rightarrow 4.75), 1-IoU (58.0 rightarrow 73.1), and AR_{1000} (49.6 rightarrow 68.3), showing that small amounts of unlabeled data with a granularity-aware self-supervised learning method can unlock the potential of vision foundation models.

Manually annotating object segmentation masks is very time consuming. Interactive object segmentation methods offer a more efficient alternative where a human annotator and a machine segmentation model collaborate. In this paper we make several contributions to interactive segmentation: (1) we systematically explore in simulation the design space of deep interactive segmentation models and report new insights and caveats; (2) we execute a large-scale annotation campaign with real human annotators, producing masks for 2.5M instances on the OpenImages dataset. We plan to release this data publicly, forming the largest existing dataset for instance segmentation. Moreover, by re-annotating part of the COCO dataset, we show that we can produce instance masks 3 times faster than traditional polygon drawing tools while also providing better quality. (3) We present a technique for automatically estimating the quality of the produced masks which exploits indirect signals from the annotation process.

Recent works on click-based interactive segmentation have demonstrated state-of-the-art results by using various inference-time optimization schemes. These methods are considerably more computationally expensive compared to feedforward approaches, as they require performing backward passes through a network during inference and are hard to deploy on mobile frameworks that usually support only forward passes. In this paper, we extensively evaluate various design choices for interactive segmentation and discover that new state-of-the-art results can be obtained without any additional optimization schemes. Thus, we propose a simple feedforward model for click-based interactive segmentation that employs the segmentation masks from previous steps. It allows not only to segment an entirely new object, but also to start with an external mask and correct it. When analyzing the performance of models trained on different datasets, we observe that the choice of a training dataset greatly impacts the quality of interactive segmentation. We find that the models trained on a combination of COCO and LVIS with diverse and high-quality annotations show performance superior to all existing models. The code and trained models are available at https://github.com/saic-vul/ritm_interactive_segmentation.

The goal of this paper is to interactively refine the automatic segmentation on challenging structures that fall behind human performance, either due to the scarcity of available annotations or the difficulty nature of the problem itself, for example, on segmenting cancer or small organs. Specifically, we propose a novel Transformer-based architecture for Interactive Segmentation (TIS), that treats the refinement task as a procedure for grouping pixels with similar features to those clicks given by the end users. Our proposed architecture is composed of Transformer Decoder variants, which naturally fulfills feature comparison with the attention mechanisms. In contrast to existing approaches, our proposed TIS is not limited to binary segmentations, and allows the user to edit masks for arbitrary number of categories. To validate the proposed approach, we conduct extensive experiments on three challenging datasets and demonstrate superior performance over the existing state-of-the-art methods. The project page is: https://wtliu7.github.io/tis/.

Interactive segmentation methods rely on user inputs to iteratively update the selection mask. A click specifying the object of interest is arguably the most simple and intuitive interaction type, and thereby the most common choice for interactive segmentation. However, user clicking patterns in the interactive segmentation context remain unexplored. Accordingly, interactive segmentation evaluation strategies rely more on intuition and common sense rather than empirical studies (e.g., assuming that users tend to click in the center of the area with the largest error). In this work, we conduct a real user study to investigate real user clicking patterns. This study reveals that the intuitive assumption made in the common evaluation strategy may not hold. As a result, interactive segmentation models may show high scores in the standard benchmarks, but it does not imply that they would perform well in a real world scenario. To assess the applicability of interactive segmentation methods, we propose a novel evaluation strategy providing a more comprehensive analysis of a model's performance. To this end, we propose a methodology for finding extreme user inputs by a direct optimization in a white-box adversarial attack on the interactive segmentation model. Based on the performance with such adversarial user inputs, we assess the robustness of interactive segmentation models w.r.t click positions. Besides, we introduce a novel benchmark for measuring the robustness of interactive segmentation, and report the results of an extensive evaluation of dozens of models.

Interactive segmentation has recently attracted attention for specialized tasks where expert input is required to further enhance the segmentation performance. In this work, we propose a novel interactive segmentation framework, where user clicks are dynamically adapted in size based on the current segmentation mask. The clicked regions form a weight map and are fed to a deep neural network as a novel weighted loss function. To evaluate our loss function, an interactive U-Net (IU-Net) model which applies both foreground and background user clicks as the main method of interaction is employed. We train and validate on the BCV dataset, while testing on spleen and colon cancer CT images from the MSD dataset to improve the overall segmentation accuracy in comparison to the standard U-Net using our weighted loss function. Applying dynamic user click sizes increases the overall accuracy by 5.60% and 10.39% respectively by utilizing only a single user interaction.

The interactive segmentation task consists in the creation of object segmentation masks based on user interactions. The most common way to guide a model towards producing a correct segmentation consists in clicks on the object and background. The recently published Segment Anything Model (SAM) supports a generalized version of the interactive segmentation problem and has been trained on an object segmentation dataset which contains 1.1B masks. Though being trained extensively and with the explicit purpose of serving as a foundation model, we show significant limitations of SAM when being applied for interactive segmentation on novel domains or object types. On the used datasets, SAM displays a failure rate FR_{30}@90 of up to 72.6 %. Since we still want such foundation models to be immediately applicable, we present a framework that can adapt SAM during immediate usage. For this we will leverage the user interactions and masks, which are constructed during the interactive segmentation process. We use this information to generate pseudo-labels, which we use to compute a loss function and optimize a part of the SAM model. The presented method causes a relative reduction of up to 48.1 % in the FR_{20}@85 and 46.6 % in the FR_{30}@90 metrics.

We aim to tackle the problem of point-based interactive segmentation, in which the key challenge is to propagate the user-provided annotations to unlabeled regions efficiently. Existing methods tackle this challenge by utilizing computationally expensive fully connected graphs or transformer architectures that sacrifice important fine-grained information required for accurate segmentation. To overcome these limitations, we propose a cascade sparse feature propagation network that learns a click-augmented feature representation for propagating user-provided information to unlabeled regions. The sparse design of our network enables efficient information propagation on high-resolution features, resulting in more detailed object segmentation. We validate the effectiveness of our method through comprehensive experiments on various benchmarks, and the results demonstrate the superior performance of our approach. Code is available at https://github.com/kleinzcy/CSFPN{https://github.com/kleinzcy/CSFPN}.

Placenta volume measurement from 3D ultrasound images is critical for predicting pregnancy outcomes, and manual annotation is the gold standard. However, such manual annotation is expensive and time-consuming. Automated segmentation algorithms can often successfully segment the placenta, but these methods may not consistently produce robust segmentations suitable for practical use. Recently, inspired by the Segment Anything Model (SAM), deep learning-based interactive segmentation models have been widely applied in the medical imaging domain. These models produce a segmentation from visual prompts provided to indicate the target region, which may offer a feasible solution for practical use. However, none of these models are specifically designed for interactively segmenting 3D ultrasound images, which remain challenging due to the inherent noise of this modality. In this paper, we evaluate publicly available state-of-the-art 3D interactive segmentation models in contrast to a human-in-the-loop approach for the placenta segmentation task. The Dice score, normalized surface Dice, averaged symmetric surface distance, and 95-percent Hausdorff distance are used as evaluation metrics. We consider a Dice score of 0.95 a successful segmentation. Our results indicate that the human-in-the-loop segmentation model reaches this standard. Moreover, we assess the efficiency of the human-in-the-loop model as a function of the amount of prompts. Our results demonstrate that the human-in-the-loop model is both effective and efficient for interactive placenta segmentation. The code is available at https://github.com/MedICL-VU/PRISM-placenta.

Object segmentation is an important step in the workflow of computational pathology. Deep learning based models generally require large amount of labeled data for precise and reliable prediction. However, collecting labeled data is expensive because it often requires expert knowledge, particularly in medical imaging domain where labels are the result of a time-consuming analysis made by one or more human experts. As nuclei, cells and glands are fundamental objects for downstream analysis in computational pathology/cytology, in this paper we propose a simple CNN-based approach to speed up collecting annotations for these objects which requires minimum interaction from the annotator. We show that for nuclei and cells in histology and cytology images, one click inside each object is enough for NuClick to yield a precise annotation. For multicellular structures such as glands, we propose a novel approach to provide the NuClick with a squiggle as a guiding signal, enabling it to segment the glandular boundaries. These supervisory signals are fed to the network as auxiliary inputs along with RGB channels. With detailed experiments, we show that NuClick is adaptable to the object scale, robust against variations in the user input, adaptable to new domains, and delivers reliable annotations. An instance segmentation model trained on masks generated by NuClick achieved the first rank in LYON19 challenge. As exemplar outputs of our framework, we are releasing two datasets: 1) a dataset of lymphocyte annotations within IHC images, and 2) a dataset of segmented WBCs in blood smear images.

