# MedNeXt: Transformer-driven Scaling of ConvNets for Medical Image Segmentation

arXiv: https://arxiv.org/abs/2303.09975 · HTML: https://mlsanity.com/paper/2303.09975/

## Key facts

- Cited by 162 papers in the map (data through 14 Oct 2026).
- Builds on 28 of its 35 references that are in the map.
- First posted on arXiv 17 Mar 2023.

## Builds on (most cited first, 28 of 28)

- [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)
- [An Image is Worth 16x16 Words: Transformers for Image Recognition at Scale](https://mlsanity.com/paper/2010.11929/) (2020)
- [PyTorch: An Imperative Style, High-Performance Deep Learning Library](https://mlsanity.com/paper/1912.01703/) (2019)
- [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)
- [EfficientNet: Rethinking Model Scaling for Convolutional Neural Networks](https://mlsanity.com/paper/1905.11946/) (2019)
- [A ConvNet for the 2020s](https://mlsanity.com/paper/2201.03545/) (2022)
- [Gaussian Error Linear Units (GELUs)](https://mlsanity.com/paper/1606.08415/) (2016)
- [TransUNet: Transformers Make Strong Encoders for Medical Image Segmentation](https://mlsanity.com/paper/2102.04306/) (2021)
- [Group Normalization](https://mlsanity.com/paper/1803.08494/) (2018)
- [3D U-Net: Learning Dense Volumetric Segmentation from Sparse Annotation](https://mlsanity.com/paper/1606.06650/) (2016)
- [Swin Transformer V2: Scaling Up Capacity and Resolution](https://mlsanity.com/paper/2111.09883/) (2021)
- [Swin-Unet: Unet-like Pure Transformer for Medical Image Segmentation](https://mlsanity.com/paper/2105.05537/) (2021)
- [A Survey on Deep Learning in Medical Image Analysis](https://mlsanity.com/paper/1702.05747/) (2017)
- [UNETR: Transformers for 3D Medical Image Segmentation](https://mlsanity.com/paper/2103.10504/) (2021)
- [Training Deep Nets with Sublinear Memory Cost](https://mlsanity.com/paper/1604.06174/) (2016)
- [Swin UNETR: Swin Transformers for Semantic Segmentation of Brain Tumors in MRI Images](https://mlsanity.com/paper/2201.01266/) (2022)
- [ImageNet-21K Pretraining for the Masses](https://mlsanity.com/paper/2104.10972/) (2021)
- [The RSNA-ASNR-MICCAI BraTS 2021 Benchmark on Brain Tumor Segmentation and Radiogenomic Classification](https://mlsanity.com/paper/2107.02314/) (2021)
- [AMOS: A Large-Scale Abdominal Multi-Organ Benchmark for Versatile Medical Image Segmentation](https://mlsanity.com/paper/2206.08023/) (2022)
- [TransBTS: Multimodal Brain Tumor Segmentation Using Transformer](https://mlsanity.com/paper/2103.04430/) (2021)
- [CoTr: Efficiently Bridging CNN and Transformer for 3D Medical Image Segmentation](https://mlsanity.com/paper/2103.03024/) (2021)
- [The state of the art in kidney and kidney tumor segmentation in contrast-enhanced CT imaging: Results of the KiTS19 Challenge](https://mlsanity.com/paper/1912.01054/) (2019)
- [3D UX-Net: A Large Kernel Volumetric ConvNet Modernizing Hierarchical Transformer for Medical Image Segmentation](https://mlsanity.com/paper/2209.15076/) (2022)
- [Convolution-Free Medical Image Segmentation using Transformers](https://mlsanity.com/paper/2102.13645/) (2021)
- [A Robust Volumetric Transformer for Accurate 3D Tumor Segmentation](https://mlsanity.com/paper/2111.13300/) (2021)
- [Large-Kernel Attention for 3D Medical Image Segmentation](https://mlsanity.com/paper/2207.11225/) (2022)

