Exemplar: Classical Priors Complement Frozen Features for Few-Shot Microscopy Segmentation at Native Resolution

Segmenting a new biomedical dataset usually means a domain-specific model trained on substantial annotation, or a foundation model steered at inference time. We present Exemplar, a few-shot segmenter that fuses a frozen DINOv3 backbone with a fixed bank of classical native-resolution filter responses in one lightweight head, fitted from the support masks alone. In the few-mask, native-resolution regime, classical priors and frozen self-supervised features are complementary: fused in one head, a single fixed configuration spans eleven biomedical imaging datasets. Under the same head, the classical bank alone reaches 0.693 on the eleven-dataset panel, scored by foreground intersection-over-union or centreline Dice, and the frozen features alone 0.672; the bank leads on seven of the eleven and the features on the rest, and fused they reach 0.782. Against five forward-pass few-shot methods, Exemplar leads in 54 of 55 method-dataset comparisons, 52 of them significant after Holm correction. From a single annotated mask it reaches 0.703 on the same panel, against 0.682 for a from-scratch nnU-Net trained on that same mask. At eight masks nnU-Net overtakes it on the panel mean, chiefly on centreline agreement, but takes 16-77x longer to fit.

Pix2Rep-v2: Data-Efficient Representation Learning for Dense Medical Imaging Applications

Dense self-supervised learning (SSL) is a powerful paradigm for learning without annotations the local descriptors required to solve dense medical imaging tasks. We present Pix2Rep-v2, a framework for SSL of pixel- and voxel-level representations suitable for few-shot downstream applications. Pix2Rep-v2 addresses the main challenges of dense SSL by leveraging a redundancy reduction objective at the pixel-level with a principle of equivariance of dense representations, that scales efficiently to 3D or wide field-of-view applications. We evaluate our method on four datasets, across multiple tasks, multiple modalities and anatomical structures using multiple backbones in 2D and 3D, and under various data regimes. As an alternative to linear probing or full fine-tuning on the downstream task, we also propose an in-context variant, without downstream training, based on a dense prototype approach. Pix2Rep-v2 shows substantially higher data-efficiency in few-shot scenarios compared to fully supervised baselines, and is competitive with the state-of-the-art e.g., +9.3 Dice points in one-shot segmentation on the M&Ms-2 dataset. Our code and pre-trained models are publicly available at https://github.com/BioMedTP/pix2rep-v2.

Training-Free Entity-Level Few-Shot Segmentation of Remote Sensing Images with Advection Refinement

Existing cross-domain few-shot segmentation approaches suffer from high training costs due to source-domain episodic training and pixel-wise dense prediction, while often producing fragmented and noisy predictions. To overcome these issues, we propose a training-free entity-level few-shot segmentation framework for remote sensing images with advection refinement. Specifically, we first leverage SAM3's generic geometric priors to generate category-agnostic entity primitives. By reformulating few-shot inference from pixel-level prediction to entity-level reasoning, foreground and background prototypes are constructed and combined with dense textual semantic responses from SAM3 to build a multi-modal semantic potential field. Furthermore, an advection equation-based semantic refinement mechanism is introduced to propagate category-aware information across both feature and similarity spaces, enhancing semantic continuity and suppressing local texture noise. Extensive experiments on multiple remote sensing datasets demonstrate that the proposed framework effectively mitigates domain shift and local noise, substantially improving SAM3's adaptation capability for remote sensing few-shot segmentation without additional training. Our code will be publicly available at https://github.com/yu-ni1989/ELFSS-AR.