Road masks obtained from remote sensing images effectively support a wide range of downstream tasks. In recent years, most studies have focused on improving the performance of fully automatic segmentation models for this task, achieving significant gains. However, current fully automatic methods are still insufficient for identifying certain challenging road segments and often produce false positive and false negative regions. Moreover, fully automatic segmentation does not support local segmentation of regions of interest or refinement of existing masks. Although the SAM model is widely used as an interactive segmentation model and performs well on natural images, it shows poor performance in remote sensing road segmentation and cannot support fine-grained local refinement. To address these limitations, we propose PC-SAM, which integrates fully automatic road segmentation and interactive segmentation within a unified framework. By carefully designing a fine-tuning strategy, the influence of point prompts is constrained to their corresponding patches, overcoming the inability of the original SAM to perform fine local corrections and enabling fine-grained interactive mask refinement. Extensive experiments on several representative remote sensing road segmentation datasets demonstrate that, when combined with point prompts, PC-SAM significantly outperforms state-of-the-art fully automatic models in road mask segmentation, while also providing flexible local mask refinement and local road segmentation. The code will be available at https://github.com/Cyber-CCOrange/PC-SAM.

Interactive segmentation models such as the Segment Anything Model (SAM) have demonstrated remarkable generalization on natural images, but they perform suboptimally on remote sensing imagery (RSI) due to severe domain shifts and the scarcity of dense annotations. To address this limitation, we propose a point-supervised self-prompting framework that adapts SAM to RSI using only sparse point annotations. Our method employs a Refine-Requery-Reinforce loop, in which coarse pseudo-masks are generated from initial points (Refine), improved with self-constructed box prompts (Requery), and embeddings are aligned for Soft Semantic Alignment to mitigate error propagation. (Reinforce). Without relying on full-mask supervision, our approach progressively enhances SAM's segmentation quality and domain robustness through self-guided prompt adaptation. We evaluate our proposed method on three RSI benchmark datasets, WHU, HRSID, and NWPU VHR-10, showing that our method consistently surpasses pretrained SAM and recent point-supervised segmentation methods. Our results demonstrate that self-prompting and semantic alignment provide an efficient path towards scalable, point-level adaptation of foundation segmentation models for remote sensing applications.

Uncertainty estimation is essential for the safe clinical deployment of medical image segmentation systems, enabling the identification of unreliable predictions and supporting human oversight. While prior work has largely focused on pixel-level uncertainty, landmark-based segmentation offers inherent topological guarantees yet remains underexplored from an uncertainty perspective. In this work, we study uncertainty estimation for anatomical landmark-based segmentation on chest X-rays. Inspired by hybrid neural network architectures that combine standard image convolutional encoders with graph-based generative decoders, and leveraging their variational latent space, we derive two complementary measures: (i) latent uncertainty, captured directly from the learned distribution parameters, and (ii) predictive uncertainty, obtained by generating multiple stochastic output predictions from latent samples. Through controlled corruption experiments we show that both uncertainty measures increase with perturbation severity, reflecting both global and local degradation. We demonstrate that these uncertainty signals can identify unreliable predictions by comparing with manual ground-truth, and support out-of-distribution detection on the CheXmask dataset. More importantly, we release CheXmask-U (huggingface.co/datasets/mcosarinsky/CheXmask-U), a large scale dataset of 657,566 chest X-ray landmark segmentations with per-node uncertainty estimates, enabling researchers to account for spatial variations in segmentation quality when using these anatomical masks. Our findings establish uncertainty estimation as a promising direction to enhance robustness and safe deployment of landmark-based anatomical segmentation methods in chest X-ray. A fully working interactive demo of the method is available at huggingface.co/spaces/matiasky/CheXmask-U and the source code at github.com/mcosarinsky/CheXmask-U.

Placenta volume measured from 3D ultrasound (3DUS) images is an important tool for tracking the growth trajectory and is associated with pregnancy outcomes. Manual segmentation is the gold standard, but it is time-consuming and subjective. Although fully automated deep learning algorithms perform well, they do not always yield high-quality results for each case. Interactive segmentation models could address this issue. However, there is limited work on interactive segmentation models for the placenta. Despite their segmentation accuracy, these methods may not be feasible for clinical use as they require relatively large computational power which may be especially prohibitive in low-resource environments, or on mobile devices. In this paper, we propose a lightweight interactive segmentation model aiming for clinical use to interactively segment the placenta from 3DUS images in real-time. The proposed model adopts the segmentation from our fully automated model for initialization and is designed in a human-in-the-loop manner to achieve iterative improvements. The Dice score and normalized surface Dice are used as evaluation metrics. The results show that our model can achieve superior performance in segmentation compared to state-of-the-art models while using significantly fewer parameters. Additionally, the proposed model is much faster for inference and robust to poor initial masks. The code is available at https://github.com/MedICL-VU/PRISM-placenta.

Egocentric Interactive hand-object segmentation (EgoIHOS) requires the segmentation of hands and interacting objects in egocentric images, which is crucial for understanding human behavior in assistive systems. Previous methods typically recognize hands and interacting objects as distinct semantic categories based solely on visual features, or simply use hand predictions as auxiliary cues for object segmentation. Despite the promising progress achieved by these methods, they fail to adequately model the interactive relationships between hands and objects while ignoring the coupled physical relationships among object categories, ultimately constraining their segmentation performance. To make up for the shortcomings of existing methods, we propose a novel method called CaRe-Ego that achieves state-of-the-art performance by emphasizing the contact between hands and objects from two aspects. First, we introduce a Hand-guided Object Feature Enhancer (HOFE) to establish the hand-object interactive relationships to extract more contact-relevant and discriminative object features. Second, we design the Contact-centric Object Decoupling Strategy (CODS) to explicitly model and disentangle coupling relationships among object categories, thereby emphasizing contact-aware feature learning. Experiments on various in-domain and out-of-domain test sets show that Care-Ego significantly outperforms existing methods with robust generalization capability. Codes are publicly available at https://github.com/yuggiehk/CaRe-Ego/.

In this study, we aim to build up a model that can Segment Anything in radiology scans, driven by medical terminologies as Text prompts, termed as SAT. Our main contributions are three folds: (i) for dataset construction, we construct the first multi-modal knowledge tree on human anatomy, including 6502 anatomical terminologies; Then, we build up the largest and most comprehensive segmentation dataset for training, by collecting over 22K 3D medical image scans from72 segmentation datasets, across 497 classes, with careful standardization on both image scans and label space; (ii) for architecture design, we propose to inject medical knowledge into a text encoder via contrastive learning, and then formulate a universal segmentation model, that can be prompted by feeding in medical terminologies in text form; (iii) As a result, we have trained SAT-Nano (110M parameters) and SAT-Pro (447M parameters), demonstrating superior or comparable performance to 72 specialist models, i.e., nnU-Nets, U-Mamba or SwinUNETR, trained on each dataset/subsets. We validate SAT as a foundational segmentation model, with better generalization on external (cross-center) datasets, and can be further improved on specific tasks after fine-tuning adaptation. Comparing with state-of-the-art interactive segmentation model MedSAM, SAT demonstrate superior performance, scalability and robustness. We further compare SAT with BiomedParse, and observe SAT is significantly superior in both internal and external evaluation. Through extensive ablation study, we validate the benefit of domain knowledge on universal segmentation, especially on tail categories. As a use case, we demonstrate that SAT can act as a powerful out-of-the-box agent for large language models, enabling visual grounding in versatile application scenarios. All the data, codes, and models in this work have been released.

Zero-shot and prompt-based technologies capitalized on using frequently occurring images to transform visual reasoning tasks, which explains why such technologies struggle with valuable yet scarce scientific image sets. In this work, we propose Zenesis, a comprehensive no-code interactive platform designed to minimize barriers posed by data readiness for scientific images. We develop lightweight multi-modal adaptation techniques that enable zero-shot operation on raw scientific data, along with human-in-the-loop refinement and heuristic-based temporal enhancement options. We demonstrate the performance of our approach through comprehensive comparison and validation on challenging Focused Ion Beam Scanning Electron Microscopy (FIB-SEM) data of catalyst-loaded membranes. Zenesis significantly outperforms baseline methods, achieving an average accuracy of 0.947, an Intersection over Union (IOU) of 0.858, and a Dice score of 0.923 for amorphous catalyst samples and accuracy of 0.987, an IOU of 0.857, and a Dice score of 0.923 for crystalline samples. These results mark a substantial improvement over traditional methods like Otsu thresholding and even advanced models like Segment Anything Model (SAM) when used in isolation. Our results demonstrate that Zenesis is a powerful tool for scientific applications, particularly in fields where high-quality annotated datasets are unavailable, accelerating accurate analysis of experimental imaging.

