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May 15, 2026IEEE Transactions on Medical Imaging0 citationsOpen Access

MT-SAM: A Mamba-Transformer Enhanced SAM with Prior-guided Prompting for Multi-modal Prostate Cancer Delineation

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LZLitao ZhaoChinese University of Hong KongYZYu ZhangSouth China Agricultural UniversityLJLibiao JiChangshu No.1 People's Hospital

Key Points

  • The aim is to improve the delineation of clinically significant prostate cancer using a novel framework called MT-SAM.
  • Developed MT-SAM, incorporating a mamba-transformer network for feature extraction.
  • Implemented a prior-guided prompting strategy to enhance model attention on prostate cancer targets.
  • Evaluated MT-SAM on public and private datasets for performance assessment.
  • Achieved 5.6-34.1% higher Dice scores compared to existing state-of-the-art methods.
  • Showed significant improvement in delineation accuracy for clinically significant prostate cancer.

Abstract

Clinically, bi-parametric MRI (bp-MRI), including T2-weighted imaging, diffusion-weighted imaging, and apparent diffusion coefficient map, offers essential prior localization of biopsy and focal therapy for suspicious clinically significant prostate cancer (csPCa), and accurate csPCa delineation from bp-MRI is crucial for better outcomes. However, due to the complexity and high variability in appearance, size, shape, and indistinct boundaries, delineating csPCa remains challenging, time-consuming, and heavily relies on the clinician's experience. To address these issues, we propose MT-SAM, a novel framework that enhances SAM with higher-quality feature extraction and a prior-guided automatic prompting strategy. Specifically, we introduce a mamba-transformer network to extract multi-stage multi-modal features from bp-MRI and fuse them into the SAM encoder via cross-mamba modules. Moreover, we propose a prior-guided pyramid-mamba prompting strategy to strengthen the model's attention on the targets. We extensively evaluate our method on both public and private datasets, and the experimental results show that our method achieves up to 5.6-34.1% higher Dice scores than state-of-the-art methods. Code is available at https://github.com/LuckLT/MT-SAM.

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Cite This Study

Zhao et al. (2026) studied this question.

synapsesocial.com/papers/6a06b81ce7dec685947aa978https://doi.org/10.1109/tmi.2026.3692645
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