Self-Auditing Parameter-Efficient Fine-Tuning for Few-Shot 3D Medical Image Segmentation

Point cloud foundation models demonstrate strong generalization, yet adapting them to downstream tasks remains challenging in low-data regimes. Full fine-tuning often leads to overfitting and significant drift from pre-trained representations, while existing parameter-efficient fine-tuning (PEFT) methods mitigate this issue by introducing additional trainable components at the cost of increased inference-time latency. We propose Momentum-Consistency Fine-Tuning (MCFT), an adapter-free approach that bridges the gap between full and parameter-efficient fine-tuning. MCFT selectively fine-tunes a portion of the pre-trained encoder while enforcing a momentum-based consistency constraint to preserve task-agnostic representations. Unlike PEFT methods, MCFT introduces no additional representation learning parameters beyond a standard task head, maintaining the original model's parameter count and inference efficiency. We further extend MCFT with two variants: a semi-supervised framework that leverages abundant unlabeled data to enhance few-shot performance, and a pruning-based variant that improves computational efficiency through structured layer removal. Extensive experiments on object recognition and part segmentation benchmarks demonstrate that MCFT consistently outperforms prior methods, achieving a 3.30% gain in 5-shot settings and up to a 6.13% improvement with semi-supervised learning, while remaining well-suited for resource-constrained deployment.

The advent of vision foundation models, notably the Segment Anything Model (SAM), has catalyzed significant advancements in natural image segmentation. However, their direct transfer to medical imaging remains severely bottlenecked by profound domain gaps, such as cross-modality and cross-center shifts. Existing Parameter-Efficient Fine-Tuning (PEFT) methods facilitate the adaptation of SAM to medical domains; nevertheless, they frequently suffer from performance degradation under severe distribution shifts. This vulnerability primarily stems from the implicit entanglement of heterogeneous frequency components within a shared low-rank subspace, which directly exacerbates sub-optimal structural alignment and localized boundary blurring. To overcome this representational bottleneck, we propose the Fourier-Adaptive Nonlinear Low-Rank Adaptor (FAN-LoRA), a novel frequency-decoupled fine-tuning architecture. FAN-LoRA explicitly separates the optimization space by employing a B-spline-driven low-pass branch for global structural alignment, synergistically coupled with a discrete Fourier high-pass branch for local textural compensation. Extensive experiments across three challenging cross-modality and cross-center benchmarks demonstrate that FAN-LoRA consistently outperforms state-of-the-art PEFT baselines. Compared to the strongest competitors, our method achieves consistent improvements in average Dice scores and notable reductions in boundary errors, while maintaining a compact module size without compromising computational efficiency.

Efficient surgical segmentation empowers clinical diagnosis, intraoperative monitoring, and downstream robotic pipelines for reconstruction and simulation. Although prompt-driven foundation models like Segment Anything Model 3 (SAM3) achieve strong segmentation performance on natural images, surgical data exhibits domain gaps against its pre-training data, resulting in degraded segmentation accuracy. Furthermore, existing medical SAM methods require full-parameter fine-tuning, incurring heavy computational consumption and low efficiency. To address these limitations, this work proposes a parameter-efficient Low-Rank Adaptation (LoRA) adaptation of SAM3 for surgical concept segmentation. We inject low-rank adapters into the prompt encoder, detector and tracker while fully freezing the vision backbone, which only optimizes 0.98% of the total model parameters and supports training on a single consumer GPU. Comprehensive experiments demonstrate that our method consistently outperforms zero-shot SAM3 and other mainstream baselines, and the generated segmentation results can be directly deployed to support downstream robotic surgical scene reconstruction and physical simulation pipelines.