https://github.com/King-HAW/GMS.
Rapid advancements in medical image segmentation performance have been significantly driven by the development of Convolutional Neural Networks (CNNs) and Vision Transformers (ViTs). However, these models introduce high computational demands and often have limited ability to generalize across diverse medical imaging datasets. In this manuscript, we introduce Generative Medical Segmentation (GMS), a novel approach leveraging a generative model for image segmentation. Concretely, GMS employs a robust pre-trained Variational Autoencoder (VAE) to derive latent representations of both images and masks, followed by a mapping model that learns the transition from image to mask in the latent space. This process culminates in generating a precise segmentation mask within the image space using the pre-trained VAE decoder. The design of GMS leads to fewer learnable parameters in the model, resulting in a reduced computational burden and enhanced generalization capability. Our extensive experimental analysis across five public datasets in different medical imaging domains demonstrates GMS outperforms existing discriminative segmentation models and has remarkable domain generalization. Our experiments suggest GMS could set a new benchmark for medical image segmentation, offering a scalable and effective solution. GMS implementation and model weights are available at