Explainable multi-module semantic guided attention based network for medical image segmentation

Medical image segmentation is crucial for improving healthcare outcomes. Convolutional neural networks (CNNs) have been widely applied in medical image analysis; however, their inherent inductive biases limit their ability to capture global contextual information. Vision transformer (ViT) architectures address this limitation by leveraging attention mechanisms to model global relationships; however, they typically require large-scale datasets for effective training, which is challenging in the field of medical imaging due to limited data availability. This study aimed to integrate the advantages of CNN and ViT architectures to improve segmentation performance on small-scale medical image datasets. In this study, we established a U-shaped network architecture based on a Transformer-assisted convolutional neural network (TAC-UNet). The TAC-UNet is primarily composed of a hybrid structure integrating CNN and Transformer components. Specifically, the hybrid architecture follows a dual-path design in which the Transformer branch continuously conveys global contextual information to the CNN backbone. This allows the CNN backbone to enhance its global perception while building on the local features it extracts, thereby improving its ability to comprehend complex image structures. A channel cross-attention (CCA) module is also incorporated as a bridge between the encoder and decoder to better reconcile the semantic discrepancies between them. Detailed experiments on three public datasets were conducted. Specifically, our model was trained on 30 images from the Multi-organ Nucleus Segmentation (MoNuSeg) training dataset, 85 images from the Gland Segmentation (GlaS) training dataset, and 551 images from the Computer Vision Center Colorectal Cancer-Clinic Database (CVC-ClinicDB) dataset. We evaluated the performance of our model on the corresponding test sets. Our TAC-UNet achieved the best Dice scores (80.36%, 90.70%, and 91.81% on the MoNuSeg, GlaS, and CVC-ClinicDB datasets, respectively) of all the models. Compared to other CNN-based, Transformer-based, and hybrid methods, the TAC-UNet demonstrated significantly superior segmentation performance. Our TAC-UNet model showed advanced segmentation performance on small-scale medical image datasets. The detailed experimental results showed the effectiveness of the method. Our model's code is available at: https://github.com/hejlhello/TAC-UNet.

Segmentation is a fundamental task in medical image analysis. Current state-of-the-art Convolutional Neural Networks on medical image segmentation capture local context information using fixed-shape receptive fields and feature detectors with position-invariant weights, which limits the robustness to the variance of input, such as medical objects of variant sizes, shapes, and domains. In order to capture global context information, we propose High-order Attention (HA), a novel attention module with adaptive receptive fields and dynamic weights. HA allows each pixel to has its own global attention map that models its relationship to all other pixels. In particular, HA constructs the attention map through graph transduction and thus captures high relevant context information at high-order. Consequently, feature maps at each position are selectively aggregated as a weighted sum of feature maps at all positions. We further embed the proposed HA module into an efficient encoder-decoder structure for medical image segmentation, namely High-order Attention Network (HANet). Extensive experiments are conducted on four benchmark sets for three tasks, i.e., REFUGE and Drishti-GS1 for optic disc/cup segmentation, DRIVE for blood vessel segmentation, and LUNA for lung segmentation. The results justify the effectiveness of the new attention module for medical image segmentation.

LCP-Net: A local context-perception deep neural network for medical image segmentation

CASF-Net: Cross-attention and cross-scale fusion network for medical image segmentation

MultiTrans: Multi-branch transformer network for medical image segmentation

As a computer-aided diagnosis technique, medical image segmentation can help doctors improve the accuracy and efficiency of disease diagnosis. In recent years, convolutional neural networks (CNNs) have made great progress in the field of medical image segmentation, and medical image segmentation networks using encoder-decoder and jump connection structures have a wide range of applications in the medical field.

MHSU-Net: A more versatile neural network for medical image segmentation

MH-Net: Model-data-driven hybrid-fusion network for medical image segmentation

Deep learning has achieved great success in the field of computer vision, and the precision in image classification and image detection has surpassed humans. Therefore, this paper combines deep learning and medical image segmentation, focusing on how to improve the accuracy and speed of segmentation algorithm of medical exercise rehabilitation image. Aiming at the shortcomings of traditional medical image recognition methods, a medical exercise rehabilitation image segmentation algorithm based on hierarchical features of convolutional neural networks is proposed, this paper calls it as hierarchical features of convolutional neural networks (HFCNN). The algorithm firstly samples the convolution output of multiple layers in the convolutional neural network to a unified scale and combines them to construct a hierarchical feature. This hierarchical feature combines the structural information of objects contained in the shallow layer of the network with the semantic information of objects contained in the deep layers of the network, so it has a strong ability to express. Secondly, the image can be segmented into multiple super pixels by the super pixel segmentation algorithm. The classifier is trained using the hierarchical features of the super pixel, and then the classification result is mapped back to the pixel. Finally, a fully connected conditional random field algorithm including one-potential potential energy and paired potential energy is constructed. The corresponding energy function is used to smooth the classification result of the pixel, and the regional consistency and continuity of the pixel mark are improved. Compared with many classical convolutional neural network algorithms, this algorithm not only accelerates the network convergence speed, shortens the training time, but also significantly improves the accuracy of segmentation algorithm of medical exercise rehabilitation image, showing good practical value.

