Medical image segmentation models adapting to new tasks in a training-free manner through in-context learning is an exciting advancement. Universal segmentation models aim to generalize across the diverse modality of medical images, yet their effectiveness often diminishes when applied to out-of-distribution (OOD) data modalities and tasks, requiring intricate fine-tuning of model for optimal performance. For addressing this challenge, we introduce SegICL, a novel approach leveraging In-Context Learning (ICL) for image segmentation. Unlike existing methods, SegICL has the capability to employ text-guided segmentation and conduct in-context learning with a small set of image-mask pairs, eliminating the need for training the model from scratch or fine-tuning for OOD tasks (including OOD modality and dataset). Extensive experimental validation of SegICL demonstrates a positive correlation between the number of prompt samples and segmentation performance on OOD modalities and tasks. This indicates that SegICL effectively address new segmentation tasks based on contextual information. Additionally, SegICL also exhibits comparable segmentation performance to mainstream models on OOD and in-distribution tasks. Our code will be released soon.
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