# TransFuse: Fusing Transformers and CNNs for Medical Image Segmentation

arXiv: https://arxiv.org/abs/2102.08005 · HTML: https://mlsanity.com/paper/2102.08005/

## Key facts

- Cited by 258 papers in the map (data through 14 Oct 2026).
- Builds on 29 of its 40 references that are in the map.
- First posted on arXiv 16 Feb 2021.

## Builds on (most cited first, 29 of 29)

- [Attention Is All You Need](https://mlsanity.com/paper/1706.03762/) (2017)
- [An Image is Worth 16x16 Words: Transformers for Image Recognition at Scale](https://mlsanity.com/paper/2010.11929/) (2020)
- [PyTorch: An Imperative Style, High-Performance Deep Learning Library](https://mlsanity.com/paper/1912.01703/) (2019)
- [U-Net: Convolutional Networks for Biomedical Image Segmentation](https://mlsanity.com/paper/1505.04597/) (2015)
- [Squeeze-and-Excitation Networks](https://mlsanity.com/paper/1709.01507/) (2017)
- [Training data-efficient image transformers & distillation through attention](https://mlsanity.com/paper/2012.12877/) (2020)
- [Wide Residual Networks](https://mlsanity.com/paper/1605.07146/) (2016)
- [CBAM: Convolutional Block Attention Module](https://mlsanity.com/paper/1807.06521/) (2018)
- [Non-local Neural Networks](https://mlsanity.com/paper/1711.07971/) (2017)
- [TransUNet: Transformers Make Strong Encoders for Medical Image Segmentation](https://mlsanity.com/paper/2102.04306/) (2021)
- [UNet++: A Nested U-Net Architecture for Medical Image Segmentation](https://mlsanity.com/paper/1807.10165/) (2018)
- [Attention U-Net: Learning Where to Look for the Pancreas](https://mlsanity.com/paper/1804.03999/) (2018)
- [Deep High-Resolution Representation Learning for Visual Recognition](https://mlsanity.com/paper/1908.07919/) (2019)
- [Rethinking Semantic Segmentation from a Sequence-to-Sequence Perspective with Transformers](https://mlsanity.com/paper/2012.15840/) (2020)
- [Kvasir-SEG: A Segmented Polyp Dataset](https://mlsanity.com/paper/1911.07069/) (2019)
- [UNet++: Redesigning Skip Connections to Exploit Multiscale Features in Image Segmentation](https://mlsanity.com/paper/1912.05074/) (2019)
- [Skin Lesion Analysis Toward Melanoma Detection: A Challenge at the 2017 International Symposium on Biomedical Imaging (ISBI), Hosted by the International Skin Imaging Collaboration (ISIC)](https://mlsanity.com/paper/1710.05006/) (2017)
- [PraNet: Parallel Reverse Attention Network for Polyp Segmentation](https://mlsanity.com/paper/2006.11392/) (2020)
- [A large annotated medical image dataset for the development and evaluation of segmentation algorithms](https://mlsanity.com/paper/1902.09063/) (2019)
- [Road Extraction by Deep Residual U-Net](https://mlsanity.com/paper/1711.10684/) (2017)
- [Attention Gated Networks: Learning to Leverage Salient Regions in Medical Images](https://mlsanity.com/paper/1808.08114/) (2018)
- [Highway Networks](https://mlsanity.com/paper/1505.00387/) (2015)
- [A Benchmark for Endoluminal Scene Segmentation of Colonoscopy Images](https://mlsanity.com/paper/1612.00799/) (2016)
- [ResUNet++: An Advanced Architecture for Medical Image Segmentation](https://mlsanity.com/paper/1911.07067/) (2019)
- [HarDNet-MSEG: A Simple Encoder-Decoder Polyp Segmentation Neural Network that Achieves over 0.9 Mean Dice and 86 FPS](https://mlsanity.com/paper/2101.07172/) (2021)
- [Fully Convolutional Multi-scale Residual DenseNets for Cardiac Segmentation and Automated Cardiac Diagnosis using Ensemble of Classifiers](https://mlsanity.com/paper/1801.05173/) (2018)
- [Improving Dermoscopic Image Segmentation with Enhanced Convolutional-Deconvolutional Networks](https://mlsanity.com/paper/1709.09780/) (2017)
- [SLSDeep: Skin Lesion Segmentation Based on Dilated Residual and Pyramid Pooling Networks](https://mlsanity.com/paper/1805.10241/) (2018)
- [Segmentation of the Proximal Femur from MR Images using Deep Convolutional Neural Networks](https://mlsanity.com/paper/1704.06176/) (2017)