Deep neural networks have become a mainstream approach to interactive segmentation. As we show in our experiments, while for some images a trained network provides accurate segmentation result with just a few clicks, for some unknown objects it cannot achieve satisfactory result even with a large amount of user input. Recently proposed backpropagating refinement (BRS) scheme introduces an optimization problem for interactive segmentation that results in significantly better performance for the hard cases. At the same time, BRS requires running forward and backward pass through a deep network several times that leads to significantly increased computational budget per click compared to other methods. We propose f-BRS (feature backpropagating refinement scheme) that solves an optimization problem with respect to auxiliary variables instead of the network inputs, and requires running forward and backward pass just for a small part of a network. Experiments on GrabCut, Berkeley, DAVIS and SBD datasets set new state-of-the-art at an order of magnitude lower time per click compared to original BRS. The code and trained models are available at https://github.com/saic-vul/fbrs_interactive_segmentation .

The realm of computer vision has witnessed a paradigm shift with the advent of foundational models, mirroring the transformative influence of large language models in the domain of natural language processing. This paper delves into the exploration of open-world segmentation, presenting a novel approach called Image Prompt Segmentation (IPSeg) that harnesses the power of vision foundational models. IPSeg lies the principle of a training-free paradigm, which capitalizes on image prompt techniques. Specifically, IPSeg utilizes a single image containing a subjective visual concept as a flexible prompt to query vision foundation models like DINOv2 and Stable Diffusion. Our approach extracts robust features for the prompt image and input image, then matches the input representations to the prompt representations via a novel feature interaction module to generate point prompts highlighting target objects in the input image. The generated point prompts are further utilized to guide the Segment Anything Model to segment the target object in the input image. The proposed method stands out by eliminating the need for exhaustive training sessions, thereby offering a more efficient and scalable solution. Experiments on COCO, PASCAL VOC, and other datasets demonstrate IPSeg's efficacy for flexible open-world segmentation using intuitive image prompts. This work pioneers tapping foundation models for open-world understanding through visual concepts conveyed in images.

During interactive segmentation, a model and a user work together to delineate objects of interest in a 3D point cloud. In an iterative process, the model assigns each data point to an object (or the background), while the user corrects errors in the resulting segmentation and feeds them back into the model. The current best practice formulates the problem as binary classification and segments objects one at a time. The model expects the user to provide positive clicks to indicate regions wrongly assigned to the background and negative clicks on regions wrongly assigned to the object. Sequentially visiting objects is wasteful since it disregards synergies between objects: a positive click for a given object can, by definition, serve as a negative click for nearby objects. Moreover, a direct competition between adjacent objects can speed up the identification of their common boundary. We introduce AGILE3D, an efficient, attention-based model that (1) supports simultaneous segmentation of multiple 3D objects, (2) yields more accurate segmentation masks with fewer user clicks, and (3) offers faster inference. Our core idea is to encode user clicks as spatial-temporal queries and enable explicit interactions between click queries as well as between them and the 3D scene through a click attention module. Every time new clicks are added, we only need to run a lightweight decoder that produces updated segmentation masks. In experiments with four different 3D point cloud datasets, AGILE3D sets a new state-of-the-art. Moreover, we also verify its practicality in real-world setups with real user studies.

In this work, we present SEEM, a promptable and interactive model for segmenting everything everywhere all at once in an image, as shown in Fig.1. In SEEM, we propose a novel decoding mechanism that enables diverse prompting for all types of segmentation tasks, aiming at a universal segmentation interface that behaves like large language models (LLMs). More specifically, SEEM is designed with four desiderata: i) Versatility. We introduce a new visual prompt to unify different spatial queries including points, boxes, scribbles and masks, which can further generalize to a different referring image; ii) Compositionality. We learn a joint visual-semantic space between text and visual prompts, which facilitates the dynamic composition of two prompt types required for various segmentation tasks; iii) Interactivity. We further incorporate learnable memory prompts into the decoder to retain segmentation history through mask-guided cross-attention from decoder to image features; and iv) Semantic-awareness. We use a text encoder to encode text queries and mask labels into the same semantic space for open-vocabulary segmentation. We conduct a comprehensive empirical study to validate the effectiveness of SEEM across diverse segmentation tasks. Notably, our single SEEM model achieves competitive performance across interactive segmentation, generic segmentation, referring segmentation, and video object segmentation on 9 datasets with minimum 1/100 supervision. Furthermore, SEEM showcases a remarkable capacity for generalization to novel prompts or their combinations, rendering it a readily universal image segmentation interface.

Foundation models for interactive segmentation in 2D natural images and videos have sparked significant interest in building 3D foundation models for medical imaging. However, the domain gaps and clinical use cases for 3D medical imaging require a dedicated model that diverges from existing 2D solutions. Specifically, such foundation models should support a full workflow that can actually reduce human effort. Treating 3D medical images as sequences of 2D slices and reusing interactive 2D foundation models seems straightforward, but 2D annotation is too time-consuming for 3D tasks. Moreover, for large cohort analysis, it's the highly accurate automatic segmentation models that reduce the most human effort. However, these models lack support for interactive corrections and lack zero-shot ability for novel structures, which is a key feature of "foundation". While reusing pre-trained 2D backbones in 3D enhances zero-shot potential, their performance on complex 3D structures still lags behind leading 3D models. To address these issues, we present VISTA3D, Versatile Imaging SegmenTation and Annotation model, that targets to solve all these challenges and requirements with one unified foundation model. VISTA3D is built on top of the well-established 3D segmentation pipeline, and it is the first model to achieve state-of-the-art performance in both 3D automatic (supporting 127 classes) and 3D interactive segmentation, even when compared with top 3D expert models on large and diverse benchmarks. Additionally, VISTA3D's 3D interactive design allows efficient human correction, and a novel 3D supervoxel method that distills 2D pretrained backbones grants VISTA3D top 3D zero-shot performance. We believe the model, recipe, and insights represent a promising step towards a clinically useful 3D foundation model. Code and weights are publicly available at https://github.com/Project-MONAI/VISTA.

The segmentation of pelvic fracture fragments in CT and X-ray images is crucial for trauma diagnosis, surgical planning, and intraoperative guidance. However, accurately and efficiently delineating the bone fragments remains a significant challenge due to complex anatomy and imaging limitations. The PENGWIN challenge, organized as a MICCAI 2024 satellite event, aimed to advance automated fracture segmentation by benchmarking state-of-the-art algorithms on these complex tasks. A diverse dataset of 150 CT scans was collected from multiple clinical centers, and a large set of simulated X-ray images was generated using the DeepDRR method. Final submissions from 16 teams worldwide were evaluated under a rigorous multi-metric testing scheme. The top-performing CT algorithm achieved an average fragment-wise intersection over union (IoU) of 0.930, demonstrating satisfactory accuracy. However, in the X-ray task, the best algorithm achieved an IoU of 0.774, which is promising but not yet sufficient for intra-operative decision-making, reflecting the inherent challenges of fragment overlap in projection imaging. Beyond the quantitative evaluation, the challenge revealed methodological diversity in algorithm design. Variations in instance representation, such as primary-secondary classification versus boundary-core separation, led to differing segmentation strategies. Despite promising results, the challenge also exposed inherent uncertainties in fragment definition, particularly in cases of incomplete fractures. These findings suggest that interactive segmentation approaches, integrating human decision-making with task-relevant information, may be essential for improving model reliability and clinical applicability.

Given a single labeled example, in-context segmentation aims to segment corresponding objects. This setting, known as one-shot segmentation in few-shot learning, explores the segmentation model's generalization ability and has been applied to various vision tasks, including scene understanding and image/video editing. While recent Segment Anything Models have achieved state-of-the-art results in interactive segmentation, these approaches are not directly applicable to in-context segmentation. In this work, we propose the Dual Consistency SAM (DC-SAM) method based on prompt-tuning to adapt SAM and SAM2 for in-context segmentation of both images and videos. Our key insights are to enhance the features of the SAM's prompt encoder in segmentation by providing high-quality visual prompts. When generating a mask prior, we fuse the SAM features to better align the prompt encoder. Then, we design a cycle-consistent cross-attention on fused features and initial visual prompts. Next, a dual-branch design is provided by using the discriminative positive and negative prompts in the prompt encoder. Furthermore, we design a simple mask-tube training strategy to adopt our proposed dual consistency method into the mask tube. Although the proposed DC-SAM is primarily designed for images, it can be seamlessly extended to the video domain with the support of SAM2. Given the absence of in-context segmentation in the video domain, we manually curate and construct the first benchmark from existing video segmentation datasets, named In-Context Video Object Segmentation (IC-VOS), to better assess the in-context capability of the model. Extensive experiments demonstrate that our method achieves 55.5 (+1.4) mIoU on COCO-20i, 73.0 (+1.1) mIoU on PASCAL-5i, and a J&F score of 71.52 on the proposed IC-VOS benchmark. Our source code and benchmark are available at https://github.com/zaplm/DC-SAM.

