Medical image segmentation requires high accuracy and robustness, yet practical commercial deployment also demands privacy preservation and computational efficiency. In this context, the U-Net architecture, which can be inherently decoupled into independent encoder and decoder components, serves as a natural commercial choice. However, pure Transformer-based variants like Swin-UNet often suffer from insufficient local detail capture and limited interpretability. In this paper, we propose a lightweight hybrid architecture built upon the Swin-UNet framework. Our model integrates a parallel CNN encoder to complement the shallow layer reasoning of Swin Transformers with local texture features. To bridge the semantic gap and enhance fine-grained spatial detail recovery, we design an asymmetric feature fusion strategy and introduce cross-layer skip (XSkip) connections that explicitly propagate shallow CNN features into the decoder. We further incorporate novel loss functions and an auxiliary supervision head (Aux-Head) to strengthen training stability, boundary delineation, and intermediate feature interpretability. Extensive experiments on the Synapse multi-organ segmentation dataset demonstrate that our approach achieves state-of-the-art competitive Dice scores and Hausdorff distances, offering an accurate, efficient, and interpretable solution for clinical deployment.
Dalia Alzu'bi, Deep Bhattacharyya, Ali Ayub +1cs.CV
Medical image segmentation is a fundamental task in computer-aided diagnosis, yet it remains challenging due to the complexity of anatomical structures and the variability across imaging modalities. In this paper, we propose AdaKAN, an Adaptive Kolmogorov-Arnold Network (KAN) that synergistically integrates convolutional operations with a novel efficient KAN (EffiKAN) block, comprised of an efficient attention mechanism and an adaptive KAN (AdaptKAN) module. This module features a dual-branch design: one branch employs a KAN layer with Bernstein polynomial activations for globally smooth and stable function approximation, while the other branch performs channel-wise refinement through projection operations and adaptive scaling. AdaKAN adopts a U-shaped architecture that effectively captures both long-range dependencies and fine-grained local features, overcoming the limitations of conventional convolutional and Transformer-based segmentation models. Skip connections are employed to preserve spatial details during encoding and facilitate accurate reconstruction during decoding. Extensive experiments conducted on diverse medical imaging datasets demonstrate that AdaKAN achieves state-of-the-art performance in segmentation accuracy.
Mohammad Arafat Hussain, Ellen Grant, Yangming Oucs.CV cs.AI
We propose parameter-efficient SSM-based U-Net architectures for 3D medical image segmentation. Convolutional U-Nets afford O(n) local mixing per layer but lack explicit global context; transformers provide global reasoning at O(n^2) cost in sequence length $n$. State-space models (SSMs), such as Mamba, offer $O(n)$ global propagation per block. Yet, existing medical SSM segmenters rely on fixed scan patterns and large parameter budgets. Dynamic Adaptive Scan (DAS), which learns data-dependent reordering before selective scan, has not been applied to medical imaging or extended to 3D volumes. We propose DAMamba-UNet3D, a hybrid encoder-decoder that integrates tri-plane 3D-DAS blocks at encoder stages E2-E4 while retaining convolutions elsewhere (~5.3M parameters). On BraTS 2020 five-fold cross-validation, DAMamba-UNet3D achieves mean Dice 0.815+/-0.013 (full-volume per-case evaluation) at ~13x lower parameter cost than SegMamba (0.824+\-0.014, ~70M). At comparable scale, DAMamba-L (~70M), a wide DAS-native variant with encoder-only DAMamba and a convolutional bottleneck, reaches 0.829+\-0.012, surpassing retrained SegMamba by 0.5pt. Component ablations show that encoder-only DAS placement is critical as bottleneck and decoder SSM blocks lower Dice. Together, the results suggest that learned tri-plane DAS in a hybrid U-Net is competitive with, and under our large-scale design may improve upon, SegMamba's fixed Tri-orientated Mamba (ToM) scanning on BraTS 2020. Code: https://github.com/marafathussain/DAMamba-UNet3D.
Hasan Ulutas, Muhammet Emin Sahin, Mustafa Fatih Erkoc +4cs.CV cs.AI
Objective: Accurate identification of acute ischemic infarcts on diffusion-weighted magnetic resonance imaging (DWI) is a critical prerequisite for reliable lesion quantification and effective clinical decision support in the management of cerebrovascular events. Methods: This study presents EPRA U-Net (Efficient Pyramid Residual Attention U-Net), a task-specific integrated architecture for efficient and accurate infarct segmentation of DWI images. In the proposed architecture, an EfficientNet-based encoder was used as a hierarchical feature extractor with a minimized parameterization. In addition, a Residual-Recurrent (R2) block (recurrent unrolling step t = 2, following the original formulation) and Atrous Spatial Pyramid Pooling (ASPP) were integrated to enhance the performance of spatial dependency modeling. Additionally, a dual attention mechanism was incorporated to highlight lesion-related activations while concurrently enabling the suppression of extraneous background responses. To prioritize lesion detection consistent with clinical imperative, a Tversky loss function was adopted, emphasizing the sensitivity of detection over its specificity during the optimization process. Results: Experimental evaluations were conducted utilizing an in-house dataset comprising 167 patients with 4,895 DWI slices; subsequently, the performance of the proposed EPRA U-Net was assessed in comparison with state-of-the-art models, specifically UNet++, DeepLabV3+, and TransUNet. The experimental results suggest that EPRA U-Net attained superior performance, evidenced by a pixel-aggregated Dice of 0.8984, a per-sample Dice of 0.9469, an IoU of 0.8155, a Recall of 0.8887, a Lesion F1 of 0.9378, and an HD95 of 11.62 px. Furthermore, a clear reduction in the rate of missed lesions, specifically by 16%, 25%, and 29%, was observed when compared with UNet++, DeepLabV3+, and TransUNet, respectively.
