  This study develops and evaluates a novel multimodal medical image zero-shot
segmentation algorithm named Text-Visual-Prompt SAM (TV-SAM) without any manual
annotations. TV-SAM incorporates and integrates large language model GPT-4,
Vision Language Model GLIP, and Segment Anything Model (SAM), to autonomously
generate descriptive text prompts and visual bounding box prompts from medical
images, thereby enhancing SAM for zero-shot segmentation. Comprehensive
evaluations are implemented on seven public datasets encompassing eight imaging
modalities to demonstrate that TV-SAM can effectively segment unseen targets
across various modalities without additional training, significantly
outperforming SAM AUTO and GSAM, closely matching the performance of SAM BBOX
with gold standard bounding box prompts, and surpassing the state-of-the-art on
specific datasets like ISIC and WBC. The study indicates that TV-SAM serves as
an effective multimodal medical image zero-shot segmentation algorithm,
highlighting the significant contribution of GPT-4 to zero-shot segmentation.
By integrating foundational models such as GPT-4, GLIP, and SAM, it could
enhance the capability to address complex problems in specialized domains. The
code is available at: https://github.com/JZK00/TV-SAM.
