Is Segment Anything Model 3 (SAM3) capable in segmenting Any Pathology Images? Digital pathology segmentation spans tissue-level and nuclei-level scales, where traditional methods often suffer from high annotation costs and poor generalization. SAM3 introduces Promptable Concept Segmentation, offering a potential automated interface via text prompts. With this work, we propose a systematic evaluation protocol to explore the capability space of SAM3 in a structured manner. Specifically, we evaluate SAM3 under different supervision settings including zero-shot, few-shot, and supervised with varying prompting strategies. Our extensive evaluation on pathological datasets including NuInsSeg, PanNuke and GlaS, reveals that: (1) text-only prompts poorly activate nuclear concepts; (2) performance is highly sensitive to visual prompt types and budgets; (3) few-shot learning offers gains, but SAM3 lacks robustness against visual prompt noise; and (4) a significant gap persists between prompt-based usage and task-trained adapter-based reference. Our study delineates SAM3's boundaries in pathology image segmentation and provides practical guidance on the necessity of pathology domain adaptation.
@article{arxiv.2604.18225,
title = {Is SAM3 ready for pathology segmentation?},
author = {Qiuyu Kong and Shakiba Sharifi and Yiming Wang and Marco Cristani and Zanxi Ruan},
journal= {arXiv preprint arXiv:2604.18225},
year = {2026}
}