mlsanityData to 7 Oct 2026

Convolution-Free Medical Image Segmentation using Transformers

arXiv 2102.13645 ↗First posted 26 Feb 2021eess.IV cs.CVcited by 49

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Abstract (arXiv)

Like other applications in computer vision, medical image segmentation has been most successfully addressed using deep learning models that rely on the convolution operation as their main building block. Convolutions enjoy important properties such as sparse interactions, weight sharing, and translation equivariance. These properties give convolutional neural networks (CNNs) a strong and useful inductive bias for vision tasks. In this work we show that a different method, based entirely on self-attention between neighboring image patches and without any convolution operations, can achieve competitive or better results. Given a 3D image block, our network divides it into n3 3D patches, where n=3 or 5 and computes a 1D embedding for each patch. The network predicts the segmentation map for the center patch of the block based on the self-attention between these patch embeddings. We show that the proposed model can achieve segmentation accuracies that are better than the state of the art CNNs on three datasets. We also propose methods for pre-training this model on large corpora of unlabeled images. Our experiments show that with pre-training the advantage of our proposed network over CNNs can be significant when labeled training data is small.

Key facts. Cited by 49 papers in the map (data through 7 Oct 2026). Builds on 18 of its 40 references that are in the map. First posted on arXiv 26 Feb 2021.

Builds on

18 of 40 references.

References · 18

  1. 2017Attention Is All You Needcited by 59,932
  2. 2014Adam: A Method for Stochastic Optimizationcited by 36,960
  3. 2020An Image is Worth 16x16 Words: Transformers for Image Recognition at Scalecited by 29,915
  4. 2015Faster R-CNN: Towards Real-Time Object Detection with Region Proposal Networkscited by 9,617
  5. 2020Training data-efficient image transformers & distillation through attentioncited by 4,560
  6. 2014Empirical Evaluation of Gated Recurrent Neural Networks on Sequence Modelingcited by 2,341
  7. 2016V-Net: Fully Convolutional Neural Networks for Volumetric Medical Image Segmentationcited by 2,284
  8. 2021TransUNet: Transformers Make Strong Encoders for Medical Image Segmentationcited by 1,552
  9. 2018UNet++: A Nested U-Net Architecture for Medical Image Segmentationcited by 1,518
  10. 2021Transformers in Vision: A Surveycited by 1,009
  11. 2018Identifying the Best Machine Learning Algorithms for Brain Tumor Segmentation, Progression Assessment, and Overall Survival Prediction in the BRATS Challengecited by 508
  12. 2019Axial Attention in Multidimensional Transformerscited by 350
6 more
  1. 2020Axial-DeepLab: Stand-Alone Axial-Attention for Panoptic Segmentationcited by 326
  2. 2016Efficient Multi-Scale 3D CNN with Fully Connected CRF for Accurate Brain Lesion Segmentationcited by 263
  3. 2019Deep Semantic Segmentation of Natural and Medical Images: A Reviewcited by 124
  4. 2018No New-Netcited by 61
  5. 2018Recurrent neural networks for aortic image sequence segmentation with sparse annotationscited by 25
  6. 2020A Deep Attentive Convolutional Neural Network for Automatic Cortical Plate Segmentation in Fetal MRIcited by 14

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Cited by year (2026 to 7 Oct)

Citing papers per year: 2021: 4; 2022: 16; 2023: 14; 2024: 12; 2025: 2; 2026: 1.

49 papers.