Benchmarking Foundation and Large Language Models for Few-Shot Medical Image Segmentation

Few-shot medical image segmentation (FS-MIS) aims to segment novel regions of interest (ROIs) from a few annotated support examples. Despite rapid progress, existing FS-MIS solutions span diverse paradigms but are evaluated under inconsistent settings, leaving their relative effectiveness unclear. We introduce FAME, a unified benchmark for evaluating FS-MIS solutions, covering specialists, SAM-based methods, CLIP-based methods, and MLLM-based methods. FAME contains 14,958 test samples across 7 anatomical sites, 9 imaging modalities, and 14 ROI categories, and evaluates models under zero-shot and ten-shot settings with additional assessment of target-absence recognition and generalization under covariate and semantic shifts. Our evaluation reveals several findings. First, effective few-shot segmentation depends on how models exploit support examples: direct visual adaptation generally outperforms prompt-based strategies. Second, increasing support examples improves performance only when models can effectively utilize them. Third, semantic transfer remains substantially more challenging than imaging-domain adaptation, and strong localization ability does not necessarily imply reliable target-absence recognition. We hope FAME provides a comprehensive understanding of current FS-MIS solutions and facilitates the development of more effective and reliable few-shot medical segmentation methods.

SADe: Sparse-Atom Support Decontamination for Few-Shot Segmentation with Weak Support Annotations

Few-shot segmentation (FSS) commonly assumes clean pixel-level support masks, yet practical support supervision often uses boxes, scribbles, coarse masks, or pseudo-masks. These weak annotations may include texture-similar distractors and background context alongside the target, contaminating class prototypes or visual prompts before query prediction. We introduce SADe, a predictor-agnostic support decontamination layer that estimates the reliability of selected support patches without query information. Central to SADe is sparse autoencoder (SAE) atom evidence: dense similarity may respond to both target and texture-similar context, whereas contrasting atom activations inside and outside the weak-support region provides factor-level reliability cues. A lightweight router combines atom evidence with dense similarity and episode statistics to predict patch reliability and generate a cleaned support mask. Trained once on synthetic weak-support episodes from FSS-1000, the router is frozen for all target evaluations. The resulting mask supports standalone prediction or can be supplied to heterogeneous FSS models through native support interfaces without altering query-side inference. Under a matched weak-support protocol, SADe achieves the highest query mIoU in six of nine standalone prompt-shot combinations. With the same ProMi query head, it is within 0.03 mIoU of SAM3-derived masks under tight boxes and surpasses them by 11.17 and 19.49 points under box-r2 and box-r4, respectively. As a plug-in, SADe improves over raw support in 70 of 72 matched box-family comparisons across four frozen downstream models and two datasets. On point and scribble prompts, its average performance remains close to the corresponding raw-support baseline. Ablations and atom-removal controls show that atom evidence contributes reliability information beyond dense similarity.

Active few-shot segmentation by reinforcing data selection

Few-shot learning enables medical image segmentation models to adapt to new tasks using only a small number of labelled examples. However, adaptation performance depends strongly on which examples are selected for the support set. Effective support sets should capture relevant variation within the target domain and be informative for adaptation, with constituent samples providing complementary information. Despite this, existing active data selection approaches largely prioritise samples individually and do not explicitly account for interactions between examples. In this work, we propose a reinforcement learning framework for support-set selection in few-shot medical image segmentation, enabling support sets to be optimised jointly rather than through independent sample scoring. Given a pool of unlabelled candidate images, an agent directly predicts a support set that maximises downstream segmentation performance. Experiments on a cross-institutional pelvic MRI dataset demonstrate improvements over random selection and current state-of-the-art methods. Our findings highlight the importance of support-set complementarity for effective adaptation and demonstrate the potential of reinforcement learning for optimising adaptation sets.

