# Encoder-Decoder Architectures for Clinically Relevant Coronary Artery Segmentation

arXiv: https://arxiv.org/abs/2106.11447 · HTML: https://mlsanity.com/paper/2106.11447/

## Key facts

- Cited by 4 papers in the map (data through 14 Oct 2026).
- Builds on 35 of its 60 references that are in the map.
- First posted on arXiv 21 Jun 2021.

## Builds on (most cited first, 30 of 35)

- [Deep Residual Learning for Image Recognition](https://mlsanity.com/paper/1512.03385/) (2015)
- [Adam: A Method for Stochastic Optimization](https://mlsanity.com/paper/1412.6980/) (2014)
- [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)
- [Batch Normalization: Accelerating Deep Network Training by Reducing Internal Covariate Shift](https://mlsanity.com/paper/1502.03167/) (2015)
- [Emerging Properties in Self-Supervised Vision Transformers](https://mlsanity.com/paper/2104.14294/) (2021)
- [Densely Connected Convolutional Networks](https://mlsanity.com/paper/1608.06993/) (2016)
- [EfficientNet: Rethinking Model Scaling for Convolutional Neural Networks](https://mlsanity.com/paper/1905.11946/) (2019)
- [Feature Pyramid Networks for Object Detection](https://mlsanity.com/paper/1612.03144/) (2016)
- [Squeeze-and-Excitation Networks](https://mlsanity.com/paper/1709.01507/) (2017)
- [Delving Deep into Rectifiers: Surpassing Human-Level Performance on ImageNet Classification](https://mlsanity.com/paper/1502.01852/) (2015)
- [Encoder-Decoder with Atrous Separable Convolution for Semantic Image Segmentation](https://mlsanity.com/paper/1802.02611/) (2018)
- [Aggregated Residual Transformations for Deep Neural Networks](https://mlsanity.com/paper/1611.05431/) (2016)
- [Pyramid Scene Parsing Network](https://mlsanity.com/paper/1612.01105/) (2016)
- [CBAM: Convolutional Block Attention Module](https://mlsanity.com/paper/1807.06521/) (2018)
- [Searching for MobileNetV3](https://mlsanity.com/paper/1905.02244/) (2019)
- [UNet++: A Nested U-Net Architecture for Medical Image Segmentation](https://mlsanity.com/paper/1807.10165/) (2018)
- [Designing Network Design Spaces](https://mlsanity.com/paper/2003.13678/) (2020)
- [CvT: Introducing Convolutions to Vision Transformers](https://mlsanity.com/paper/2103.15808/) (2021)
- [Generalised Dice overlap as a deep learning loss function for highly unbalanced segmentations](https://mlsanity.com/paper/1707.03237/) (2017)
- [CoAtNet: Marrying Convolution and Attention for All Data Sizes](https://mlsanity.com/paper/2106.04803/) (2021)
- [LeViT: a Vision Transformer in ConvNet's Clothing for Faster Inference](https://mlsanity.com/paper/2104.01136/) (2021)
- [Road Extraction by Deep Residual U-Net](https://mlsanity.com/paper/1711.10684/) (2017)
- [Incorporating Convolution Designs into Visual Transformers](https://mlsanity.com/paper/2103.11816/) (2021)
- [LinkNet: Exploiting Encoder Representations for Efficient Semantic Segmentation](https://mlsanity.com/paper/1707.03718/) (2017)
- [ResUNet++: An Advanced Architecture for Medical Image Segmentation](https://mlsanity.com/paper/1911.07067/) (2019)
- [Pyramid Attention Network for Semantic Segmentation](https://mlsanity.com/paper/1805.10180/) (2018)
- [Concurrent Spatial and Channel Squeeze & Excitation in Fully Convolutional Networks](https://mlsanity.com/paper/1803.02579/) (2018)
- [Regularization for Deep Learning: A Taxonomy](https://mlsanity.com/paper/1710.10686/) (2017)

## Built on by (most cited first, 4 of 4)

- [Using Soft Labels to Model Uncertainty in Medical Image Segmentation](https://mlsanity.com/paper/2109.12622/) (2021)
- [AGMN: Association Graph-based Graph Matching Network for Coronary Artery Semantic Labeling on Invasive Coronary Angiograms](https://mlsanity.com/paper/2301.04733/) (2023)
- [CASR-Net: An Image Processing-focused Deep Learning-based Coronary Artery Segmentation and Refinement Network for X-ray Coronary Angiogram](https://mlsanity.com/paper/2510.27315/) (2025)
- [Optimized Hybrid Focal Margin Loss for Crack Segmentation](https://mlsanity.com/paper/2302.04395/) (2023)

## Abstract (arXiv)

Coronary X-ray angiography is a crucial clinical procedure for the diagnosis and treatment of coronary artery disease, which accounts for roughly 16% of global deaths every year. However, the images acquired in these procedures have low resolution and poor contrast, making lesion detection and assessment challenging. Accurate coronary artery segmentation not only helps mitigate these problems, but also allows the extraction of relevant anatomical features for further analysis by quantitative methods. Although automated segmentation of coronary arteries has been proposed before, previous approaches have used non-optimal segmentation criteria, leading to less useful results. Most methods either segment only the major vessel, discarding important information from the remaining ones, or segment the whole coronary tree based mostly on contrast information, producing a noisy output that includes vessels that are not relevant for diagnosis. We adopt a better-suited clinical criterion and segment vessels according to their clinical relevance. Additionally, we simultaneously perform catheter segmentation, which may be useful for diagnosis due to the scale factor provided by the catheter's known diameter, and is a task that has not yet been performed with good results. To derive the optimal approach, we conducted an extensive comparative study of encoder-decoder architectures trained on a combination of focal loss and a variant of generalized dice loss. Based on the EfficientNet and the UNet++ architectures, we propose a line of efficient and high-performance segmentation models using a new decoder architecture, the EfficientUNet++, whose best-performing version achieved average dice scores of 0.8904 and 0.7526 for the artery and catheter classes, respectively, and an average generalized dice score of 0.9234.