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Main Authors: Li, Jieru, Chen, Matthew, Nnamdi, Micky C., Tamo, J. Ben, Marteau, Benoit L., Wang, May D.
Format: Preprint
Published: 2026
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Online Access:https://arxiv.org/abs/2604.09814
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author Li, Jieru
Chen, Matthew
Nnamdi, Micky C.
Tamo, J. Ben
Marteau, Benoit L.
Wang, May D.
author_facet Li, Jieru
Chen, Matthew
Nnamdi, Micky C.
Tamo, J. Ben
Marteau, Benoit L.
Wang, May D.
contents Medical image segmentation models built on Segment Anything Model (SAM) achieve strong performance on clean benchmarks, yet their reliability often degrades under realistic image corruptions such as noise, blur, motion artifacts, and modality-specific distortions. Existing approaches address either medical-domain adaptation or corruption robustness, but not both jointly. In SAM, we find that these capabilities are concentrated in complementary modules: the image encoder preserves medical priors, while the mask decoder governs corruption robustness. Motivated by this observation, we propose RobustMedSAM, which adopts module-wise checkpoint fusion by initializing the image encoder from MedSAM and the mask decoder from RobustSAM under a shared ViT-B architecture. We then fine-tune only the mask decoder on 35 medical datasets from MedSegBench, spanning six imaging modalities and 12 corruption types, while freezing the remaining components to preserve pretrained medical representations. We additionally investigate an SVD-based parameter-efficient variant for limited encoder adaptation. Experiments on both in-distribution and out-of-distribution benchmarks show that RobustMedSAM improves degraded-image Dice from 0.613 to 0.719 (+0.106) over SAM, demonstrating that structured fusion of complementary pretrained models is an effective and practical approach for robust medical image segmentation.
format Preprint
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institution arXiv
publishDate 2026
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spellingShingle RobustMedSAM: Degradation-Resilient Medical Image Segmentation via Robust Foundation Model Adaptation
Li, Jieru
Chen, Matthew
Nnamdi, Micky C.
Tamo, J. Ben
Marteau, Benoit L.
Wang, May D.
Computer Vision and Pattern Recognition
Medical image segmentation models built on Segment Anything Model (SAM) achieve strong performance on clean benchmarks, yet their reliability often degrades under realistic image corruptions such as noise, blur, motion artifacts, and modality-specific distortions. Existing approaches address either medical-domain adaptation or corruption robustness, but not both jointly. In SAM, we find that these capabilities are concentrated in complementary modules: the image encoder preserves medical priors, while the mask decoder governs corruption robustness. Motivated by this observation, we propose RobustMedSAM, which adopts module-wise checkpoint fusion by initializing the image encoder from MedSAM and the mask decoder from RobustSAM under a shared ViT-B architecture. We then fine-tune only the mask decoder on 35 medical datasets from MedSegBench, spanning six imaging modalities and 12 corruption types, while freezing the remaining components to preserve pretrained medical representations. We additionally investigate an SVD-based parameter-efficient variant for limited encoder adaptation. Experiments on both in-distribution and out-of-distribution benchmarks show that RobustMedSAM improves degraded-image Dice from 0.613 to 0.719 (+0.106) over SAM, demonstrating that structured fusion of complementary pretrained models is an effective and practical approach for robust medical image segmentation.
title RobustMedSAM: Degradation-Resilient Medical Image Segmentation via Robust Foundation Model Adaptation
topic Computer Vision and Pattern Recognition
url https://arxiv.org/abs/2604.09814