## Built on by (most cited first, 30 of 162)

- [SegMamba: Long-range Sequential Modeling Mamba For 3D Medical Image Segmentation](https://mlsanity.com/paper/2401.13560/) (2024)
- [nnU-Net Revisited: A Call for Rigorous Validation in 3D Medical Image Segmentation](https://mlsanity.com/paper/2404.09556/) (2024)
- [The TopCoW Challenge -- Topology-Aware Circle of Willis Segmentation for CT and MR Angiography](https://mlsanity.com/paper/2312.17670/) (2023)
- [Revisiting MAE pre-training for 3D medical image segmentation](https://mlsanity.com/paper/2410.23132/) (2024)
- [Loss Functions in the Era of Semantic Segmentation: A Survey and Outlook](https://mlsanity.com/paper/2312.05391/) (2023)
- [Touchstone Benchmark: Are We on the Right Way for Evaluating AI Algorithms for Medical Segmentation?](https://mlsanity.com/paper/2411.03670/) (2024)
- [Primus: Enforcing Attention Usage for 3D Medical Image Segmentation](https://mlsanity.com/paper/2503.01835/) (2025)
- [vesselFM: A Foundation Model for Universal 3D Blood Vessel Segmentation](https://mlsanity.com/paper/2411.17386/) (2024)
- [AMAES: Augmented Masked Autoencoder Pretraining on Public Brain MRI Data for 3D-Native Segmentation](https://mlsanity.com/paper/2408.00640/) (2024)
- [Versatile Medical Image Segmentation Learned from Multi-Source Datasets via Model Self-Disambiguation](https://mlsanity.com/paper/2311.10696/) (2023)
- [Advanced Tumor Segmentation in Medical Imaging: An Ensemble Approach for BraTS 2023 Adult Glioma and Pediatric Tumor Tasks](https://mlsanity.com/paper/2403.09262/) (2024)
- [xLSTM-UNet can be an Effective 2D & 3D Medical Image Segmentation Backbone with Vision-LSTM (ViL) better than its Mamba Counterpart](https://mlsanity.com/paper/2407.01530/) (2024)
- [HySparK: Hybrid Sparse Masking for Large Scale Medical Image Pre-Training](https://mlsanity.com/paper/2408.05815/) (2024)
- [ReCo-KD: Region- and Context-Aware Knowledge Distillation for Efficient 3D Medical Image Segmentation](https://mlsanity.com/paper/2601.08301/) (2026)
- [D-Net: Dynamic Large Kernel with Dynamic Feature Fusion for Volumetric Medical Image Segmentation](https://mlsanity.com/paper/2403.10674/) (2024)
- [Improving Representation of High-frequency Components for Medical Visual Foundation Models](https://mlsanity.com/paper/2407.14651/) (2024)
- [Tri-Plane Mamba: Efficiently Adapting Segment Anything Model for 3D Medical Images](https://mlsanity.com/paper/2409.08492/) (2024)
- [Adapting Vision Foundation Models for Real-time Ultrasound Image Segmentation](https://mlsanity.com/paper/2503.24368/) (2025)
- [Rethinking Brain Tumor Segmentation from the Frequency Domain Perspective](https://mlsanity.com/paper/2506.10142/) (2025)
- [BraTS orchestrator : Democratizing and Disseminating state-of-the-art brain tumor image analysis](https://mlsanity.com/paper/2506.13807/) (2025)
- [Citrus-V: Advancing Medical Foundation Models with Unified Medical Image Grounding for Clinical Reasoning](https://mlsanity.com/paper/2509.19090/) (2025)
- [MambaMIM: Pre-training Mamba with State Space Token Interpolation and its Application to Medical Image Segmentation](https://mlsanity.com/paper/2408.08070/) (2024)
- [Medical Image Segmentation via Single-Source Domain Generalization with Random Amplitude Spectrum Synthesis](https://mlsanity.com/paper/2409.04768/) (2024)
- [De-Identification of Medical Imaging Data: A Comprehensive Tool for Ensuring Patient Privacy](https://mlsanity.com/paper/2410.12402/) (2024)
- [Towards Universal Text-driven CT Image Segmentation](https://mlsanity.com/paper/2503.06030/) (2025)
- [MIRAGE: Multimodal foundation model and benchmark for comprehensive retinal OCT image analysis](https://mlsanity.com/paper/2506.08900/) (2025)
- [Pre-Trained LLM is a Semantic-Aware and Generalizable Segmentation Booster](https://mlsanity.com/paper/2506.18034/) (2025)
- [One registration is worth two segmentations](https://mlsanity.com/paper/2405.10879/) (2024)
- [Test-time generative augmentation for medical image segmentation](https://mlsanity.com/paper/2406.17608/) (2024)
- [Adult Glioma Segmentation in Sub-Saharan Africa using Transfer Learning on Stratified Finetuning Data](https://mlsanity.com/paper/2412.04111/) (2024)

## Abstract (arXiv)

There has been exploding interest in embracing Transformer-based architectures for medical image segmentation. However, the lack of large-scale annotated medical datasets make achieving performances equivalent to those in natural images challenging. Convolutional networks, in contrast, have higher inductive biases and consequently, are easily trainable to high performance. Recently, the ConvNeXt architecture attempted to modernize the standard ConvNet by mirroring Transformer blocks. In this work, we improve upon this to design a modernized and scalable convolutional architecture customized to challenges of data-scarce medical settings. We introduce MedNeXt, a Transformer-inspired large kernel segmentation network which introduces - 1) A fully ConvNeXt 3D Encoder-Decoder Network for medical image segmentation, 2) Residual ConvNeXt up and downsampling blocks to preserve semantic richness across scales, 3) A novel technique to iteratively increase kernel sizes by upsampling small kernel networks, to prevent performance saturation on limited medical data, 4) Compound scaling at multiple levels (depth, width, kernel size) of MedNeXt. This leads to state-of-the-art performance on 4 tasks on CT and MRI modalities and varying dataset sizes, representing a modernized deep architecture for medical image segmentation. Our code is made publicly available at: https://github.com/MIC-DKFZ/MedNeXt.