# SwinCross: Cross-modal Swin Transformer for Head-and-Neck Tumor Segmentation in PET/CT Images

arXiv: https://arxiv.org/abs/2302.03861 · HTML: https://mlsanity.com/paper/2302.03861/

## Key facts

- Cited by 5 papers in the map (data through 14 Oct 2026).
- Builds on 55 of its 92 references that are in the map.
- First posted on arXiv 8 Feb 2023.

## Builds on (most cited first, 30 of 55)

- [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)
- [BERT: Pre-training of Deep Bidirectional Transformers for Language Understanding](https://mlsanity.com/paper/1810.04805/) (2018)
- [Language Models are Few-Shot Learners](https://mlsanity.com/paper/2005.14165/) (2020)
- [An Image is Worth 16x16 Words: Transformers for Image Recognition at Scale](https://mlsanity.com/paper/2010.11929/) (2020)
- [Very Deep Convolutional Networks for Large-Scale Image Recognition](https://mlsanity.com/paper/1409.1556/) (2014)
- [Swin Transformer: Hierarchical Vision Transformer using Shifted Windows](https://mlsanity.com/paper/2103.14030/) (2021)
- [End-to-End Object Detection with Transformers](https://mlsanity.com/paper/2005.12872/) (2020)
- [DeepLab: Semantic Image Segmentation with Deep Convolutional Nets, Atrous Convolution, and Fully Connected CRFs](https://mlsanity.com/paper/1606.00915/) (2016)
- [SegFormer: Simple and Efficient Design for Semantic Segmentation with Transformers](https://mlsanity.com/paper/2105.15203/) (2021)
- [Non-local Neural Networks](https://mlsanity.com/paper/1711.07971/) (2017)
- [TransUNet: Transformers Make Strong Encoders for Medical Image Segmentation](https://mlsanity.com/paper/2102.04306/) (2021)
- [LXMERT: Learning Cross-Modality Encoder Representations from Transformers](https://mlsanity.com/paper/1908.07490/) (2019)
- [VisualBERT: A Simple and Performant Baseline for Vision and Language](https://mlsanity.com/paper/1908.03557/) (2019)
- [Oscar: Object-Semantics Aligned Pre-training for Vision-Language Tasks](https://mlsanity.com/paper/2004.06165/) (2020)
- [Per-Pixel Classification is Not All You Need for Semantic Segmentation](https://mlsanity.com/paper/2107.06278/) (2021)
- [Multi-Scale Context Aggregation by Dilated Convolutions](https://mlsanity.com/paper/1511.07122/) (2015)
- [UNETR: Transformers for 3D Medical Image Segmentation](https://mlsanity.com/paper/2103.10504/) (2021)
- [Swin UNETR: Swin Transformers for Semantic Segmentation of Brain Tumors in MRI Images](https://mlsanity.com/paper/2201.01266/) (2022)
- [CrossViT: Cross-Attention Multi-Scale Vision Transformer for Image Classification](https://mlsanity.com/paper/2103.14899/) (2021)
- [Image Transformer](https://mlsanity.com/paper/1802.05751/) (2018)
- [PVT v2: Improved Baselines with Pyramid Vision Transformer](https://mlsanity.com/paper/2106.13797/) (2021)
- [VideoBERT: A Joint Model for Video and Language Representation Learning](https://mlsanity.com/paper/1904.01766/) (2019)
- [The Medical Segmentation Decathlon](https://mlsanity.com/paper/2106.05735/) (2021)
- [Understanding the Effective Receptive Field in Deep Convolutional Neural Networks](https://mlsanity.com/paper/1701.04128/) (2017)
- [Intriguing Properties of Vision Transformers](https://mlsanity.com/paper/2105.10497/) (2021)
- [Tensor Fusion Network for Multimodal Sentiment Analysis](https://mlsanity.com/paper/1707.07250/) (2017)
- [VATT: Transformers for Multimodal Self-Supervised Learning from Raw Video, Audio and Text](https://mlsanity.com/paper/2104.11178/) (2021)
- [Multi-Modal Fusion Transformer for End-to-End Autonomous Driving](https://mlsanity.com/paper/2104.09224/) (2021)
- [MaX-DeepLab: End-to-End Panoptic Segmentation with Mask Transformers](https://mlsanity.com/paper/2012.00759/) (2020)

## Built on by (most cited first, 5 of 5)

- [3D Lymphoma Segmentation on PET/CT Images via Multi-Scale Information Fusion with Cross-Attention](https://mlsanity.com/paper/2402.02349/) (2024)
- [Segmentation-Free Outcome Prediction from Head and Neck Cancer PET/CT Images: Deep Learning-Based Feature Extraction from Multi-Angle Maximum Intensity Projections (MA-MIPs)](https://mlsanity.com/paper/2405.01756/) (2024)
- [SAM2-SGP: Enhancing SAM2 for Medical Image Segmentation via Support-Set Guided Prompting](https://mlsanity.com/paper/2506.19658/) (2025)
- [UMambaAdj: Advancing GTV Segmentation for Head and Neck Cancer in MRI-Guided RT with UMamba and nnU-Net ResEnc Planner](https://mlsanity.com/paper/2410.12940/) (2024)
- [CoMLP: Cooperatively-Gated MLPs for Fine-Grained Cross-Modal Information Fusion in Medical Image Segmentation](https://mlsanity.com/paper/2609.04781/) (2026)

## Abstract (arXiv)

Radiotherapy (RT) combined with cetuximab is the standard treatment for patients with inoperable head and neck cancers. Segmentation of head and neck (H&N) tumors is a prerequisite for radiotherapy planning but a time-consuming process. In recent years, deep convolutional neural networks have become the de facto standard for automated image segmentation. However, due to the expensive computational cost associated with enlarging the field of view in DCNNs, their ability to model long-range dependency is still limited, and this can result in sub-optimal segmentation performance for objects with background context spanning over long distances. On the other hand, Transformer models have demonstrated excellent capabilities in capturing such long-range information in several semantic segmentation tasks performed on medical images. Inspired by the recent success of Vision Transformers and advances in multi-modal image analysis, we propose a novel segmentation model, debuted, Cross-Modal Swin Transformer (SwinCross), with cross-modal attention (CMA) module to incorporate cross-modal feature extraction at multiple resolutions.To validate the effectiveness of the proposed method, we performed experiments on the HECKTOR 2021 challenge dataset and compared it with the nnU-Net (the backbone of the top-5 methods in HECKTOR 2021) and other state-of-the-art transformer-based methods such as UNETR, and Swin UNETR. The proposed method is experimentally shown to outperform these comparing methods thanks to the ability of the CMA module to capture better inter-modality complimentary feature representations between PET and CT, for the task of head-and-neck tumor segmentation.