# MaxViT-UNet: Multi-Axis Attention for Medical Image Segmentation

arXiv: https://arxiv.org/abs/2305.08396 · HTML: https://mlsanity.com/paper/2305.08396/

## Key facts

- Cited by 8 papers in the map (data through 14 Oct 2026).
- Builds on 48 of its 92 references that are in the map.
- First posted on arXiv 15 May 2023.

## Builds on (most cited first, 30 of 48)

- [Attention Is All You Need](https://mlsanity.com/paper/1706.03762/) (2017)
- [Adam: A Method for Stochastic Optimization](https://mlsanity.com/paper/1412.6980/) (2014)
- [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)
- [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)
- [Layer Normalization](https://mlsanity.com/paper/1607.06450/) (2016)
- [Fully Convolutional Networks for Semantic Segmentation](https://mlsanity.com/paper/1411.4038/) (2014)
- [MobileNetV2: Inverted Residuals and Linear Bottlenecks](https://mlsanity.com/paper/1801.04381/) (2018)
- [Squeeze-and-Excitation Networks](https://mlsanity.com/paper/1709.01507/) (2017)
- [Delving Deep into Rectifiers: Surpassing Human-Level Performance on ImageNet Classification](https://mlsanity.com/paper/1502.01852/) (2015)
- [Gaussian Error Linear Units (GELUs)](https://mlsanity.com/paper/1606.08415/) (2016)
- [Pyramid Scene Parsing Network](https://mlsanity.com/paper/1612.01105/) (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)
- [3D U-Net: Learning Dense Volumetric Segmentation from Sparse Annotation](https://mlsanity.com/paper/1606.06650/) (2016)
- [Attention U-Net: Learning Where to Look for the Pancreas](https://mlsanity.com/paper/1804.03999/) (2018)
- [Unified Perceptual Parsing for Scene Understanding](https://mlsanity.com/paper/1807.10221/) (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)
- [Panoptic Segmentation](https://mlsanity.com/paper/1801.00868/) (2018)
- [Transformer in Transformer](https://mlsanity.com/paper/2103.00112/) (2021)
- [UNet++: Redesigning Skip Connections to Exploit Multiscale Features in Image Segmentation](https://mlsanity.com/paper/1912.05074/) (2019)
- [CoAtNet: Marrying Convolution and Attention for All Data Sizes](https://mlsanity.com/paper/2106.04803/) (2021)
- [MaxViT: Multi-Axis Vision Transformer](https://mlsanity.com/paper/2204.01697/) (2022)
- [Conditional Positional Encodings for Vision Transformers](https://mlsanity.com/paper/2102.10882/) (2021)
- [Early Convolutions Help Transformers See Better](https://mlsanity.com/paper/2106.14881/) (2021)
- [Medical Transformer: Gated Axial-Attention for Medical Image Segmentation](https://mlsanity.com/paper/2102.10662/) (2021)
- [CMT: Convolutional Neural Networks Meet Vision Transformers](https://mlsanity.com/paper/2107.06263/) (2021)
- [MAXIM: Multi-Axis MLP for Image Processing](https://mlsanity.com/paper/2201.02973/) (2022)

## Built on by (most cited first, 8 of 8)

- [A Recent Survey of Vision Transformers for Medical Image Segmentation](https://mlsanity.com/paper/2312.00634/) (2023)
- [MIST: Medical Image Segmentation Transformer with Convolutional Attention Mixing (CAM) Decoder](https://mlsanity.com/paper/2310.19898/) (2023)
- [LKCell: Efficient Cell Nuclei Instance Segmentation with Large Convolution Kernels](https://mlsanity.com/paper/2407.18054/) (2024)
- [CB-HVTNet: A channel-boosted hybrid vision transformer network for lymphocyte assessment in histopathological images](https://mlsanity.com/paper/2305.09211/) (2023)
- [Improving 3D Medical Image Segmentation at Boundary Regions using Local Self-attention and Global Volume Mixing](https://mlsanity.com/paper/2410.15360/) (2024)
- [Particle Multi-Axis Transformer for Jet Tagging](https://mlsanity.com/paper/2406.06638/) (2024)
- [Channel Boosted CNN-Transformer-based Multi-Level and Multi-Scale Nuclei Segmentation](https://mlsanity.com/paper/2407.19186/) (2024)
- [Automated MRI Tumor Segmentation using hybrid U-Net with Transformer and Efficient Attention](https://mlsanity.com/paper/2506.15562/) (2025)

## Abstract (arXiv)

Since their emergence, Convolutional Neural Networks (CNNs) have made significant strides in medical image analysis. However, the local nature of the convolution operator may pose a limitation for capturing global and long-range interactions in CNNs. Recently, Transformers have gained popularity in the computer vision community and also in medical image segmentation due to their ability to process global features effectively. The scalability issues of the self-attention mechanism and lack of the CNN-like inductive bias may have limited their adoption. Therefore, hybrid Vision transformers (CNN-Transformer), exploiting the advantages of both Convolution and Self-attention Mechanisms, have gained importance. In this work, we present MaxViT-UNet, a new Encoder-Decoder based UNet type hybrid vision transformer (CNN-Transformer) for medical image segmentation. The proposed Hybrid Decoder is designed to harness the power of both the convolution and self-attention mechanisms at each decoding stage with a nominal memory and computational burden. The inclusion of multi-axis self-attention, within each decoder stage, significantly enhances the discriminating capacity between the object and background regions, thereby helping in improving the segmentation efficiency. In the Hybrid Decoder, a new block is also proposed. The fusion process commences by integrating the upsampled lower-level decoder features, obtained through transpose convolution, with the skip-connection features derived from the hybrid encoder. Subsequently, the fused features undergo refinement through the utilization of a multi-axis attention mechanism. The proposed decoder block is repeated multiple times to segment the nuclei regions progressively. Experimental results on MoNuSeg18 and MoNuSAC20 datasets demonstrate the effectiveness of the proposed technique.