# PAANet: Progressive Alternating Attention for Automatic Medical Image Segmentation

arXiv: https://arxiv.org/abs/2111.10618 · HTML: https://mlsanity.com/paper/2111.10618/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 22 of its 27 references that are in the map.
- First posted on arXiv 20 Nov 2021.

## Builds on (most cited first, 22 of 22)

- [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)
- [Encoder-Decoder with Atrous Separable Convolution for Semantic Image Segmentation](https://mlsanity.com/paper/1802.02611/) (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)
- [Residual Dense Network for Image Super-Resolution](https://mlsanity.com/paper/1802.08797/) (2018)
- [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)
- [Road Extraction by Deep Residual U-Net](https://mlsanity.com/paper/1711.10684/) (2017)
- [ResUNet++: An Advanced Architecture for Medical Image Segmentation](https://mlsanity.com/paper/1911.07067/) (2019)
- [MultiResUNet : Rethinking the U-Net Architecture for Multimodal Biomedical Image Segmentation](https://mlsanity.com/paper/1902.04049/) (2019)
- [DoubleU-Net: A Deep Convolutional Neural Network for Medical Image Segmentation](https://mlsanity.com/paper/2006.04868/) (2020)
- [Progressively Normalized Self-Attention Network for Video Polyp Segmentation](https://mlsanity.com/paper/2105.08468/) (2021)
- [HyperDense-Net: A hyper-densely connected CNN for multi-modal image segmentation](https://mlsanity.com/paper/1804.02967/) (2018)
- [Kvasir-Instrument: Diagnostic and therapeutic tool segmentation dataset in gastrointestinal endoscopy](https://mlsanity.com/paper/2011.08065/) (2020)
- [MSRF-Net: A Multi-Scale Residual Fusion Network for Biomedical Image Segmentation](https://mlsanity.com/paper/2105.07451/) (2021)
- [A Comprehensive Study on Colorectal Polyp Segmentation with ResUNet++, Conditional Random Field and Test-Time Augmentation](https://mlsanity.com/paper/2107.12435/) (2021)
- [FocusNet: An attention-based Fully Convolutional Network for Medical Image Segmentation](https://mlsanity.com/paper/1902.03091/) (2019)
- [Feature Fusion Encoder Decoder Network For Automatic Liver Lesion Segmentation](https://mlsanity.com/paper/1903.11834/) (2019)
- [Real-Time Polyp Detection, Localization and Segmentation in Colonoscopy Using Deep Learning](https://mlsanity.com/paper/2011.07631/) (2020)
- [Deep Residual Dense U-Net for Resolution Enhancement in Accelerated MRI Acquisition](https://mlsanity.com/paper/2001.04488/) (2020)

## Abstract (arXiv)

Medical image segmentation can provide detailed information for clinical analysis which can be useful for scenarios where the detailed location of a finding is important. Knowing the location of disease can play a vital role in treatment and decision-making. Convolutional neural network (CNN) based encoder-decoder techniques have advanced the performance of automated medical image segmentation systems. Several such CNN-based methodologies utilize techniques such as spatial- and channel-wise attention to enhance performance. Another technique that has drawn attention in recent years is residual dense blocks (RDBs). The successive convolutional layers in densely connected blocks are capable of extracting diverse features with varied receptive fields and thus, enhancing performance. However, consecutive stacked convolutional operators may not necessarily generate features that facilitate the identification of the target structures. In this paper, we propose a progressive alternating attention network (PAANet). We develop progressive alternating attention dense (PAAD) blocks, which construct a guiding attention map (GAM) after every convolutional layer in the dense blocks using features from all scales. The GAM allows the following layers in the dense blocks to focus on the spatial locations relevant to the target region. Every alternate PAAD block inverts the GAM to generate a reverse attention map which guides ensuing layers to extract boundary and edge-related information, refining the segmentation process. Our experiments on three different biomedical image segmentation datasets exhibit that our PAANet achieves favourable performance when compared to other state-of-the-art methods.