DAUPNet: Domain-Aware Uncertainty Modeling for Reliable Prototype Discrimination in Cross-Domain Few-Shot Semantic Segmentation

Cross-domain few-shot semantic segmentation (CD-FSS) has predominantly been formulated as learning domain-invariant representations or improving support-query correspondence. Nevertheless, large domain shifts still make prototype matching unreliable: inconsistent hierarchical responses corrupt the support representation, deterministic prototypes cannot express boundary and appearance ambiguity, and treating prototypes with different reliability equally during optimization weakens foreground-background separation. We therefore propose DAUPNet, a unified framework that reformulates cross-domain prototype matching as uncertainty-aware prototype discrimination. DAUPNet first harmonizes hierarchical support-query features to provide stable evidence, then represents foreground and background prototypes probabilistically, and finally uses their estimated uncertainty to regulate contrastive optimization. On four standard target domains, DAUPNet achieves 72.6% and 76.7% average mIoU in the 1-shot and 5-shot settings, respectively, including substantial gains on the two medical domains. These results demonstrate that modeling prototype uncertainty and incorporating it into optimization provides a robust and interpretable approach to CD-FSS under severe domain shift. The code is available at https://github.com/madness-Lei/DAUPNet

HyperBank: A Differentiable Bank of Classical Priors for Few-Shot Spheroid Microscopy Segmentation

Few-shot spheroid segmentation must adapt to new cell lines, microscopes, and illumination conditions from only a small set of annotated images. While foundation few-shot segmenters can be accurate, their large opaque backbones make it difficult to understand which visual cues drive success or failure. We study this question with HyperBank, a differentiable bank of classical image-processing operators combining Frangi vesselness, a Sauvola threshold pyramid, structure-tensor responses, gradient magnitude, and Laplacian-of-Gaussian filters. HyperBank is fitted on the annotated support images and evaluated on disjoint held-out images across three independently acquired spheroid datasets. We treat it not as a general replacement for foundation models, but as a compact, interpretable few-shot microscopy pipeline and an analytic-prior probe of which classical cues carry the few-shot signal. The results show that, adapted on the same few annotated support images, a compact bank of analytic priors is competitive with, and on small-cluster, contrast-driven data can outperform, much larger foundation models, while those models remain stronger on externally sourced, texture-dominated spheroids. Leave-one-family-out ablations indicate that the useful few-shot signal is distributed across operator families and strengthened by support-set-tuned morphology.

RUFNet: Query-Guided Support Mask Refinement and Uncertainty Fusion based on Hybrid Mamba for Few-Shot Brain Tumor Segmentation

Few-shot brain tumor segmentation remains challenging due to noisy support masks, inter-patient variations between support and query images, and the lack of pixel-wise confidence estimation. This study proposes RUFNet, a Hybrid Mamba-based few-shot framework that combines support mask refinement with uncertainty-aware posterior fusion. To preserve support-query dependencies with manageable cost, RUFNet adopts a Hybrid Mamba interaction backbone with linear complexity. To reduce support-mask noise, an Attention-Guided Mask Refinement module (AGMR) uses query features to recalibrate support masks and improve prototype consistency. To handle ambiguous predictions, an Uncertainty-Aware Posterior Fusion module (UAPF) estimates pixel-wise variance and adaptively balances few-shot predictions with query-aligned priors. On the Brain Tumor Segmentation Challenge (BraTS) 2020 dataset, RUFNet achieves Dice coefficients of 84.3% and 86.1% in the 1-way 1-shot and 1-way 5-shot settings, respectively, outperforming the compared state-of-the-art methods. These results suggest that Hybrid Mamba interaction, mask refinement and uncertainty modelling can improve the robustness of few-shot medical image segmentation. The official implementation code is available at https://github.com/hdy6438/RUFNet.

FROST: Training-Free Few-Shot Segmentation with Frozen Features and Nonparametric Statistics