When using convolutional neural networks (CNNs) for segmentation of organs and lesions in medical images, the conventional approach is to work with inputs and outputs either as single slice [two-dimensional (2D)] or whole volumes [three-dimensional (3D)]. One common alternative, in this study denoted as pseudo-3D, is to use a stack of adjacent slices as input and produce a prediction for at least the central slice. This approach gives the network the possibility to capture 3D spatial information, with only a minor additional computational cost. In this study, we systematically evaluate the segmentation performance and computational costs of this pseudo-3D approach as a function of the number of input slices, and compare the results to conventional end-to-end 2D and 3D CNNs, and to triplanar orthogonal 2D CNNs. The standard pseudo-3D method regards the neighboring slices as multiple input image channels. We additionally design and evaluate a novel, simple approach where the input stack is a volumetric input that is repeatably convolved in 3D to obtain a 2D feature map. This 2D map is in turn fed into a standard 2D network. We conducted experiments using two different CNN backbone architectures and on eight diverse data sets covering different anatomical regions, imaging modalities, and segmentation tasks. We found that while both pseudo-3D methods can process a large number of slices at once and still be computationally much more efficient than fully 3D CNNs, a significant improvement over a regular 2D CNN was only observed with two of the eight data sets. triplanar networks had the poorest performance of all the evaluated models. An analysis of the structural properties of the segmentation masks revealed no relations to the segmentation performance with respect to the number of input slices. A post hoc rank sum test which combined all metrics and data sets yielded that only our newly proposed pseudo-3D method with an input size of 13 slices outperformed almost all methods. In the general case, multislice inputs appear not to improve segmentation results over using 2D or 3D CNNs. For the particular case of 13 input slices, the proposed novel pseudo-3D method does appear to have a slight advantage across all data sets compared to all other methods evaluated in this work.

While convolutional neural networks (CNNs) and vision transformers (ViTs) have advanced medical image segmentation, they face inherent limitations such as local receptive fields in CNNs and high computational complexity in ViTs. This paper introduces Deconver, a novel network that integrates traditional deconvolution techniques from image restoration as a core learnable component within a U -shaped architecture. Deconver replaces computationally expensive attention mechanisms with efficient nonnegative deconvolution (NDC) operations, enabling the restoration of high-frequency details while suppressing artifacts. Key innovations include a backpropagation-friendly NDC layer based on a provably monotonic update rule and a parameter-efficient design. Evaluated across five datasets (ISLES'22, Spleen, BraTS'23, GlaS, and FIVES) covering both 2D and 3D segmentation tasks, Deconver achieves state-of-the-art performance in Dice scores and Hausdorff distance while reducing computational costs (FLOPs) by up to 90% compared to leading baselines. By bridging traditional image restoration with deep learning, this work offers a practical solution for high-precision segmentation in resource-constrained clinical workflows.

Semantic segmentation of medical images provides an important cornerstone for subsequent tasks of image analysis and understanding. With rapid advancements in deep learning methods, conventional U-Net segmentation networks have been applied in many fields. Based on exploratory experiments, features at multiple scales have been found to be of great importance for the segmentation of medical images. In this paper, we propose a scale-attention deep learning network (SA-Net), which extracts features of different scales in a residual module and uses an attention module to enforce the scale-attention capability. SA-Net can better learn the multi-scale features and achieve more accurate segmentation for different medical image. In addition, this work validates the proposed method across multiple datasets. The experiment results show SA-Net achieves excellent performances in the applications of vessel detection in retinal images, lung segmentation, artery/vein(A/V) classification in retinal images and blastocyst segmentation. To facilitate SA-Net utilization by the scientific community, the code implementation will be made publicly available.

MC-DC: An MLP-CNN Based Dual-path Complementary Network for Medical Image Segmentation

TANet: Triple Attention Network for medical image segmentation

Segmenting medical images via explicit–implicit attention aggregation