Cell instance segmentation models trained on cell-specific datasets suffer severe performance drops on out-of-distribution cell types, while interactive foundation models overcome this through per-instance prompting at a cost that is prohibitively expensive for histopathology images containing hundreds to thousands of densely packed instances. We introduce Group Prompting, a new paradigm that shifts interactive segmentation from per-instance O(N) to per-type O(T), where a single click per cell type suffices to segment all instances of that type. Our key observation is that the frozen image encoder of the Segment Anything Model (SAM) already clusters same-type cells in its feature space before any prompt is given. Exploiting this property, we propose Chain-of-Prompts (CoP), a training-free framework that recursively expands a single user click by (1) identifying reliable same-type locations through non-parametric gating of multi-scale encoder features, and (2) selecting the most spatially distant reliable point as the next prompt to maximize coverage. On three cell-type-annotated benchmarks, CoP with one click per type retains over 90% of per-instance performance and surpasses fully-supervised methods without any additional training. On four morphologically homogeneous benchmarks, a single click retains over 99%. Project Page: https://shjo-april.github.io/Chain-of-Prompts/

Open-world semantic segmentation presently relies significantly on extensive image-text pair datasets, which often suffer from a lack of fine-grained pixel annotations on sufficient categories. The acquisition of such data is rendered economically prohibitive due to the substantial investments of both human labor and time. In light of the formidable image generation capabilities of diffusion models, we introduce a novel diffusion model-driven pipeline for automatically generating datasets tailored to the needs of open-world semantic segmentation, named "MagicSeg". Our MagicSeg initiates from class labels and proceeds to generate high-fidelity textual descriptions, which in turn serve as guidance for the diffusion model to generate images. Rather than only generating positive samples for each label, our process encompasses the simultaneous generation of corresponding negative images, designed to serve as paired counterfactual samples for contrastive training. Then, to provide a self-supervised signal for open-world segmentation pretraining, our MagicSeg integrates an open-vocabulary detection model and an interactive segmentation model to extract object masks as precise segmentation labels from images based on the provided category labels. By applying our dataset to the contrastive language-image pretraining model with the pseudo mask supervision and the auxiliary counterfactual contrastive training, the downstream model obtains strong performance on open-world semantic segmentation. We evaluate our model on PASCAL VOC, PASCAL Context, and COCO, achieving SOTA with performance of 62.9%, 26.7%, and 40.2%, respectively, demonstrating our dataset's effectiveness in enhancing open-world semantic segmentation capabilities. Project website: https://github.com/ckxhp/magicseg.

In this paper, we introduce Medical SAM 2 (MedSAM-2), an advanced segmentation model that utilizes the SAM 2 framework to address both 2D and 3D medical image segmentation tasks. By adopting the philosophy of taking medical images as videos, MedSAM-2 not only applies to 3D medical images but also unlocks new One-prompt Segmentation capability. That allows users to provide a prompt for just one or a specific image targeting an object, after which the model can autonomously segment the same type of object in all subsequent images, regardless of temporal relationships between the images. We evaluated MedSAM-2 across a variety of medical imaging modalities, including abdominal organs, optic discs, brain tumors, thyroid nodules, and skin lesions, comparing it against state-of-the-art models in both traditional and interactive segmentation settings. Our findings show that MedSAM-2 not only surpasses existing models in performance but also exhibits superior generalization across a range of medical image segmentation tasks. Our code will be released at: https://github.com/MedicineToken/Medical-SAM2

The recent Segment Anything Model (SAM) 2 has demonstrated remarkable foundational competence in semantic segmentation, with its memory mechanism and mask decoder further addressing challenges in video tracking and object occlusion, thereby achieving superior results in interactive segmentation for both images and videos. Building upon our previous empirical studies, we further explore the zero-shot segmentation performance of SAM 2 in robot-assisted surgery based on prompts, alongside its robustness against real-world corruption. For static images, we employ two forms of prompts: 1-point and bounding box, while for video sequences, the 1-point prompt is applied to the initial frame. Through extensive experimentation on the MICCAI EndoVis 2017 and EndoVis 2018 benchmarks, SAM 2, when utilizing bounding box prompts, outperforms state-of-the-art (SOTA) methods in comparative evaluations. The results with point prompts also exhibit a substantial enhancement over SAM's capabilities, nearing or even surpassing existing unprompted SOTA methodologies. Besides, SAM 2 demonstrates improved inference speed and less performance degradation against various image corruption. Although slightly unsatisfactory results remain in specific edges or regions, SAM 2's robust adaptability to 1-point prompts underscores its potential for downstream surgical tasks with limited prompt requirements.

Image segmentation is usually addressed by training a model for a fixed set of object classes. Incorporating additional classes or more complex queries later is expensive as it requires re-training the model on a dataset that encompasses these expressions. Here we propose a system that can generate image segmentations based on arbitrary prompts at test time. A prompt can be either a text or an image. This approach enables us to create a unified model (trained once) for three common segmentation tasks, which come with distinct challenges: referring expression segmentation, zero-shot segmentation and one-shot segmentation. We build upon the CLIP model as a backbone which we extend with a transformer-based decoder that enables dense prediction. After training on an extended version of the PhraseCut dataset, our system generates a binary segmentation map for an image based on a free-text prompt or on an additional image expressing the query. We analyze different variants of the latter image-based prompts in detail. This novel hybrid input allows for dynamic adaptation not only to the three segmentation tasks mentioned above, but to any binary segmentation task where a text or image query can be formulated. Finally, we find our system to adapt well to generalized queries involving affordances or properties. Code is available at https://eckerlab.org/code/clipseg.

Interactive video object segmentation is a crucial video task, having various applications from video editing to data annotating. However, current approaches struggle to accurately segment objects across diverse domains. Recently, Segment Anything Model (SAM) introduces interactive visual prompts and demonstrates impressive performance across different domains. In this paper, we propose a training-free prompt tracking framework for interactive video object segmentation (I-PT), leveraging the powerful generalization of SAM. Although point tracking efficiently captures the pixel-wise information of objects in a video, points tend to be unstable when tracked over a long period, resulting in incorrect segmentation. Towards fast and robust interaction, we jointly adopt sparse points and boxes tracking, filtering out unstable points and capturing object-wise information. To better integrate reference information from multiple interactions, we introduce a cross-round space-time module (CRSTM), which adaptively aggregates mask features from previous rounds and frames, enhancing the segmentation stability. Our framework has demonstrated robust zero-shot video segmentation results on popular VOS datasets with interaction types, including DAVIS 2017, YouTube-VOS 2018, and MOSE 2023, maintaining a good tradeoff between performance and interaction time.

Interactive segmentation of 3D Gaussians opens a great opportunity for real-time manipulation of 3D scenes thanks to the real-time rendering capability of 3D Gaussian Splatting. However, the current methods suffer from time-consuming post-processing to deal with noisy segmentation output. Also, they struggle to provide detailed segmentation, which is important for fine-grained manipulation of 3D scenes. In this study, we propose Click-Gaussian, which learns distinguishable feature fields of two-level granularity, facilitating segmentation without time-consuming post-processing. We delve into challenges stemming from inconsistently learned feature fields resulting from 2D segmentation obtained independently from a 3D scene. 3D segmentation accuracy deteriorates when 2D segmentation results across the views, primary cues for 3D segmentation, are in conflict. To overcome these issues, we propose Global Feature-guided Learning (GFL). GFL constructs the clusters of global feature candidates from noisy 2D segments across the views, which smooths out noises when training the features of 3D Gaussians. Our method runs in 10 ms per click, 15 to 130 times as fast as the previous methods, while also significantly improving segmentation accuracy. Our project page is available at https://seokhunchoi.github.io/Click-Gaussian

Recently, there have been explorations of generalist segmentation models that can effectively tackle a variety of image segmentation tasks within a unified in-context learning framework. However, these methods still struggle with task ambiguity in in-context segmentation, as not all in-context examples can accurately convey the task information. In order to address this issue, we present SINE, a simple image Segmentation framework utilizing in-context examples. Our approach leverages a Transformer encoder-decoder structure, where the encoder provides high-quality image representations, and the decoder is designed to yield multiple task-specific output masks to effectively eliminate task ambiguity. Specifically, we introduce an In-context Interaction module to complement in-context information and produce correlations between the target image and the in-context example and a Matching Transformer that uses fixed matching and a Hungarian algorithm to eliminate differences between different tasks. In addition, we have further perfected the current evaluation system for in-context image segmentation, aiming to facilitate a holistic appraisal of these models. Experiments on various segmentation tasks show the effectiveness of the proposed method.

Interactive segmentation has an important role in facilitating the annotation process of future LiDAR datasets. Existing approaches sequentially segment individual objects at each LiDAR scan, repeating the process throughout the entire sequence, which is redundant and ineffective. In this work, we propose interactive 4D segmentation, a new paradigm that allows segmenting multiple objects on multiple LiDAR scans simultaneously, and Interactive4D, the first interactive 4D segmentation model that segments multiple objects on superimposed consecutive LiDAR scans in a single iteration by utilizing the sequential nature of LiDAR data. While performing interactive segmentation, our model leverages the entire space-time volume, leading to more efficient segmentation. Operating on the 4D volume, it directly provides consistent instance IDs over time and also simplifies tracking annotations. Moreover, we show that click simulations are crucial for successful model training on LiDAR point clouds. To this end, we design a click simulation strategy that is better suited for the characteristics of LiDAR data. To demonstrate its accuracy and effectiveness, we evaluate Interactive4D on multiple LiDAR datasets, where Interactive4D achieves a new state-of-the-art by a large margin. We publicly release the code and models at https://vision.rwth-aachen.de/Interactive4D.