## Built on by (most cited first, 30 of 258)

- [Swin-Unet: Unet-like Pure Transformer for Medical Image Segmentation](https://mlsanity.com/paper/2105.05537/) (2021)
- [UNETR: Transformers for 3D Medical Image Segmentation](https://mlsanity.com/paper/2103.10504/) (2021)
- [TransMIL: Transformer based Correlated Multiple Instance Learning for Whole Slide Image Classification](https://mlsanity.com/paper/2106.00908/) (2021)
- [Medical Transformer: Gated Axial-Attention for Medical Image Segmentation](https://mlsanity.com/paper/2102.10662/) (2021)
- [VM-UNet: Vision Mamba UNet for Medical Image Segmentation](https://mlsanity.com/paper/2402.02491/) (2024)
- [Transformers in Medical Imaging: A Survey](https://mlsanity.com/paper/2201.09873/) (2022)
- [nnU-Net Revisited: A Call for Rigorous Validation in 3D Medical Image Segmentation](https://mlsanity.com/paper/2404.09556/) (2024)
- [UCTransNet: Rethinking the Skip Connections in U-Net from a Channel-wise Perspective with Transformer](https://mlsanity.com/paper/2109.04335/) (2021)
- [nnFormer: Interleaved Transformer for Volumetric Segmentation](https://mlsanity.com/paper/2109.03201/) (2021)
- [Polyp-PVT: Polyp Segmentation with Pyramid Vision Transformers](https://mlsanity.com/paper/2108.06932/) (2021)
- [DS-TransUNet:Dual Swin Transformer U-Net for Medical Image Segmentation](https://mlsanity.com/paper/2106.06716/) (2021)
- [Transformer-Based Visual Segmentation: A Survey](https://mlsanity.com/paper/2304.09854/) (2023)
- [UNETR++: Delving into Efficient and Accurate 3D Medical Image Segmentation](https://mlsanity.com/paper/2212.04497/) (2022)
- [Recent advances and clinical applications of deep learning in medical image analysis](https://mlsanity.com/paper/2105.13381/) (2021)
- [Mixed Transformer U-Net For Medical Image Segmentation](https://mlsanity.com/paper/2111.04734/) (2021)
- [Video Polyp Segmentation: A Deep Learning Perspective](https://mlsanity.com/paper/2203.14291/) (2022)
- [Convolution Meets LoRA: Parameter Efficient Finetuning for Segment Anything Model](https://mlsanity.com/paper/2401.17868/) (2024)
- [Delving into Masked Autoencoders for Multi-Label Thorax Disease Classification](https://mlsanity.com/paper/2210.12843/) (2022)
- [Advances in Medical Image Analysis with Vision Transformers: A Comprehensive Review](https://mlsanity.com/paper/2301.03505/) (2023)
- [Large AI Models in Health Informatics: Applications, Challenges, and the Future](https://mlsanity.com/paper/2303.11568/) (2023)
- [TransAttUnet: Multi-level Attention-guided U-Net with Transformer for Medical Image Segmentation](https://mlsanity.com/paper/2107.05274/) (2021)
- [MALUNet: A Multi-Attention and Light-weight UNet for Skin Lesion Segmentation](https://mlsanity.com/paper/2211.01784/) (2022)
- [A Comprehensive Survey of Foundation Models in Medicine](https://mlsanity.com/paper/2406.10729/) (2024)
- [Vision Mamba: A Comprehensive Survey and Taxonomy](https://mlsanity.com/paper/2405.04404/) (2024)
- [EGE-UNet: an Efficient Group Enhanced UNet for skin lesion segmentation](https://mlsanity.com/paper/2307.08473/) (2023)
- [Generalist Vision Foundation Models for Medical Imaging: A Case Study of Segment Anything Model on Zero-Shot Medical Segmentation](https://mlsanity.com/paper/2304.12637/) (2023)
- [TriTransNet: RGB-D Salient Object Detection with a Triplet Transformer Embedding Network](https://mlsanity.com/paper/2108.03990/) (2021)
- [Transformers in Medical Image Analysis: A Review](https://mlsanity.com/paper/2202.12165/) (2022)
- [Beyond Adapting SAM: Towards End-to-End Ultrasound Image Segmentation via Auto Prompting](https://mlsanity.com/paper/2309.06824/) (2023)
- [VM-UNET-V2 Rethinking Vision Mamba UNet for Medical Image Segmentation](https://mlsanity.com/paper/2403.09157/) (2024)

## Abstract (arXiv)

Medical image segmentation - the prerequisite of numerous clinical needs - has been significantly prospered by recent advances in convolutional neural networks (CNNs). However, it exhibits general limitations on modeling explicit long-range relation, and existing cures, resorting to building deep encoders along with aggressive downsampling operations, leads to redundant deepened networks and loss of localized details. Hence, the segmentation task awaits a better solution to improve the efficiency of modeling global contexts while maintaining a strong grasp of low-level details. In this paper, we propose a novel parallel-in-branch architecture, TransFuse, to address this challenge. TransFuse combines Transformers and CNNs in a parallel style, where both global dependency and low-level spatial details can be efficiently captured in a much shallower manner. Besides, a novel fusion technique - BiFusion module is created to efficiently fuse the multi-level features from both branches. Extensive experiments demonstrate that TransFuse achieves the newest state-of-the-art results on both 2D and 3D medical image sets including polyp, skin lesion, hip, and prostate segmentation, with significant parameter decrease and inference speed improvement.
