Segment anything model (SAM), an eminent universal image segmentation model, has recently gathered considerable attention within the domain of medical image segmentation. Despite the remarkable performance of SAM on natural images, it grapples with significant performance degradation and limited generalization when confronted with medical images, particularly with those involving objects of low contrast, faint boundaries, intricate shapes, and diminutive sizes. In this paper, we propose SAMUS, a universal model tailored for ultrasound image segmentation. In contrast to previous SAM-based universal models, SAMUS pursues not only better generalization but also lower deployment cost, rendering it more suitable for clinical applications. Specifically, based on SAM, a parallel CNN branch is introduced to inject local features into the ViT encoder through cross-branch attention for better medical image segmentation. Then, a position adapter and a feature adapter are developed to adapt SAM from natural to medical domains and from requiring large-size inputs (1024x1024) to small-size inputs (256x256) for more clinical-friendly deployment. A comprehensive ultrasound dataset, comprising about 30k images and 69k masks and covering six object categories, is collected for verification. Extensive comparison experiments demonstrate SAMUS's superiority against the state-of-the-art task-specific models and universal foundation models under both task-specific evaluation and generalization evaluation. Moreover, SAMUS is deployable on entry-level GPUs, as it has been liberated from the constraints of long sequence encoding. The code, data, and models will be released at https://github.com/xianlin7/SAMUS.
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