We investigate the problem of automatically placing an object into a background image for image compositing. Given a background image and a segmented object, the goal is to train a model to predict plausible placements (location and scale) of the object for compositing. The quality of the composite image highly depends on the predicted location/scale. Existing works either generate candidate bounding boxes or apply sliding-window search using global representations from background and object images, which fail to model local information in background images. However, local clues in background images are important to determine the compatibility of placing the objects with certain locations/scales. In this paper, we propose to learn the correlation between object features and all local background features with a transformer module so that detailed information can be provided on all possible location/scale configurations. A sparse contrastive loss is further proposed to train our model with sparse supervision. Our new formulation generates a 3D heatmap indicating the plausibility of all location/scale combinations in one network forward pass, which is over 10 times faster than the previous sliding-window method. It also supports interactive search when users provide a pre-defined location or scale. The proposed method can be trained with explicit annotation or in a self-supervised manner using an off-the-shelf inpainting model, and it outperforms state-of-the-art methods significantly. The user study shows that the trained model generalizes well to real-world images with diverse challenging scenes and object categories.

Task-generic promptable image segmentation aims to achieve segmentation of diverse samples under a single task description by utilizing only one task-generic prompt. Current methods leverage the generalization capabilities of Vision-Language Models (VLMs) to infer instance-specific prompts from these task-generic prompts in order to guide the segmentation process. However, when VLMs struggle to generalise to some image instances, predicting instance-specific prompts becomes poor. To solve this problem, we introduce Instance-specific Negative Mining for Task-Generic Promptable Segmentation (INT). The key idea of INT is to adaptively reduce the influence of irrelevant (negative) prior knowledge whilst to increase the use the most plausible prior knowledge, selected by negative mining with higher contrast, in order to optimise instance-specific prompts generation. Specifically, INT consists of two components: (1) instance-specific prompt generation, which progressively fliters out incorrect information in prompt generation; (2) semantic mask generation, which ensures each image instance segmentation matches correctly the semantics of the instance-specific prompts. INT is validated on six datasets, including camouflaged objects and medical images, demonstrating its effectiveness, robustness and scalability.

Referring Image Segmentation is a comprehensive task to segment an object referred by a textual query from an image. In nature, the level of difficulty in this task is affected by the existence of similar objects and the complexity of the referring expression. Recent RIS models still show a significant performance gap between easy and hard scenarios. We pose that the bottleneck exists in the data, and propose a simple but powerful data augmentation method, Negative-mined Mosaic Augmentation (NeMo). This method augments a training image into a mosaic with three other negative images carefully curated by a pretrained multimodal alignment model, e.g., CLIP, to make the sample more challenging. We discover that it is critical to properly adjust the difficulty level, neither too ambiguous nor too trivial. The augmented training data encourages the RIS model to recognize subtle differences and relationships between similar visual entities and to concretely understand the whole expression to locate the right target better. Our approach shows consistent improvements on various datasets and models, verified by extensive experiments.

Conversational image segmentation grounds abstract, intent-driven concepts into pixel-accurate masks. Prior work on referring image grounding focuses on categorical and spatial queries (e.g., "left-most apple") and overlooks functional and physical reasoning (e.g., "where can I safely store the knife?"). We address this gap and introduce Conversational Image Segmentation (CIS) and ConverSeg, a benchmark spanning entities, spatial relations, intent, affordances, functions, safety, and physical reasoning. We also present ConverSeg-Net, which fuses strong segmentation priors with language understanding, and an AI-powered data engine that generates prompt-mask pairs without human supervision. We show that current language-guided segmentation models are inadequate for CIS, while ConverSeg-Net trained on our data engine achieves significant gains on ConverSeg and maintains strong performance on existing language-guided segmentation benchmarks. Project webpage: https://glab-caltech.github.io/converseg/

Recently, groundbreaking results have been presented on open-vocabulary semantic image segmentation. Such methods segment each pixel in an image into arbitrary categories provided at run-time in the form of text prompts, as opposed to a fixed set of classes defined at training time. In this work, we present a zero-shot volumetric open-vocabulary semantic scene segmentation method. Our method builds on the insight that we can fuse image features from a vision-language model into a neural implicit representation. We show that the resulting feature field can be segmented into different classes by assigning points to natural language text prompts. The implicit volumetric representation enables us to segment the scene both in 3D and 2D by rendering feature maps from any given viewpoint of the scene. We show that our method works on noisy real-world data and can run in real-time on live sensor data dynamically adjusting to text prompts. We also present quantitative comparisons on the ScanNet dataset.

Recent interactive matting methods have shown satisfactory performance in capturing the primary regions of objects, but they fall short in extracting fine-grained details in edge regions. Diffusion models trained on billions of image-text pairs, demonstrate exceptional capability in modeling highly complex data distributions and synthesizing realistic texture details, while exhibiting robust text-driven interaction capabilities, making them an attractive solution for interactive matting. To this end, we propose SDMatte, a diffusion-driven interactive matting model, with three key contributions. First, we exploit the powerful priors of diffusion models and transform the text-driven interaction capability into visual prompt-driven interaction capability to enable interactive matting. Second, we integrate coordinate embeddings of visual prompts and opacity embeddings of target objects into U-Net, enhancing SDMatte's sensitivity to spatial position information and opacity information. Third, we propose a masked self-attention mechanism that enables the model to focus on areas specified by visual prompts, leading to better performance. Extensive experiments on multiple datasets demonstrate the superior performance of our method, validating its effectiveness in interactive matting. Our code and model are available at https://github.com/vivoCameraResearch/SDMatte.

We present a systematic study on a new task called dichotomous image segmentation (DIS) , which aims to segment highly accurate objects from natural images. To this end, we collected the first large-scale DIS dataset, called DIS5K, which contains 5,470 high-resolution (e.g., 2K, 4K or larger) images covering camouflaged, salient, or meticulous objects in various backgrounds. DIS is annotated with extremely fine-grained labels. Besides, we introduce a simple intermediate supervision baseline (IS-Net) using both feature-level and mask-level guidance for DIS model training. IS-Net outperforms various cutting-edge baselines on the proposed DIS5K, making it a general self-learned supervision network that can facilitate future research in DIS. Further, we design a new metric called human correction efforts (HCE) which approximates the number of mouse clicking operations required to correct the false positives and false negatives. HCE is utilized to measure the gap between models and real-world applications and thus can complement existing metrics. Finally, we conduct the largest-scale benchmark, evaluating 16 representative segmentation models, providing a more insightful discussion regarding object complexities, and showing several potential applications (e.g., background removal, art design, 3D reconstruction). Hoping these efforts can open up promising directions for both academic and industries. Project page: https://xuebinqin.github.io/dis/index.html.

The efficient rendering and explicit nature of 3DGS promote the advancement of 3D scene manipulation. However, existing methods typically encounter challenges in controlling the manipulation region and are unable to furnish the user with interactive feedback, which inevitably leads to unexpected results. Intuitively, incorporating interactive 3D segmentation tools can compensate for this deficiency. Nevertheless, existing segmentation frameworks impose a pre-processing step of scene-specific parameter training, which limits the efficiency and flexibility of scene manipulation. To deliver a 3D region control module that is well-suited for scene manipulation with reliable efficiency, we propose interactive Segment-and-Manipulate 3D Gaussians (iSegMan), an interactive segmentation and manipulation framework that only requires simple 2D user interactions in any view. To propagate user interactions to other views, we propose Epipolar-guided Interaction Propagation (EIP), which innovatively exploits epipolar constraint for efficient and robust interaction matching. To avoid scene-specific training to maintain efficiency, we further propose the novel Visibility-based Gaussian Voting (VGV), which obtains 2D segmentations from SAM and models the region extraction as a voting game between 2D Pixels and 3D Gaussians based on Gaussian visibility. Taking advantage of the efficient and precise region control of EIP and VGV, we put forth a Manipulation Toolbox to implement various functions on selected regions, enhancing the controllability, flexibility and practicality of scene manipulation. Extensive results on 3D scene manipulation and segmentation tasks fully demonstrate the significant advantages of iSegMan. Project page is available at https://zhao-yian.github.io/iSegMan.