Few-shot segmentation asks a model to delineate a target class in a query image from only a handful of annotated examples, a setting most acute in remote sensing, where labels are scarce and the imagery departs sharply from the natural images on which vision backbones are pretrained. Prevailing approaches either train a segmenter on labelled episodes, which raises accuracy within the training distribution but binds the model to it, or reduce each class to a lossy summary of frozen features, a single prototype, a few cluster prototypes, or a discrete clustering, none of which preserves the internal structure of a multimodal class. We argue that a class is better described by a distribution than by a point, and that frozen self-supervised features already carry enough structure to estimate that distribution directly. We introduce FROST, a training-free few-shot segmenter that treats the reference foreground and background as two point clouds on the unit sphere of frozen DINOv3 features and labels each query token by a nonparametric density ratio, with a threshold the Bayes rule fixes at zero under equal priors. Because the variance of a density estimate shrinks as its sample grows, the decision sharpens as references accumulate, and every remaining quantity from the kernel bandwidth to the spatial gate is read from the support set rather than tuned. We develop FROST for overhead imagery, where a class is typically a scatter of many small and dissimilar instances that a density tracks but a lossy summary blurs. Across seventeen remote-sensing benchmarks FROST surpasses both training-free and learning-based methods, leading by 5.6 mIoU from a single annotated example and widening its lead as the support set grows, all while remaining among the smallest models compared. Code is available at https://github.com/jhpark-ai/FROST.

PSP: Harnessing Position and Shape Priors for Cross-Domain Few-Shot Medical Image Segmentation

Few-Shot Medical Image Segmentation (FSMIS) offers a powerful solution to data scarcity but struggles to generalize across different imaging modalities. This performance collapse stems primarily from the drastic texture discrepancies between domains, which mislead models trained on source-specific intensity distributions. While existing methods attempt to align frequency or local texture features, they often fail to decouple semantic structure from domain-specific appearance. To address this, we identify a critical invariance: despite distinct imaging physics, the position and geometric shape of organs remain robustly consistent across modalities. Therefore, we propose a novel framework that harnesses Position and Shape Priors (PSP) for cross-domain FSMIS. Specifically, PSP first introduces a Position Coordinate Embedding (PCE) module to inject relative spatial coordinates for rapid organ localization. Subsequently, a Shape Prototype Modulation (SPM) module constructs domain-invariant structural prototypes via explicit shape priors, effectively filtering out texture noise. Furthermore, the Hybrid-Prototype Prediction (HPP) module adaptively calibrates the support prototype to the query feature distribution, mitigating feature misalignment. Extensive experiments on two public medical imaging datasets demonstrate that PSP significantly outperforms state-of-the-art methods.

Mask to Concept: Auto-Promptable SAM3 via Efficient Test-Time Concept Embedding Search for Few-Shot Annotation

Transforming foundation segmentation models from human-prompted tools into auto-promptable annotators is critical for scalable medical data annotation. Current methods commonly depend on external feature matchers or auxiliary networks to automate geometric prompting, but introducing architectural overhead and limiting performance scalability. Although SAM3 natively supports concept segmentation via reusable text prompts, its direct use in medical imaging is hindered by a lack of fine-grained clinical knowledge and the ambiguity of human-written descriptions. In this work, we propose Mask to Concept (M2C), an efficient framework that adapts SAM3 for medical few-shot annotation without external modules, parameter retraining, or manual text engineering. Using only a few labeled images, M2C enables SAM3 to automatically search for transferable visual concepts entirely within its frozen architecture: it initializes a learnable concept embedding, uses it to prompt segmentation, and updates the embedding by gradients of minimizing the concept segmentation error. We further introduce a Hybrid Uncertainty Estimation (HUE) module that calculates the prediction entropy and maps concept predictions back to the box prompts, measuring concept-geometry prompting inconsistency. Highly uncertain samples are flagged actively for human correction, and the corrected masks are then fed back to M2C to continuously search for more precise concept embeddings, forming a self-enhancing annotation loop with minimal expert effort. Experiments on medical segmentation benchmarks show that our method achieves SOTA few-shot segmentation performance and outstanding annotation efficiency, offering a practical and efficient pathway toward scalable medical image labeling. Codes are at https://github.com/Huster-Hq/M2C.

