Adapt or specialize? A comprehensive evaluation of adapted SAM versus task-specific CNNs for fetal abdominal segmentation

Zero-shot SAM variants performed poorly, particularly on small or low-contrast structures. In contrast, adapted SAM models consistently outperformed CNNs, reaching DSC scores up to 0.90 (liver) and 0.80 (artery). Prompt-based interaction enables semi-automated, human-in-the-loop workflows, supporting clinical applicability.