Seeing Through the Tool: A Controlled Benchmark for Occlusion Robustness in Foundation Segmentation Models

Fuente: arXiv
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Main Authors: Ho, Nhan, Le, Luu, Nguyen, Thanh-Huy, Nguyen, Thien, Liu, Xiaofeng, Bagci, Ulas
Format: Preprint
Published: 2026
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_version_ 1866910125774602240
author Ho, Nhan
Le, Luu
Nguyen, Thanh-Huy
Nguyen, Thien
Liu, Xiaofeng
Bagci, Ulas
author_facet Ho, Nhan
Le, Luu
Nguyen, Thanh-Huy
Nguyen, Thien
Liu, Xiaofeng
Bagci, Ulas
contents Occlusion, where target structures are partially hidden by surgical instruments or overlapping tissues, remains a critical yet underexplored challenge for foundation segmentation models in clinical endoscopy. We introduce OccSAM-Bench, a benchmark designed to systematically evaluate SAM-family models under controlled, synthesized surgical occlusion. Our framework simulates two occlusion types (i.e., surgical tool overlay and cutout) across three calibrated severity levels on three public polyp datasets. We propose a novel three-region evaluation protocol that decomposes segmentation performance into full, visible-only, and invisible targets. This metric exposes behaviors that standard amodal evaluation obscures, revealing two distinct model archetypes: Occluder-Aware models (SAM, SAM 2, SAM 3, MedSAM3), which prioritize visible tissue delineation and reject instruments, and Occluder-Agnostic models (MedSAM, MedSAM2), which confidently predict into occluded regions. SAM-Med2D aligns with neither and underperforms across all conditions. Ultimately, our results demonstrate that occlusion robustness is not uniform across architectures, and model selection must be driven by specific clinical intent-whether prioritizing conservative visible-tissue segmentation or the amodal inference of hidden anatomy.
format Preprint
id arxiv_https___arxiv_org_abs_2604_11711
institution arXiv
publishDate 2026
record_format arxiv
spellingShingle Seeing Through the Tool: A Controlled Benchmark for Occlusion Robustness in Foundation Segmentation Models
Ho, Nhan
Le, Luu
Nguyen, Thanh-Huy
Nguyen, Thien
Liu, Xiaofeng
Bagci, Ulas
Computer Vision and Pattern Recognition
Occlusion, where target structures are partially hidden by surgical instruments or overlapping tissues, remains a critical yet underexplored challenge for foundation segmentation models in clinical endoscopy. We introduce OccSAM-Bench, a benchmark designed to systematically evaluate SAM-family models under controlled, synthesized surgical occlusion. Our framework simulates two occlusion types (i.e., surgical tool overlay and cutout) across three calibrated severity levels on three public polyp datasets. We propose a novel three-region evaluation protocol that decomposes segmentation performance into full, visible-only, and invisible targets. This metric exposes behaviors that standard amodal evaluation obscures, revealing two distinct model archetypes: Occluder-Aware models (SAM, SAM 2, SAM 3, MedSAM3), which prioritize visible tissue delineation and reject instruments, and Occluder-Agnostic models (MedSAM, MedSAM2), which confidently predict into occluded regions. SAM-Med2D aligns with neither and underperforms across all conditions. Ultimately, our results demonstrate that occlusion robustness is not uniform across architectures, and model selection must be driven by specific clinical intent-whether prioritizing conservative visible-tissue segmentation or the amodal inference of hidden anatomy.
title Seeing Through the Tool: A Controlled Benchmark for Occlusion Robustness in Foundation Segmentation Models
topic Computer Vision and Pattern Recognition
url https://arxiv.org/abs/2604.11711