We study image segmentation from an information-theoretic perspective, proposing a novel adversarial method that performs unsupervised segmentation by partitioning images into maximally independent sets. More specifically, we group image pixels into foreground and background, with the goal of minimizing predictability of one set from the other. An easily computed loss drives a greedy search process to maximize inpainting error over these partitions. Our method does not involve training deep networks, is computationally cheap, class-agnostic, and even applicable in isolation to a single unlabeled image. Experiments demonstrate that it achieves a new state-of-the-art in unsupervised segmentation quality, while being substantially faster and more general than competing approaches.

Image segmentation is a vital task for providing human assistance and enhancing autonomy in our daily lives. In particular, RGB-D segmentation-leveraging both visual and depth cues-has attracted increasing attention as it promises richer scene understanding than RGB-only methods. However, most existing efforts have primarily focused on semantic segmentation and thus leave a critical gap. There is a relative scarcity of instance-level RGB-D segmentation datasets, which restricts current methods to broad category distinctions rather than fully capturing the fine-grained details required for recognizing individual objects. To bridge this gap, we introduce three RGB-D instance segmentation benchmarks, distinguished at the instance level. These datasets are versatile, supporting a wide range of applications from indoor navigation to robotic manipulation. In addition, we present an extensive evaluation of various baseline models on these benchmarks. This comprehensive analysis identifies both their strengths and shortcomings, guiding future work toward more robust, generalizable solutions. Finally, we propose a simple yet effective method for RGB-D data integration. Extensive evaluations affirm the effectiveness of our approach, offering a robust framework for advancing toward more nuanced scene understanding.

Fine-grained 3D part segmentation is crucial for enabling embodied AI systems to perform complex manipulation tasks, such as interacting with specific functional components of an object. However, existing interactive segmentation methods are largely confined to coarse, instance-level targets, while non-interactive approaches struggle with sparse, real-world scans and suffer from a severe lack of annotated data. To address these limitations, we introduce PinPoint3D, a novel interactive framework for fine-grained, multi-granularity 3D segmentation, capable of generating precise part-level masks from only a few user point clicks. A key component of our work is a new 3D data synthesis pipeline that we developed to create a large-scale, scene-level dataset with dense part annotations, overcoming a critical bottleneck that has hindered progress in this field. Through comprehensive experiments and user studies, we demonstrate that our method significantly outperforms existing approaches, achieving an average IoU of around 55.8% on each object part under first-click settings and surpassing 71.3% IoU with only a few additional clicks. Compared to current state-of-the-art baselines, PinPoint3D yields up to a 16% improvement in IoU and precision, highlighting its effectiveness on challenging, sparse point clouds with high efficiency. Our work represents a significant step towards more nuanced and precise machine perception and interaction in complex 3D environments.

We present Segment Anything Model 2 (SAM 2), a foundation model towards solving promptable visual segmentation in images and videos. We build a data engine, which improves model and data via user interaction, to collect the largest video segmentation dataset to date. Our model is a simple transformer architecture with streaming memory for real-time video processing. SAM 2 trained on our data provides strong performance across a wide range of tasks. In video segmentation, we observe better accuracy, using 3x fewer interactions than prior approaches. In image segmentation, our model is more accurate and 6x faster than the Segment Anything Model (SAM). We believe that our data, model, and insights will serve as a significant milestone for video segmentation and related perception tasks. We are releasing a version of our model, the dataset and an interactive demo.

Promptable segmentation typically requires instance-specific manual prompts to guide the segmentation of each desired object. To minimize such a need, task-generic promptable segmentation has been introduced, which employs a single task-generic prompt to segment various images of different objects in the same task. Current methods use Multimodal Large Language Models (MLLMs) to reason detailed instance-specific prompts from a task-generic prompt for improving segmentation accuracy. The effectiveness of this segmentation heavily depends on the precision of these derived prompts. However, MLLMs often suffer hallucinations during reasoning, resulting in inaccurate prompting. While existing methods focus on eliminating hallucinations to improve a model, we argue that MLLM hallucinations can reveal valuable contextual insights when leveraged correctly, as they represent pre-trained large-scale knowledge beyond individual images. In this paper, we utilize hallucinations to mine task-related information from images and verify its accuracy for enhancing precision of the generated prompts. Specifically, we introduce an iterative Prompt-Mask Cycle generation framework (ProMaC) with a prompt generator and a mask generator.The prompt generator uses a multi-scale chain of thought prompting, initially exploring hallucinations for extracting extended contextual knowledge on a test image.These hallucinations are then reduced to formulate precise instance-specific prompts, directing the mask generator to produce masks that are consistent with task semantics by mask semantic alignment. The generated masks iteratively induce the prompt generator to focus more on task-relevant image areas and reduce irrelevant hallucinations, resulting jointly in better prompts and masks. Experiments on 5 benchmarks demonstrate the effectiveness of ProMaC. Code given in https://lwpyh.github.io/ProMaC/.

Medical image segmentation remains challenging due to limited annotations for training, ambiguous anatomical features, and domain shifts. While vision-language models such as CLIP offer strong cross-modal representations, their potential for dense, text-guided medical image segmentation remains underexplored. We present MedCLIPSeg, a novel framework that adapts CLIP for robust, data-efficient, and uncertainty-aware medical image segmentation. Our approach leverages patch-level CLIP embeddings through probabilistic cross-modal attention, enabling bidirectional interaction between image and text tokens and explicit modeling of predictive uncertainty. Together with a soft patch-level contrastive loss that encourages more nuanced semantic learning across diverse textual prompts, MedCLIPSeg effectively improves data efficiency and domain generalizability. Extensive experiments across 16 datasets spanning five imaging modalities and six organs demonstrate that MedCLIPSeg outperforms prior methods in accuracy, efficiency, and robustness, while providing interpretable uncertainty maps that highlight local reliability of segmentation results. This work demonstrates the potential of probabilistic vision-language modeling for text-driven medical image 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).

Text-to-image models give rise to workflows which often begin with an exploration step, where users sift through a large collection of generated images. The global nature of the text-to-image generation process prevents users from narrowing their exploration to a particular object in the image. In this paper, we present a technique to generate a collection of images that depicts variations in the shape of a specific object, enabling an object-level shape exploration process. Creating plausible variations is challenging as it requires control over the shape of the generated object while respecting its semantics. A particular challenge when generating object variations is accurately localizing the manipulation applied over the object's shape. We introduce a prompt-mixing technique that switches between prompts along the denoising process to attain a variety of shape choices. To localize the image-space operation, we present two techniques that use the self-attention layers in conjunction with the cross-attention layers. Moreover, we show that these localization techniques are general and effective beyond the scope of generating object variations. Extensive results and comparisons demonstrate the effectiveness of our method in generating object variations, and the competence of our localization techniques.

Language has emerged as a natural interface for image editing. In this paper, we introduce a method for region-based image editing driven by textual prompts, without the need for user-provided masks or sketches. Specifically, our approach leverages an existing pretrained text-to-image model and introduces a bounding box generator to find the edit regions that are aligned with the textual prompts. We show that this simple approach enables flexible editing that is compatible with current image generation models, and is able to handle complex prompts featuring multiple objects, complex sentences or long paragraphs. We conduct an extensive user study to compare our method against state-of-the-art methods. Experiments demonstrate the competitive performance of our method in manipulating images with high fidelity and realism that align with the language descriptions provided. Our project webpage: https://yuanze-lin.me/LearnableRegions_page.

Large-scale text-to-image diffusion models have significantly improved the state of the art in generative image modelling and allow for an intuitive and powerful user interface to drive the image generation process. Expressing spatial constraints, e.g. to position specific objects in particular locations, is cumbersome using text; and current text-based image generation models are not able to accurately follow such instructions. In this paper we consider image generation from text associated with segments on the image canvas, which combines an intuitive natural language interface with precise spatial control over the generated content. We propose ZestGuide, a zero-shot segmentation guidance approach that can be plugged into pre-trained text-to-image diffusion models, and does not require any additional training. It leverages implicit segmentation maps that can be extracted from cross-attention layers, and uses them to align the generation with input masks. Our experimental results combine high image quality with accurate alignment of generated content with input segmentations, and improve over prior work both quantitatively and qualitatively, including methods that require training on images with corresponding segmentations. Compared to Paint with Words, the previous state-of-the art in image generation with zero-shot segmentation conditioning, we improve by 5 to 10 mIoU points on the COCO dataset with similar FID scores.

Due to the inherent flexibility of prompting, foundation models have emerged as the predominant force in the fields of natural language processing and computer vision. The recent introduction of the Segment Anything Model (SAM) signifies a noteworthy expansion of the prompt-driven paradigm into the domain of image segmentation, thereby introducing a plethora of previously unexplored capabilities. However, the viability of its application to medical image segmentation remains uncertain, given the substantial distinctions between natural and medical images. In this work, we provide a comprehensive overview of recent endeavors aimed at extending the efficacy of SAM to medical image segmentation tasks, encompassing both empirical benchmarking and methodological adaptations. Additionally, we explore potential avenues for future research directions in SAM's role within medical image segmentation. While direct application of SAM to medical image segmentation does not yield satisfactory performance on multi-modal and multi-target medical datasets so far, numerous insights gleaned from these efforts serve as valuable guidance for shaping the trajectory of foundational models in the realm of medical image analysis. To support ongoing research endeavors, we maintain an active repository that contains an up-to-date paper list and a succinct summary of open-source projects at https://github.com/YichiZhang98/SAM4MIS.

