Automated segmentation is a fundamental medical image analysis task, which enjoys significant advances due to the advent of deep learning. While foundation models have been useful in natural language processing and some vision tasks for some time, the foundation model developed with image segmentation in mind - Segment Anything Model (SAM) - has been developed only recently and has shown similar promise. However, there are still no systematic analyses or ``best-practice'' guidelines for optimal fine-tuning of SAM for medical image segmentation. This work summarizes existing fine-tuning strategies with various backbone architectures, model components, and fine-tuning algorithms across 18 combinations, and evaluates them on 17 datasets covering all common radiology modalities. Our study reveals that (1) fine-tuning SAM leads to slightly better performance than previous segmentation methods, (2) fine-tuning strategies that use parameter-efficient learning in both the encoder and decoder are superior to other strategies, (3) network architecture has a small impact on final performance, (4) further training SAM with self-supervised learning can improve final model performance. We also demonstrate the ineffectiveness of some methods popular in the literature and further expand our experiments into few-shot and prompt-based settings. Lastly, we released our code and MRI-specific fine-tuned weights, which consistently obtained superior performance over the original SAM, at https://github.com/mazurowski-lab/finetune-SAM.

对于自动分割医学图像的研究，本文总结了目前的微调策略，并在包括所有常见放射学模态的17个数据集上进行评估，研究发现微调 Segment Anything Model (SAM) 相较于以前的分割方法具有稍微更好的性能，使用参数效率高的学习在编码器和解码器中进行微调的策略优于其他策略，网络架构对最终性能影响不大，通过自监督学习进一步训练 SAM 可以提高最终模型性能。

基于基础模型构建最佳的医学图像分割算法：使用Segment Anything Model的综合实证研究