# Joint Liver and Hepatic Lesion Segmentation in MRI using a Hybrid CNN with Transformer Layers

arXiv: https://arxiv.org/abs/2201.10981 · HTML: https://mlsanity.com/paper/2201.10981/

## Key facts

- Cited by 1 papers in the map (data through 14 Oct 2026).
- Builds on 25 of its 49 references that are in the map.
- First posted on arXiv 26 Jan 2022.

## Builds on (most cited first, 25 of 25)

- [Attention Is All You Need](https://mlsanity.com/paper/1706.03762/) (2017)
- [Deep Residual Learning for Image Recognition](https://mlsanity.com/paper/1512.03385/) (2015)
- [U-Net: Convolutional Networks for Biomedical Image Segmentation](https://mlsanity.com/paper/1505.04597/) (2015)
- [Swin Transformer: Hierarchical Vision Transformer using Shifted Windows](https://mlsanity.com/paper/2103.14030/) (2021)
- [Training data-efficient image transformers & distillation through attention](https://mlsanity.com/paper/2012.12877/) (2020)
- [Pyramid Scene Parsing Network](https://mlsanity.com/paper/1612.01105/) (2016)
- [Non-local Neural Networks](https://mlsanity.com/paper/1711.07971/) (2017)
- [Rethinking Atrous Convolution for Semantic Image Segmentation](https://mlsanity.com/paper/1706.05587/) (2017)
- [TransUNet: Transformers Make Strong Encoders for Medical Image Segmentation](https://mlsanity.com/paper/2102.04306/) (2021)
- [Generating Long Sequences with Sparse Transformers](https://mlsanity.com/paper/1904.10509/) (2019)
- [Attention U-Net: Learning Where to Look for the Pancreas](https://mlsanity.com/paper/1804.03999/) (2018)
- [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)
- [Image Transformer](https://mlsanity.com/paper/1802.05751/) (2018)
- [The Liver Tumor Segmentation Benchmark (LiTS)](https://mlsanity.com/paper/1901.04056/) (2019)
- [Medical Transformer: Gated Axial-Attention for Medical Image Segmentation](https://mlsanity.com/paper/2102.10662/) (2021)
- [Attention Gated Networks: Learning to Leverage Salient Regions in Medical Images](https://mlsanity.com/paper/1808.08114/) (2018)
- [TransFuse: Fusing Transformers and CNNs for Medical Image Segmentation](https://mlsanity.com/paper/2102.08005/) (2021)
- [Automatic Liver and Tumor Segmentation of CT and MRI Volumes using Cascaded Fully Convolutional Neural Networks](https://mlsanity.com/paper/1702.05970/) (2017)
- [Modified U-Net (mU-Net) with Incorporation of Object-Dependent High Level Features for Improved Liver and Liver-Tumor Segmentation in CT Images](https://mlsanity.com/paper/1911.00140/) (2019)
- [Deep Attentive Features for Prostate Segmentation in 3D Transrectal Ultrasound](https://mlsanity.com/paper/1907.01743/) (2019)
- [Liver lesion segmentation informed by joint liver segmentation](https://mlsanity.com/paper/1707.07734/) (2017)
- [Recurrent Fully Convolutional Neural Networks for Multi-slice MRI Cardiac Segmentation](https://mlsanity.com/paper/1608.03974/) (2016)
- [Multi-phase Liver Tumor Segmentation with Spatial Aggregation and Uncertain Region Inpainting](https://mlsanity.com/paper/2108.00911/) (2021)
- [United adversarial learning for liver tumor segmentation and detection of multi-modality non-contrast MRI](https://mlsanity.com/paper/2201.02629/) (2022)

## Built on by (most cited first, 1 of 1)

- [Leveraging Swin Transformer for enhanced diagnosis of Alzheimer's disease using multi-shell diffusion MRI](https://mlsanity.com/paper/2507.09996/) (2025)

## Abstract (arXiv)

Deep learning-based segmentation of the liver and hepatic lesions therein steadily gains relevance in clinical practice due to the increasing incidence of liver cancer each year. Whereas various network variants with overall promising results in the field of medical image segmentation have been successfully developed over the last years, almost all of them struggle with the challenge of accurately segmenting hepatic lesions in magnetic resonance imaging (MRI). This led to the idea of combining elements of convolutional and transformer-based architectures to overcome the existing limitations. This work presents a hybrid network called SWTR-Unet, consisting of a pretrained ResNet, transformer blocks as well as a common Unet-style decoder path. This network was primarily applied to single-modality non-contrast-enhanced liver MRI and additionally to the publicly available computed tomography (CT) data of the liver tumor segmentation (LiTS) challenge to verify the applicability on other modalities. For a broader evaluation, multiple state-of-the-art networks were implemented and applied, ensuring a direct comparability. Furthermore, correlation analysis and an ablation study were carried out, to investigate various influencing factors on the segmentation accuracy of the presented method. With Dice scores of averaged 98+-2% for liver and 81+-28% lesion segmentation on the MRI dataset and 97+-2% and 79+-25%, respectively on the CT dataset, the proposed SWTR-Unet proved to be a precise approach for liver and hepatic lesion segmentation with state-of-the-art results for MRI and competing accuracy in CT imaging. The achieved segmentation accuracy was found to be on par with manually performed expert segmentations as indicated by inter-observer variabilities for liver lesion segmentation. In conclusion, the presented method could save valuable time and resources in clinical practice.