MS-DKC: A Dataset Knowledge Card Framework for Designing and Adapting Medical Image Segmentation Models

Despite rapid advances in MIS, fair and reproducible comparisons of segmentation models remain challenging due to heterogeneous datasets, inconsistent evaluation protocols, and rapidly evolving architectures. In particular, comparisons often implicitly assume that model rankings are invariant to data partitioning, preprocessing, metric aggregation, uncertainty estimation, and computational constraints. The lack of extensible and unified evaluation frameworks further limits systematic investigation of new models, datasets, and training paradigms. We present MEDSEGBENCHMARKER (MSB), a configuration-driven framework for controlled benchmarking of 2D MIS. It integrates duplicate and near-duplicate image detection, group-aware data splitting, YAML study specifications, resumable training, hyperparameter optimization, cross-validation, and checkpoint-based evaluation. Rather than retaining only aggregate performance measures, MSB exports sample- and class-level pixel counts and predictions together with the evaluation context. These elementary artifacts enable post-hoc analyses without repeated inference. We demonstrate MSB in a case study involving three heterogeneous 2D datasets and multiple MIS and general-purpose vision models evaluated at 256- and 512-pixel input resolutions. Reaggregation of identical predictions changes the top-ranked architecture in three of six dataset-resolution settings, despite high rank correlations between aggregation strategies. Increasing input resolution produces model- and dataset-dependent performance gains and losses that must be considered alongside empirically measured inference complexity. These results show that seemingly minor choices in evaluation and experimental setup can affect benchmark conclusions. MSB, available at GitHub, provides a practical and extensible basis for making benchmark conditions and evaluation choices explicit and reproducible.

Medical image segmentation plays a critical role in clinical diagnostics, treatment planning, disease monitoring, and neurological disorder identification. This article presents a comprehensive review of its systematic development, covering widely used public datasets, representative methods built on the U-Net, Transformer, and SAM architectures, and key evaluation metrics with their differences, followed by an analysis of major challenges from multiple perspectives. Unlike surveys that focus on a single model family or a specific clinical application, this review organizes U-Net-, Transformer-, and SAM-based methods within a unified analytical framework, with a particular focus on their effectiveness in improving segmentation accuracy and efficiency. This work aims to guide future research and support clinical translation of medical image segmentation, with all related resources publicly available in our GitHub repository: https://github.com/andrew-pengyu/Awsome_MedSeg/tree/main.

We present APRIL-MedSeg, a YAML-driven modular framework for 2D medical image segmentation. It provides a unified and extensible ecosystem that decomposes segmentation networks into reusable components. Also, the framework integrates a broad spectrum of advanced paradigms, including semi-supervised learning, domain adaptation, knowledge distillation, weakly supervised learning, and text-guided segmentation as well as foundation model support. A registry-based configuration system with inheritance enables flexible and reproducible experiment management, supporting seamless switching across models, datasets, and training strategies. In addition, the framework provides a unified interface for medical datasets, augmentation pipelines, deployment utilities and model ensembling. Overall, APRIL-MedSeg is designed as a general-purpose research and development platform that bridges algorithmic innovation and practical deployment, while also serving as a structured ecosystem for systematically organizing and reproducing advances in medical image segmentation. The code is available at https://github.com/juntaoJianggavin/APRIL-MedSeg under an Apache 2.0 license.