We present SLIP (SAM+CLIP), an enhanced architecture for zero-shot object segmentation. SLIP combines the Segment Anything Model (SAM) kirillov2023segment with the Contrastive Language-Image Pretraining (CLIP) radford2021learning. By incorporating text prompts into SAM using CLIP, SLIP enables object segmentation without prior training on specific classes or categories. We fine-tune CLIP on a Pokemon dataset, allowing it to learn meaningful image-text representations. SLIP demonstrates the ability to recognize and segment objects in images based on contextual information from text prompts, expanding the capabilities of SAM for versatile object segmentation. Our experiments demonstrate the effectiveness of the SLIP architecture in segmenting objects in images based on textual cues. The integration of CLIP's text-image understanding capabilities into SAM expands the capabilities of the original architecture and enables more versatile and context-aware object segmentation.

Open-set image segmentation poses a significant challenge because existing methods often demand extensive training or fine-tuning and generally struggle to segment unified objects consistently across diverse text reference expressions. Motivated by this, we propose Segment Anyword, a novel training-free visual concept prompt learning approach for open-set language grounded segmentation that relies on token-level cross-attention maps from a frozen diffusion model to produce segmentation surrogates or mask prompts, which are then refined into targeted object masks. Initial prompts typically lack coherence and consistency as the complexity of the image-text increases, resulting in suboptimal mask fragments. To tackle this issue, we further introduce a novel linguistic-guided visual prompt regularization that binds and clusters visual prompts based on sentence dependency and syntactic structural information, enabling the extraction of robust, noise-tolerant mask prompts, and significant improvements in segmentation accuracy. The proposed approach is effective, generalizes across different open-set segmentation tasks, and achieves state-of-the-art results of 52.5 (+6.8 relative) mIoU on Pascal Context 59, 67.73 (+25.73 relative) cIoU on gRefCOCO, and 67.4 (+1.1 relative to fine-tuned methods) mIoU on GranDf, which is the most complex open-set grounded segmentation task in the field.

Prompt engineering has shown remarkable success with large language models, yet its systematic exploration in computer vision remains limited. In semantic segmentation, both textual and visual prompts offer distinct advantages: textual prompts through open-vocabulary methods allow segmentation of arbitrary categories, while visual reference prompts provide intuitive reference examples. However, existing benchmarks evaluate these modalities in isolation, without direct comparison under identical conditions. We present Show or Tell (SoT), a novel benchmark specifically designed to evaluate both visual and textual prompts for semantic segmentation across 14 datasets spanning 7 diverse domains (common scenes, urban, food, waste, parts, tools, and land-cover). We evaluate 5 open-vocabulary methods and 4 visual reference prompt approaches, adapting the latter to handle multi-class segmentation through a confidence-based mask merging strategy. Our extensive experiments reveal that open-vocabulary methods excel with common concepts easily described by text but struggle with complex domains like tools, while visual reference prompt methods achieve good average results but exhibit high variability depending on the input prompt. Through comprehensive quantitative and qualitative analysis, we identify the strengths and weaknesses of both prompting modalities, providing valuable insights to guide future research in vision foundation models for segmentation tasks.

Referring image segmentation, the task of segmenting any arbitrary entities described in free-form texts, opens up a variety of vision applications. However, manual labeling of training data for this task is prohibitively costly, leading to lack of labeled data for training. We address this issue by a weakly supervised learning approach using text descriptions of training images as the only source of supervision. To this end, we first present a new model that discovers semantic entities in input image and then combines such entities relevant to text query to predict the mask of the referent. We also present a new loss function that allows the model to be trained without any further supervision. Our method was evaluated on four public benchmarks for referring image segmentation, where it clearly outperformed the existing method for the same task and recent open-vocabulary segmentation models on all the benchmarks.

In this paper, we present DeepSIM, a generative model for conditional image manipulation based on a single image. We find that extensive augmentation is key for enabling single image training, and incorporate the use of thin-plate-spline (TPS) as an effective augmentation. Our network learns to map between a primitive representation of the image to the image itself. The choice of a primitive representation has an impact on the ease and expressiveness of the manipulations and can be automatic (e.g. edges), manual (e.g. segmentation) or hybrid such as edges on top of segmentations. At manipulation time, our generator allows for making complex image changes by modifying the primitive input representation and mapping it through the network. Our method is shown to achieve remarkable performance on image manipulation tasks.

In this work, we present a novel framework built to simplify 3D asset generation for amateur users. To enable interactive generation, our method supports a variety of input modalities that can be easily provided by a human, including images, text, partially observed shapes and combinations of these, further allowing to adjust the strength of each input. At the core of our approach is an encoder-decoder, compressing 3D shapes into a compact latent representation, upon which a diffusion model is learned. To enable a variety of multi-modal inputs, we employ task-specific encoders with dropout followed by a cross-attention mechanism. Due to its flexibility, our model naturally supports a variety of tasks, outperforming prior works on shape completion, image-based 3D reconstruction, and text-to-3D. Most interestingly, our model can combine all these tasks into one swiss-army-knife tool, enabling the user to perform shape generation using incomplete shapes, images, and textual descriptions at the same time, providing the relative weights for each input and facilitating interactivity. Despite our approach being shape-only, we further show an efficient method to texture the generated shape using large-scale text-to-image models.

Segmenting an object in a video presents significant challenges. Each pixel must be accurately labelled, and these labels must remain consistent across frames. The difficulty increases when the segmentation is with arbitrary granularity, meaning the number of segments can vary arbitrarily, and masks are defined based on only one or a few sample images. In this paper, we address this issue by employing a pre-trained text to image diffusion model supplemented with an additional tracking mechanism. We demonstrate that our approach can effectively manage various segmentation scenarios and outperforms state-of-the-art alternatives.

Single image reflection removal is inherently ambiguous, as both the reflection and transmission components requiring separation may follow natural image statistics. Existing methods attempt to address the issue by using various types of low-level and physics-based cues as sources of reflection signals. However, these cues are not universally applicable, since they are only observable in specific capture scenarios. This leads to a significant performance drop when test images do not align with their assumptions. In this paper, we aim to explore a novel flexible interactive reflection removal approach that leverages various forms of sparse human guidance, such as points and bounding boxes, as auxiliary high-level prior to achieve robust reflection removal. However, incorporating the raw user guidance naively into the existing reflection removal network does not result in performance gains. To this end, we innovatively transform raw user input into a unified form -- reflection masks using an Interactive Segmentation Foundation Model. Such a design absorbs the quintessence of the foundational segmentation model and flexible human guidance, thereby mitigating the challenges of reflection separations. Furthermore, to fully utilize user guidance and reduce user annotation costs, we design a mask-guided reflection removal network, comprising our proposed self-adaptive prompt block. This block adaptively incorporates user guidance as anchors and refines transmission features via cross-attention mechanisms. Extensive results on real-world images validate that our method demonstrates state-of-the-art performance on various datasets with the help of flexible and sparse user guidance. Our code and dataset will be publicly available here https://github.com/ShawnChenn/FlexibleReflectionRemoval.

Obtaining accurate labels for instance segmentation is particularly challenging due to the complex nature of the task. Each image necessitates multiple annotations, encompassing not only the object's class but also its precise spatial boundaries. These requirements elevate the likelihood of errors and inconsistencies in both manual and automated annotation processes. By simulating different noise conditions, we provide a realistic scenario for assessing the robustness and generalization capabilities of instance segmentation models in different segmentation tasks, introducing COCO-N and Cityscapes-N. We also propose a benchmark for weakly annotation noise, dubbed COCO-WAN, which utilizes foundation models and weak annotations to simulate semi-automated annotation tools and their noisy labels. This study sheds light on the quality of segmentation masks produced by various models and challenges the efficacy of popular methods designed to address learning with label noise.

This paper focuses on the Referring Image Segmentation (RIS) task, which aims to segment objects from an image based on a given language description. The critical problem of RIS is achieving fine-grained alignment between different modalities to recognize and segment the target object. Recent advances using the attention mechanism for cross-modal interaction have achieved excellent progress. However, current methods tend to lack explicit principles of interaction design as guidelines, leading to inadequate cross-modal comprehension. Additionally, most previous works use a single-modal mask decoder for prediction, losing the advantage of full cross-modal alignment. To address these challenges, we present a Fully Aligned Network (FAN) that follows four cross-modal interaction principles. Under the guidance of reasonable rules, our FAN achieves state-of-the-art performance on the prevalent RIS benchmarks (RefCOCO, RefCOCO+, G-Ref) with a simple architecture.

