# Parameter-Efficient Transformer with Hybrid Axial-Attention for Medical Image Segmentation

arXiv: https://arxiv.org/abs/2211.09533 · HTML: https://mlsanity.com/paper/2211.09533/

## Key facts

- Cited by 1 papers in the map (data through 14 Oct 2026).
- Builds on 25 of its 37 references that are in the map.
- First posted on arXiv 17 Nov 2022.

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

- [Attention Is All You Need](https://mlsanity.com/paper/1706.03762/) (2017)
- [BERT: Pre-training of Deep Bidirectional Transformers for Language Understanding](https://mlsanity.com/paper/1810.04805/) (2018)
- [An Image is Worth 16x16 Words: Transformers for Image Recognition at Scale](https://mlsanity.com/paper/2010.11929/) (2020)
- [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)
- [Feature Pyramid Networks for Object Detection](https://mlsanity.com/paper/1612.03144/) (2016)
- [Squeeze-and-Excitation Networks](https://mlsanity.com/paper/1709.01507/) (2017)
- [Transformer-XL: Attentive Language Models Beyond a Fixed-Length Context](https://mlsanity.com/paper/1901.02860/) (2019)
- [Relational inductive biases, deep learning, and graph networks](https://mlsanity.com/paper/1806.01261/) (2018)
- [Swin-Unet: Unet-like Pure Transformer for Medical Image Segmentation](https://mlsanity.com/paper/2105.05537/) (2021)
- [Self-Attention with Relative Position Representations](https://mlsanity.com/paper/1803.02155/) (2018)
- [Striving for Simplicity: The All Convolutional Net](https://mlsanity.com/paper/1412.6806/) (2014)
- [Grad-CAM++: Improved Visual Explanations for Deep Convolutional Networks](https://mlsanity.com/paper/1710.11063/) (2017)
- [Convolutional Sequence to Sequence Learning](https://mlsanity.com/paper/1705.03122/) (2017)
- [A Survey of Transformers](https://mlsanity.com/paper/2106.04554/) (2021)
- [Bottleneck Transformers for Visual Recognition](https://mlsanity.com/paper/2101.11605/) (2021)
- [Axial Attention in Multidimensional Transformers](https://mlsanity.com/paper/1912.12180/) (2019)
- [Axial-DeepLab: Stand-Alone Axial-Attention for Panoptic Segmentation](https://mlsanity.com/paper/2003.07853/) (2020)
- [Medical Transformer: Gated Axial-Attention for Medical Image Segmentation](https://mlsanity.com/paper/2102.10662/) (2021)
- [TransBTS: Multimodal Brain Tumor Segmentation Using Transformer](https://mlsanity.com/paper/2103.04430/) (2021)
- [TransFuse: Fusing Transformers and CNNs for Medical Image Segmentation](https://mlsanity.com/paper/2102.08005/) (2021)
- [Coordinate Attention for Efficient Mobile Network Design](https://mlsanity.com/paper/2103.02907/) (2021)
- [Rethinking and Improving Relative Position Encoding for Vision Transformer](https://mlsanity.com/paper/2107.14222/) (2021)
- [Inf-Net: Automatic COVID-19 Lung Infection Segmentation from CT Images](https://mlsanity.com/paper/2004.14133/) (2020)
- [Visualizing Convolutional Neural Networks to Improve Decision Support for Skin Lesion Classification](https://mlsanity.com/paper/1809.03851/) (2018)

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

- [SymTC: A Symbiotic Transformer-CNN Net for Instance Segmentation of Lumbar Spine MRI](https://mlsanity.com/paper/2401.09627/) (2024)

## Abstract (arXiv)

Transformers have achieved remarkable success in medical image analysis owing to their powerful capability to use flexible self-attention mechanism. However, due to lacking intrinsic inductive bias in modeling visual structural information, they generally require a large-scale pre-training schedule, limiting the clinical applications over expensive small-scale medical data. To this end, we propose a parameter-efficient transformer to explore intrinsic inductive bias via position information for medical image segmentation. Specifically, we empirically investigate how different position encoding strategies affect the prediction quality of the region of interest (ROI), and observe that ROIs are sensitive to the position encoding strategies. Motivated by this, we present a novel Hybrid Axial-Attention (HAA), a form of position self-attention that can be equipped with spatial pixel-wise information and relative position information as inductive bias. Moreover, we introduce a gating mechanism to alleviate the burden of training schedule, resulting in efficient feature selection over small-scale datasets. Experiments on the BraTS and Covid19 datasets prove the superiority of our method over the baseline and previous works. Internal workflow visualization with interpretability is conducted to better validate our success.