# Two-stage Contextual Transformer-based Convolutional Neural Network for Airway Extraction from CT Images

arXiv: https://arxiv.org/abs/2212.07651 · HTML: https://mlsanity.com/paper/2212.07651/

## Key facts

- Cited by 10 papers in the map (data through 14 Oct 2026).
- Builds on 27 of its 87 references that are in the map.
- First posted on arXiv 15 Dec 2022.

## Builds on (most cited first, 27 of 27)

- [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)
- [Swin Transformer: Hierarchical Vision Transformer using Shifted Windows](https://mlsanity.com/paper/2103.14030/) (2021)
- [SegFormer: Simple and Efficient Design for Semantic Segmentation with Transformers](https://mlsanity.com/paper/2105.15203/) (2021)
- [V-Net: Fully Convolutional Neural Networks for Volumetric Medical Image Segmentation](https://mlsanity.com/paper/1606.04797/) (2016)
- [TransUNet: Transformers Make Strong Encoders for Medical Image Segmentation](https://mlsanity.com/paper/2102.04306/) (2021)
- [3D U-Net: Learning Dense Volumetric Segmentation from Sparse Annotation](https://mlsanity.com/paper/1606.06650/) (2016)
- [Rethinking Semantic Segmentation from a Sequence-to-Sequence Perspective with Transformers](https://mlsanity.com/paper/2012.15840/) (2020)
- [A Survey on Deep Learning in Medical Image Analysis](https://mlsanity.com/paper/1702.05747/) (2017)
- [Efficient Transformers: A Survey](https://mlsanity.com/paper/2009.06732/) (2020)
- [Do Vision Transformers See Like Convolutional Neural Networks?](https://mlsanity.com/paper/2108.08810/) (2021)
- [Medical Transformer: Gated Axial-Attention for Medical Image Segmentation](https://mlsanity.com/paper/2102.10662/) (2021)
- [DS-TransUNet:Dual Swin Transformer U-Net for Medical Image Segmentation](https://mlsanity.com/paper/2106.06716/) (2021)
- [Contextual Transformer Networks for Visual Recognition](https://mlsanity.com/paper/2107.12292/) (2021)
- [Alleviating Class-wise Gradient Imbalance for Pulmonary Airway Segmentation](https://mlsanity.com/paper/2011.11952/) (2020)
- [AirwayNet: A Voxel-Connectivity Aware Approach for Accurate Airway Segmentation Using Convolutional Neural Networks](https://mlsanity.com/paper/1907.06852/) (2019)
- [Learning Tubule-Sensitive CNNs for Pulmonary Airway and Artery-Vein Segmentation in CT](https://mlsanity.com/paper/2012.05767/) (2020)
- [A joint 3D UNet-Graph Neural Network-based method for Airway Segmentation from chest CTs](https://mlsanity.com/paper/1908.08588/) (2019)
- [Automatic Airway Segmentation in chest CT using Convolutional Neural Networks](https://mlsanity.com/paper/1808.04576/) (2018)
- [Fuzzy Attention Neural Network to Tackle Discontinuity in Airway Segmentation](https://mlsanity.com/paper/2209.02048/) (2022)
- [NaviAirway: a Bronchiole-sensitive Deep Learning-based Airway Segmentation Pipeline](https://mlsanity.com/paper/2203.04294/) (2022)
- [BREAK: Bronchi Reconstruction by gEodesic transformation And sKeleton embedding](https://mlsanity.com/paper/2202.00002/) (2022)
- [FDA: Feature Decomposition and Aggregation for Robust Airway Segmentation](https://mlsanity.com/paper/2109.02920/) (2021)
- [Graph Refinement based Airway Extraction using Mean-Field Networks and Graph Neural Networks](https://mlsanity.com/paper/1811.08674/) (2018)
- [Coarse-to-fine Airway Segmentation Using Multi information Fusion Network and CNN-based Region Growing](https://mlsanity.com/paper/2102.12755/) (2021)

## Built on by (most cited first, 10 of 10)

- [Rethinking Exemplars for Continual Semantic Segmentation in Endoscopy Scenes: Entropy-based Mini-Batch Pseudo-Replay](https://mlsanity.com/paper/2308.14100/) (2023)
- [CAT-ViL: Co-Attention Gated Vision-Language Embedding for Visual Question Localized-Answering in Robotic Surgery](https://mlsanity.com/paper/2307.05182/) (2023)
- [Surgical-VQLA++: Adversarial Contrastive Learning for Calibrated Robust Visual Question-Localized Answering in Robotic Surgery](https://mlsanity.com/paper/2408.04958/) (2024)
- [Hunting imaging biomarkers in pulmonary fibrosis: Benchmarks of the AIIB23 challenge](https://mlsanity.com/paper/2312.13752/) (2023)
- [GDDS: Pulmonary Bronchioles Segmentation with Group Deep Dense Supervision](https://mlsanity.com/paper/2303.09212/) (2023)
- [Semi-supervised Learning for Segmentation of Bleeding Regions in Video Capsule Endoscopy](https://mlsanity.com/paper/2308.02869/) (2023)
- [Progressive Curriculum Learning with Scale-Enhanced U-Net for Continuous Airway Segmentation](https://mlsanity.com/paper/2410.18456/) (2024)
- [Transferring Knowledge from High-Quality to Low-Quality MRI for Adult Glioma Diagnosis](https://mlsanity.com/paper/2410.18698/) (2024)
- [Landmark Detection using Transformer Toward Robot-assisted Nasal Airway Intubation](https://mlsanity.com/paper/2308.02845/) (2023)
- [Airway Segmentation Network for Enhanced Tubular Feature Extraction](https://mlsanity.com/paper/2507.06581/) (2025)

## Abstract (arXiv)

Accurate airway extraction from computed tomography (CT) images is a critical step for planning navigation bronchoscopy and quantitative assessment of airway-related chronic obstructive pulmonary disease (COPD). The existing methods are challenging to sufficiently segment the airway, especially the high-generation airway, with the constraint of the limited label and cannot meet the clinical use in COPD. We propose a novel two-stage 3D contextual transformer-based U-Net for airway segmentation using CT images. The method consists of two stages, performing initial and refined airway segmentation. The two-stage model shares the same subnetwork with different airway masks as input. Contextual transformer block is performed both in the encoder and decoder path of the subnetwork to finish high-quality airway segmentation effectively. In the first stage, the total airway mask and CT images are provided to the subnetwork, and the intrapulmonary airway mask and corresponding CT scans to the subnetwork in the second stage. Then the predictions of the two-stage method are merged as the final prediction. Extensive experiments were performed on in-house and multiple public datasets. Quantitative and qualitative analysis demonstrate that our proposed method extracted much more branches and lengths of the tree while accomplishing state-of-the-art airway segmentation performance. The code is available at https://github.com/zhaozsq/airway_segmentation.