Yue He, Min Liu, Qinghao Liu et al.
Image registration is a fundamental task in medical image analysis. Deformations are often closely related to the morphological characteristics of tissues, making accurate feature extraction crucial. Recent weakly supervised methods improve registration by incorporating anatomical priors such as segmentation masks or landmarks, either as inputs or in the loss function. However, such weak labels are often not readily available, limiting their practical use. Motivated by the strong representation learning ability of visual foundation models, this paper introduces SAMIR, an efficient medical image registration framework that utilizes the Segment Anything Model (SAM) to enhance feature extraction. SAM is pretrained on large-scale natural image datasets and can learn robust, general-purpose visual representations. Rather than using raw input images, we design a task-specific adaptation pipeline using SAM's image encoder to extract structure-aware feature embeddings, enabling more accurate modeling of anatomical consistency and deformation patterns. We further design a lightweight 3D head to refine features within the embedding space, adapting to local deformations in medical images. Additionally, we introduce a Hierarchical Feature Consistency Loss to guide coarse-to-fine feature matching and improve anatomical alignment. Extensive experiments demonstrate that SAMIR significantly outperforms state-of-the-art methods on benchmark datasets for both intra-subject cardiac image registration and inter-subject abdomen CT image registration, achieving performance improvements of 2.68% on ACDC and 6.44% on the abdomen dataset. The source code will be publicly available on GitHub following the acceptance of this paper.