Training-free Cross-domain Few-shot Segmentation via Robust Semantic Representation and Matching

Cross-domain Few-shot Segmentation (CD-FSS) aims to transfer knowledge learned from source domain to distinct target domains, segmenting unseen target classes with only a few annotated samples. Although existing methods have made significant progress, they still rely on training or fine-tuning processes, which incur high computational costs and risk overfitting. We observe that when powerful and general-purpose vision foundation models are incorporated into these methods, their performance shows only marginal improvement or even degrades due to overfitting. To address this, we eliminate trainable parameters and propose a training-free framework to avoid both training overhead and overfitting. Built upon the self-supervised vision encoder DINOv3, our framework addresses cross-domain challenges through three core modules. First, the Semantic-aware Feature Re-fusion (SAFR) module identifies and re-fuses features that emphasize semantic patterns, generating representations with enhanced semantic discriminability. Additionally, the Adaptive Support Enhancement (ASE) module narrows semantic gaps between support and query through robust query information aggregation. Finally, the Hybrid Prototype Matching (HPM) module integrates matching results from diverse prototypes to adapt to varying semantic complexity across domains. Extensive experiments on four target domain datasets demonstrate that our method achieves state-of-the-art performance in CD-FSS without any training.

Hierarchical Spatial and Channel Aggregation for Cross-domain Few-shot Segmentation

Cross-domain Few-shot Segmentation (CD-FSS) aims to learn generalizable segmentation capability from abundant annotated samples in the source domain, enabling accurate segmentation of novel classes in the target domain with only a few annotated samples. Existing CD-FSS methods mainly focus on mitigating feature distribution shifts caused by style gaps while ignoring significant differences in class semantic granularity and discriminative attributes across domains, leading to two key degradations in support-query matching: semantic over-alignment and attribute over-alignment. To this end, we propose the Dual Hierarchical Aggregation Network (DHANet), which comprises three key modules. First, the Hierarchical Spatial Aggregation (HSA) module performs multi-scale region aggregation of pixel features along the spatial dimension, generating hierarchical semantic-enhanced features to alleviate semantic over-alignment. Additionally, the HCA module conducts multi-scale attribute aggregation along the channel dimension, generating hierarchical attribute-enhanced features to mitigate attribute over-alignment. Finally, we propose the Online Probabilistic Semantic Bank (OPSB), which progressively constructs and updates class probability distributions from query predictions during inference, and samples multiple pseudo-prototypes as additional support information to mitigate insufficient support. Extensive experiments on four target-domain datasets demonstrate that our method achieves state-of-the-art performance.

Training-Free Generalized Few-Shot Segmentation through Open-Vocabulary Semantic Arbitration

Generalized Few-Shot Semantic Segmentation (GFSS) has traditionally been approached as a representation-learning problem, requiring task-specific adaptation to incorporate novel classes from limited support examples. Recent foundation models, however, already exhibit strong open-vocabulary recognition and segmentation capabilities, raising a different question: can GFSS be solved through inference-time coordination of frozen semantic priors rather than parameter adaptation? We answer this question with Open-V, a training-free GFSS framework that combines Segment Anything (SAM3) Promptable Concept Segmentation (PCS) with a K-shot CLIP support centroid through calibrated per-pixel semantic arbitration. OpenV introduces no trainable components and supports arbitrary semantic categories at inference time. Beyond segmentation performance, our study contributes three broader findings. First, we show that support information can be incorporated through inference-time semantic grounding, and that its contribution increases as foundation-model text priors weaken on label-disjoint vocabularies. Second, we identify a reproducibility confound in foundationmodel segmentation, demonstrating that preprocessing and evaluation-space mismatches can silently distort reported performance. Finally, we validate Open-V across PASCAL5i, COCO-20i, and ADE-OW, showing that training-free coordination of foundation-model priors generalizes across both conventional GFSS and open-vocabulary evaluation settings. On PASCAL-5i (1-shot), Open-V attains base/novel/harmonic mIoU of 78.4/77.5/77.9, without GFSS-specific training surpassing the strongest trained baseline by +17.7 HM.