# Fine-Tuned Segment Anything Model with Low-Rank Adaptation for Chest X-Ray Images

**Authors:** Saeed S. Alahmari, Michael R. Gardner, Fawaz Alqahtani, Tawfiq Salem

PMC · DOI: 10.3390/diagnostics16060847 · 2026-03-12

## TL;DR

This paper shows that fine-tuning the Segment Anything Model with low-rank adaptation improves chest X-ray segmentation accuracy and efficiency.

## Contribution

The novel approach combines low-rank adaptation with SAM for efficient and effective medical image segmentation.

## Key findings

- Fine-tuned SAM with LoRA outperforms zero-shot SAM methods in segmentation accuracy.
- The proposed method also surpasses CNN baselines like U-Net and DeepLabv3+.
- LoRA reduces memory and computational needs while preserving pre-trained SAM knowledge.

## Abstract

Background: This paper investigates the use of the Segment Anything Model (SAM) for chest X-ray (CXR) image segmentation, with a focus on improving its performance using low-rank adaptation (LoRA). Methods: We evaluate three versions of SAM: two zero-shot methods (using coordinate and bounding box prompts) and a fine-tuned SAM using LoRA. To support these approaches, we also trained two standard convolutional neural networks (CNNs), U-Net and DeepLabv3+, to generate draft lung segmentations that serve as input prompts for the SAM methods. Our fine-tuning approach uses LoRA to add lightweight trainable adapters within the Transformer blocks of the SAM, allowing only a small subset of parameters to be updated. The rest of the SAM remains frozen, helping preserve its pre-trained knowledge while reducing memory and computational needs. We tested all models on a dataset of CXR images labeled for COVID-19, viral pneumonia, and normal cases. Results: Results show that fine-tuned SAM with LoRA outperforms zero-shot SAM methods and CNN baselines in terms of segmentation accuracy and efficiency. Conclusions: This demonstrates the potential of combining LoRA with SAM for practical and effective medical image segmentation.

## Linked entities

- **Diseases:** COVID-19 (MONDO:0100096), viral pneumonia (MONDO:0006012)

## Full-text entities

- **Diseases:** COVID-19 (MESH:D000086382)

## Figures

8 figures with captions in the complete paper: https://tomesphere.com/paper/PMC13025311/full.md

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Source: https://tomesphere.com/paper/PMC13025311