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  1. 2022Transformers in Medical Imaging: A Surveycited by 245
  2. 2021nnFormer: Interleaved Transformer for Volumetric Segmentationcited by 179
  3. 2021ResViT: Residual vision transformers for multi-modal medical image synthesiscited by 177
  4. 2023MedNeXt: Transformer-driven Scaling of ConvNets for Medical Image Segmentationcited by 161
  5. 2022UNETR++: Delving into Efficient and Accurate 3D Medical Image Segmentationcited by 112
  6. 2022Transformers in Medical Image Analysis: A Reviewcited by 41
  7. 2022Transforming medical imaging with Transformers? A comparative review of key properties, current progresses, and future perspectivescited by 32
  8. 2021More than Encoder: Introducing Transformer Decoder to Upsamplecited by 26
  9. 2022Surface Vision Transformers: Attention-Based Modelling applied to Cortical Analysiscited by 25
  10. 20223D Vision with Transformers: A Surveycited by 21
  11. 2023Transformers in Healthcare: A Surveycited by 17
  12. 2023E2ENet: Dynamic Sparse Feature Fusion for Accurate and Efficient 3D Medical Image Segmentationcited by 16
37 more
  1. 2022A survey on attention mechanisms for medical applications: are we moving towards better algorithms?cited by 15
  2. 2022BATFormer: Towards Boundary-Aware Lightweight Transformer for Efficient Medical Image Segmentationcited by 14
  3. 2022Optimizing Vision Transformers for Medical Image Segmentationcited by 12
  4. 2022Continual Hippocampus Segmentation with Transformerscited by 11
  5. 2022The Lighter The Better: Rethinking Transformers in Medical Image Segmentation Through Adaptive Pruningcited by 9
  6. 2023Attention Mechanisms in Medical Image Segmentation: A Surveycited by 9
  7. 2023ConvFormer: Plug-and-Play CNN-Style Transformers for Improving Medical Image Segmentationcited by 9
  8. 2022Joint Class-Affinity Loss Correction for Robust Medical Image Segmentation with Noisy Labelscited by 8
  9. 2023MaxViT-UNet: Multi-Axis Attention for Medical Image Segmentationcited by 8
  10. 2024SuperFormer: Volumetric Transformer Architectures for MRI Super-Resolutioncited by 8
  11. 2021Hepatic vessel segmentation based on 3D swin-transformer with inductive biased multi-head self-attentioncited by 7
  12. 2023Revisiting Computer-Aided Tuberculosis Diagnosiscited by 6
  13. 2023Frequency Domain Adversarial Training for Robust Volumetric Medical Segmentationcited by 6
  14. 2024Self Pre-training with Topology- and Spatiality-aware Masked Autoencoders for 3D Medical Image Segmentationcited by 6
  15. 2024CNN-Transformer Rectified Collaborative Learning for Medical Image Segmentationcited by 6
  16. 2023MCANet: Medical Image Segmentation with Multi-Scale Cross-Axis Attentioncited by 5
  17. 2024Transformers-based architectures for stroke segmentation: A reviewcited by 5
  18. 2024Sli2Vol+: Segmenting 3D Medical Images Based on an Object Estimation Guided Correspondence Flow Networkcited by 5
  19. 2024CAMS: Convolution and Attention-Free Mamba-based Cardiac Image Segmentationcited by 4
  20. 2024HResFormer: Hybrid Residual Transformer for Volumetric Medical Image Segmentationcited by 4
  21. 2022Memory transformers for full context and high-resolution 3D Medical Segmentationcited by 3
  22. 2022ConvTransSeg: A Multi-resolution Convolution-Transformer Network for Medical Image Segmentationcited by 3
  23. 2023Learning Multi-axis Representation in Frequency Domain for Medical Image Segmentationcited by 3
  24. 2024Detailed delineation of the fetal brain in diffusion MRI via multi-task learningcited by 2
  25. 2024Improving 3D Medical Image Segmentation at Boundary Regions using Local Self-attention and Global Volume Mixingcited by 2
  26. 2025Multi-Modal Brain Tumor Segmentation via 3D Multi-Scale Self-attention and Cross-attentioncited by 2
  27. 2022Deep is a Luxury We Don't Havecited by 1
  28. 2023Direct segmentation of brain white matter tracts in diffusion MRIcited by 1
  29. 2024PGDiffSeg: Prior-Guided Denoising Diffusion Model with Parameter-Shared Attention for Breast Cancer Segmentationcited by 1
  30. 2024TSUBF-Net: Trans-Spatial UNet-like Network with Bi-direction Fusion for Segmentation of Adenoid Hypertrophy in CTcited by 1
  31. 2025MLRU++: Multiscale Lightweight Residual UNETR++ with Attention for Efficient 3D Medical Image Segmentationcited by 1
  32. 2022Surface Vision Transformers: Flexible Attention-Based Modelling of Biomedical Surfacescited by 0
  33. 2023Artificial Intelligence Model for Tumoral Clinical Decision Support Systemscited by 0
  34. 2023Learnable Weight Initialization for Volumetric Medical Image Segmentationcited by 0
  35. 2023TransCC: Transformer Network for Coronary Artery CCTA Segmentationcited by 0
  36. 2024MedContext: Learning Contextual Cues for Efficient Volumetric Medical Segmentationcited by 0
  37. 2026Domain-Adaptive Arrhythmia Classification Using a Hybrid Transformer on Wearable Heart Signalscited by 0