Selection is a core operation in interactive image editing. To be practical, a user should be able to specify and disambiguate the desired selection region through either text or click-based interactions, and the system should support selecting not only objects but also other criteria, such as materials. Material-based selection is valuable for tasks like re-texturing surfaces or editing instances of a specific material. However, existing vision-language-model (VLM) based selection methods are object-centric and typically support a single interaction modality, limiting their applicability. In this work, we thus present Mask Any Object And Material (MAOAM), a unified selection framework that enables precise object and material-level selection across both text- and click-based interactions. MAOAM leverages a VLM with a segmentation head to produce pixel-accurate masks from user prompts: the VLM interprets the user's selection intent (object or material-level) and encodes visual entities, attributes, and spatial relations, while the segmentation head decodes the output token into a mask. A key challenge is the lack of material selection datasets with text annotations. We propose a scalable data generation pipeline: we collect real and synthetic images with material masks, and leverage VLMs to generate material descriptions with rich visual-semantics. We train MAOAM with a multi-task objective over click and text-based selection, along with an auxiliary VQA task derived from the material descriptions to facilitate deeper material understanding. Despite being trained with uni-modal prompts, our model exhibits an emergent improvement in selection when combining text and clicks at inference, enabling flexible image editing workflows. Experiments demonstrate accurate and coherent selections across diverse objects, materials, and interaction scenarios, highlighting robustness in practice.

Accurate image segmentation is essential for modern computer vision applications such as image editing, autonomous driving, and medical image analysis. In recent years, Dichotomous Image Segmentation (DIS) has become a standard task for training and evaluating highly accurate segmentation models. Existing DIS approaches often fail to preserve fine-grained details or fully capture the semantic structure of the foreground. To address these challenges, we present FlowDIS, a novel dichotomous image segmentation method built on the flow matching framework, which learns a time-dependent vector field to transport the image distribution to the corresponding mask distribution, optionally conditioned on a text prompt. Moreover, with our Position-Aware Instance Pairing (PAIP) training strategy, FlowDIS offers strong controllability through text prompts, enabling precise, pixel-level object segmentation. Extensive experiments demonstrate that our method significantly outperforms state-of-the-art approaches both with and without language guidance. Compared with the best prior DIS method, FlowDIS achieves a 5.5% higher F_β^ω measure and 43% lower MAE (M) on the DIS-TE test set. The code is available at: https://github.com/Picsart-AI-Research/FlowDIS

Designing metrics for evaluating instance segmentation revolves around comprehensively considering object detection and segmentation accuracy. However, other important properties, such as sensitivity, continuity, and equality, are overlooked in the current study. In this paper, we reveal that most existing metrics have a limited resolution of segmentation quality. They are only conditionally sensitive to the change of masks or false predictions. For certain metrics, the score can change drastically in a narrow range which could provide a misleading indication of the quality gap between results. Therefore, we propose a new metric called sortedAP, which strictly decreases with both object- and pixel-level imperfections and has an uninterrupted penalization scale over the entire domain. We provide the evaluation toolkit and experiment code at https://www.github.com/looooongChen/sortedAP.

In-context prompting in large language models (LLMs) has become a prevalent approach to improve zero-shot capabilities, but this idea is less explored in the vision domain. Existing visual prompting methods focus on referring segmentation to segment the most relevant object, falling short of addressing many generic vision tasks like open-set segmentation and detection. In this paper, we introduce a universal visual in-context prompting framework for both tasks. In particular, we build on top of an encoder-decoder architecture, and develop a versatile prompt encoder to support a variety of prompts like strokes, boxes, and points. We further enhance it to take an arbitrary number of reference image segments as the context. Our extensive explorations show that the proposed visual in-context prompting elicits extraordinary referring and generic segmentation capabilities to refer and detect, yielding competitive performance to close-set in-domain datasets and showing promising results on many open-set segmentation datasets. By joint training on COCO and SA-1B, our model achieves 57.7 PQ on COCO and 23.2 PQ on ADE20K. Code will be available at https://github.com/UX-Decoder/DINOv.

In this paper, we tackle an emerging computer vision task, open-vocabulary universal image segmentation, that aims to perform semantic/instance/panoptic segmentation (background semantic labeling + foreground instance segmentation) for arbitrary categories of text-based descriptions in inference time. We first build a baseline method by directly adopting pre-trained CLIP models without finetuning or distillation. We then develop MaskCLIP, a Transformer-based approach with a MaskCLIP Visual Encoder, which is an encoder-only module that seamlessly integrates mask tokens with a pre-trained ViT CLIP model for semantic/instance segmentation and class prediction. MaskCLIP learns to efficiently and effectively utilize pre-trained partial/dense CLIP features within the MaskCLIP Visual Encoder that avoids the time-consuming student-teacher training process. MaskCLIP outperforms previous methods for semantic/instance/panoptic segmentation on ADE20K and PASCAL datasets. We show qualitative illustrations for MaskCLIP with online custom categories. Project website: https://maskclip.github.io.

Semantic instance segmentation remains a challenging task. In this work we propose to tackle the problem with a discriminative loss function, operating at the pixel level, that encourages a convolutional network to produce a representation of the image that can easily be clustered into instances with a simple post-processing step. The loss function encourages the network to map each pixel to a point in feature space so that pixels belonging to the same instance lie close together while different instances are separated by a wide margin. Our approach of combining an off-the-shelf network with a principled loss function inspired by a metric learning objective is conceptually simple and distinct from recent efforts in instance segmentation. In contrast to previous works, our method does not rely on object proposals or recurrent mechanisms. A key contribution of our work is to demonstrate that such a simple setup without bells and whistles is effective and can perform on par with more complex methods. Moreover, we show that it does not suffer from some of the limitations of the popular detect-and-segment approaches. We achieve competitive performance on the Cityscapes and CVPPP leaf segmentation benchmarks.

Large Language Models (LLMs) demonstrate strong capabilities in broad knowledge representation, yet they are inherently deficient in pixel-level perceptual understanding. Although the Segment Anything Model (SAM) represents a significant advancement in visual-prompt-driven image segmentation, it exhibits notable limitations in multi-mask prediction and category-specific segmentation tasks, and it cannot integrate all segmentation tasks within a unified model architecture. To address these limitations, we present X-SAM, a streamlined Multimodal Large Language Model (MLLM) framework that extends the segmentation paradigm from segment anything to any segmentation. Specifically, we introduce a novel unified framework that enables more advanced pixel-level perceptual comprehension for MLLMs. Furthermore, we propose a new segmentation task, termed Visual GrounDed (VGD) segmentation, which segments all instance objects with interactive visual prompts and empowers MLLMs with visual grounded, pixel-wise interpretative capabilities. To enable effective training on diverse data sources, we present a unified training strategy that supports co-training across multiple datasets. Experimental results demonstrate that X-SAM achieves state-of-the-art performance on a wide range of image segmentation benchmarks, highlighting its efficiency for multimodal, pixel-level visual understanding. Code is available at https://github.com/wanghao9610/X-SAM.

Promptable segmentation models such as SAM have established a powerful paradigm, enabling strong generalization to unseen objects and domains with minimal user input, including points, bounding boxes, and text prompts. Among these, bounding boxes stand out as particularly effective, often outperforming points while significantly reducing annotation costs. However, current training and evaluation protocols typically rely on synthetic prompts generated through simple heuristics, offering limited insight into real-world robustness. In this paper, we investigate the robustness of promptable segmentation models to natural variations in bounding box prompts. First, we conduct a controlled user study and collect thousands of real bounding box annotations. Our analysis reveals substantial variability in segmentation quality across users for the same model and instance, indicating that SAM-like models are highly sensitive to natural prompt noise. Then, since exhaustive testing of all possible user inputs is computationally prohibitive, we reformulate robustness evaluation as a white-box optimization problem over the bounding box prompt space. We introduce BREPS, a method for generating adversarial bounding boxes that minimize or maximize segmentation error while adhering to naturalness constraints. Finally, we benchmark state-of-the-art models across 10 datasets, spanning everyday scenes to medical imaging. Code - https://github.com/emb-ai/BREPS.

We provide a probabilistic interpretation of attention and show that the standard dot-product attention in transformers is a special case of Maximum A Posteriori (MAP) inference. The proposed approach suggests the use of Expectation Maximization algorithms for online adaptation of key and value model parameters. This approach is useful for cases in which external agents, e.g., annotators, provide inference-time information about the correct values of some tokens, e.g, the semantic category of some pixels, and we need for this new information to propagate to other tokens in a principled manner. We illustrate the approach on an interactive semantic segmentation task in which annotators and models collaborate online to improve annotation efficiency. Using standard benchmarks, we observe that key adaptation boosts model performance (sim10% mIoU) in the low feedback regime and value propagation improves model responsiveness in the high feedback regime. A PyTorch layer implementation of our probabilistic attention model will be made publicly available here: https://github.com/apple/ml-probabilistic-attention.