# M2SNet: Multi-scale in Multi-scale Subtraction Network for Medical Image Segmentation

arXiv: https://arxiv.org/abs/2303.10894 · HTML: https://mlsanity.com/paper/2303.10894/

## Key facts

- Cited by 13 papers in the map (data through 14 Oct 2026).
- Builds on 58 of its 104 references that are in the map.
- First posted on arXiv 20 Mar 2023.

## Builds on (most cited first, 30 of 58)

- [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)
- [U-Net: Convolutional Networks for Biomedical Image Segmentation](https://mlsanity.com/paper/1505.04597/) (2015)
- [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)
- [The Unreasonable Effectiveness of Deep Features as a Perceptual Metric](https://mlsanity.com/paper/1801.03924/) (2018)
- [Feature Pyramid Networks for Object Detection](https://mlsanity.com/paper/1612.03144/) (2016)
- [Fully Convolutional Networks for Semantic Segmentation](https://mlsanity.com/paper/1411.4038/) (2014)
- [A ConvNet for the 2020s](https://mlsanity.com/paper/2201.03545/) (2022)
- [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)
- [Perceptual Losses for Real-Time Style Transfer and Super-Resolution](https://mlsanity.com/paper/1603.08155/) (2016)
- [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)
- [Attention U-Net: Learning Where to Look for the Pancreas](https://mlsanity.com/paper/1804.03999/) (2018)
- [ESRGAN: Enhanced Super-Resolution Generative Adversarial Networks](https://mlsanity.com/paper/1809.00219/) (2018)
- [Swin-Unet: Unet-like Pure Transformer for Medical Image Segmentation](https://mlsanity.com/paper/2105.05537/) (2021)
- [High-Resolution Image Synthesis and Semantic Manipulation with Conditional GANs](https://mlsanity.com/paper/1711.11585/) (2017)
- [Focal Loss for Dense Object Detection](https://mlsanity.com/paper/1708.02002/) (2017)
- [PVT v2: Improved Baselines with Pyramid Vision Transformer](https://mlsanity.com/paper/2106.13797/) (2021)
- [Kvasir-SEG: A Segmented Polyp Dataset](https://mlsanity.com/paper/1911.07069/) (2019)
- [UNet++: Redesigning Skip Connections to Exploit Multiscale Features in Image Segmentation](https://mlsanity.com/paper/1912.05074/) (2019)
- [Structure-measure: A New Way to Evaluate Foreground Maps](https://mlsanity.com/paper/1708.00786/) (2017)
- [Res2Net: A New Multi-scale Backbone Architecture](https://mlsanity.com/paper/1904.01169/) (2019)
- [PraNet: Parallel Reverse Attention Network for Polyp Segmentation](https://mlsanity.com/paper/2006.11392/) (2020)
- [U2-Net: Going Deeper with Nested U-Structure for Salient Object Detection](https://mlsanity.com/paper/2005.09007/) (2020)
- [Enhanced-alignment Measure for Binary Foreground Map Evaluation](https://mlsanity.com/paper/1805.10421/) (2018)
- [nnU-Net: Self-adapting Framework for U-Net-Based Medical Image Segmentation](https://mlsanity.com/paper/1809.10486/) (2018)
- [Tversky loss function for image segmentation using 3D fully convolutional deep networks](https://mlsanity.com/paper/1706.05721/) (2017)

## Built on by (most cited first, 13 of 13)

- [Spider: A Unified Framework for Context-dependent Concept Segmentation](https://mlsanity.com/paper/2405.01002/) (2024)
- [A Survey on Deep Learning for Polyp Segmentation: Techniques, Challenges and Future Trends](https://mlsanity.com/paper/2311.18373/) (2023)
- [Concealed Object Segmentation with Hierarchical Coherence Modeling](https://mlsanity.com/paper/2401.11767/) (2024)
- [Inspiring the Next Generation of Segment Anything Models: Comprehensively Evaluate SAM and SAM 2 with Diverse Prompts Towards Context-Dependent Concepts under Different Scenes](https://mlsanity.com/paper/2412.01240/) (2024)
- [TP-Seg: Task-Prototype Framework for Unified Medical Lesion Segmentation](https://mlsanity.com/paper/2604.00684/) (2026)
- [Colorectal Polyp Segmentation in the Deep Learning Era: A Comprehensive Survey](https://mlsanity.com/paper/2401.11734/) (2024)
- [MedVKAN: Efficient Feature Extraction with Mamba and KAN for Medical Image Segmentation](https://mlsanity.com/paper/2505.11797/) (2025)
- [Power Battery Detection](https://mlsanity.com/paper/2508.07797/) (2025)
- [Beyond Pixel Overlap: A Framework for Decomposing Segmentation Evaluation Metrics](https://mlsanity.com/paper/2607.00886/) (2026)
- [Medical Visual Prompting (MVP): A Unified Framework for Versatile and High-Quality Medical Image Segmentation](https://mlsanity.com/paper/2404.01127/) (2024)
- [Polyp-E: Benchmarking the Robustness of Deep Segmentation Models via Polyp Editing](https://mlsanity.com/paper/2410.16732/) (2024)
- [Phi-SegNet: Phase-Integrated Supervision for Medical Image Segmentation](https://mlsanity.com/paper/2601.16064/) (2026)
- [De-occluding broadband metalens](https://mlsanity.com/paper/2601.19403/) (2026)

## Abstract (arXiv)

Accurate medical image segmentation is critical for early medical diagnosis. Most existing methods are based on U-shape structure and use element-wise addition or concatenation to fuse different level features progressively in decoder. However, both the two operations easily generate plenty of redundant information, which will weaken the complementarity between different level features, resulting in inaccurate localization and blurred edges of lesions. To address this challenge, we propose a general multi-scale in multi-scale subtraction network (M2SNet) to finish diverse segmentation from medical image. Specifically, we first design a basic subtraction unit (SU) to produce the difference features between adjacent levels in encoder. Next, we expand the single-scale SU to the intra-layer multi-scale SU, which can provide the decoder with both pixel-level and structure-level difference information. Then, we pyramidally equip the multi-scale SUs at different levels with varying receptive fields, thereby achieving the inter-layer multi-scale feature aggregation and obtaining rich multi-scale difference information. In addition, we build a training-free network ``LossNet'' to comprehensively supervise the task-aware features from bottom layer to top layer, which drives our multi-scale subtraction network to capture the detailed and structural cues simultaneously. Without bells and whistles, our method performs favorably against most state-of-the-art methods under different evaluation metrics on eleven datasets of four different medical image segmentation tasks of diverse image modalities, including color colonoscopy imaging, ultrasound imaging, computed tomography (CT), and optical coherence tomography (OCT). The source code can be available at https://github.com/Xiaoqi-Zhao-DLUT/MSNet.