Abstract
Medical image segmentation is vital for clinical diagnosis and treatment; however, current solutions face three major limitations: (1) the lack of a universal framework capable of handling diverse modalities and anatomical targets, (2) the limited scalability to adapt to evolving clinical needs and new datasets, and (3) the lack of instructive interfaces that make models usable for non-expert users. To address these challenges, this paper presents MedSegAgent, a universal and scalable multi-agent system for instructive medical image segmentation. Specifically, MedSegAgent comprises five agents: one query parsing agent that processes natural language requests, three coarse-to-fine filtering agents (modality filtering, anatomical filtering, and label selection) for identifying relevant datasets and label values, and one execution agent responsible for model inference and result integration. Based on this framework, MedSegAgent utilizes 23 diverse datasets and pre-trained models to perform 343 types of segmentation across various modalities and anatomical targets. Experimental results demonstrate that MedSegAgent simplifies model selection while maintaining high performance, accurately identifying matching datasets and labels in 94.27% of queries and locating at least one suitable match in 99.03% of queries. MedSegAgent offers a universal and scalable solution for diverse medical image segmentation tasks, bridging the gap between user-friendly queries and the complexities of model selection and deployment.