Accurate segmentation of curvilinear structures remains challenging in biomedical imaging due to their thin geometry, complex topology, and sensitivity to noise. This is particularly critical for microscopy images of cytoskeletal network, where low signal-to-noise ratios and dense filament crossings often lead to fragmented or inaccurate segmentation. In this work, we propose CurvSegFlow, a segmentation framework based on time-conditioned flow matching. Instead of predicting a segmentation mask in a single pass, the method models segmentation as a dynamic process that progressively refines a noisy initialization into the target structure through a learned velocity field. The proposed model combines a U-Net backbone with triple-term loss function and temporal embeddings to guide the refinement process across reconstruction stages. This formulation enables gradual error correction and improves the continuity of thin structures. CurvSegFlow is evaluated on multiple synthetic and real microtubule datasets, as well as on public benchmarks of retinal vessels, corneal nerves and coronary arteries. Across datasets, the method achieves competitive or superior performance compared to established segmentation models, with consistent improvements in precision and structural continuity, particularly under low signal-to-noise conditions. These results show that flow-based iterative refinement provides a robust and general framework for curvilinear structure segmentation. Overall, the proposed approach improves segmentation quality in challenging imaging conditions and generalizes effectively across modalities without architectural changes.
Medical image segmentation plays a critical role in clinical diagnostics, treatment planning, disease monitoring, and neurological disorder identification. This article presents a comprehensive review of its systematic development, covering widely used public datasets, representative methods built on the U-Net, Transformer, and SAM architectures, and key evaluation metrics with their differences, followed by an analysis of major challenges from multiple perspectives. Unlike surveys that focus on a single model family or a specific clinical application, this review organizes U-Net-, Transformer-, and SAM-based methods within a unified analytical framework, with a particular focus on their effectiveness in improving segmentation accuracy and efficiency. This work aims to guide future research and support clinical translation of medical image segmentation, with all related resources publicly available in our GitHub repository: https://github.com/andrew-pengyu/Awsome_MedSeg/tree/main.
Fully sampled MRI requires dense k-space acquisition, leading to long scan times, reduced clinical throughput, and increased sensitivity to patient motion. Accelerated MRI addresses this by acquiring undersampled k-space data and reconstructing the missing information computationally. However, reconstruction from undersampled measurements is highly ill-posed and can introduce aliasing artifacts, noise amplification, and loss of anatomical detail. Although conventional parallel imaging and compressed sensing methods mitigate these issues, and deep learning methods have further improved reconstruction quality, preserving high-frequency structures under aggressive undersampling remains challenging. In this work, we propose a Variational Network with a Wavelet-based U-Net (W-UNet) for accelerated MRI reconstruction. The framework combines physics-guided iterative reconstruction with learnable multi-scale frequency representations. Standard pooling operations are replaced with Discrete Wavelet Transform and Inverse Wavelet Transform modules, enabling lossless downsampling while preserving low-frequency structure and high-frequency edge details. Integrated into the refinement and sensitivity map estimation stages, the proposed design improves artifact suppression, feature preservation, and reconstruction fidelity in both single-coil and multi-coil settings. Experiments on fastMRI knee and M4Raw brain datasets show state-of-the-art performance. Ablation studies further confirm the effectiveness of wavelet-based feature decomposition for accelerated MRI reconstruction.
Joao Batista Florindo, Amanda Pontes de Oliveira Ornelascs.CV
Biomedical image segmentation is a critical task in medical diagnosis and treatment planning, enabling precise delineation of anatomical structures and pathological regions. Despite significant advancements, challenges persist due to the inherent variability, noise, and complex morphology present in diverse medical imaging modalities. This paper introduces ConvNeXt-FD, a novel deep learning architecture for robust biomedical image segmentation, built upon a U-Net-like encoder-decoder framework leveraging the powerful ConvNeXt backbone. Our approach integrates a hybrid loss function combining the Dice coefficient with a boundary-aware regularization term inspired by a differentiable formulation of Fractal Dimension, designed to enhance the model's sensitivity to object boundaries and shape fidelity. We rigorously evaluate ConvNeXt-FD across six distinct biomedical datasets: BUSI (Breast Ultrasound Images), DDTI (Thyroid Ultrasound Images), FluoCells (Fluorescent Cell Images), IDRiD (Diabetic Retinopathy Images for Optic Disc Segmentation), ISIC2018 (Skin Lesion Images), and MoNuSeg (Nuclei Segmentation). Experimental results demonstrate that ConvNeXt-FD, particularly when initialized with ImageNet pre-trained weights, achieves competitive and often superior performance compared to existing state-of-the-art methods across various metrics, including Dice, Jaccard, Accuracy, Sensitivity, Specificity, and False Positive Rate. The integration of ConvNeXt as a strong encoder, coupled with the boundary-aware regularization, proves effective in capturing both high-level semantic features and fine-grained boundary details, leading to more accurate and reliable segmentations in challenging biomedical contexts.