# Structurally Different Neural Network Blocks for the Segmentation of Atrial and Aortic Perivascular Adipose Tissue in Multi-centre CT Angiography Scans

arXiv: https://arxiv.org/abs/2306.03494 · HTML: https://mlsanity.com/paper/2306.03494/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 9 of its 20 references that are in the map.
- First posted on arXiv 6 Jun 2023.

## Builds on (most cited first, 9 of 9)

- [Swin Transformer: Hierarchical Vision Transformer using Shifted Windows](https://mlsanity.com/paper/2103.14030/) (2021)
- [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)
- [Instance Normalization: The Missing Ingredient for Fast Stylization](https://mlsanity.com/paper/1607.08022/) (2016)
- [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)
- [3D MRI brain tumor segmentation using autoencoder regularization](https://mlsanity.com/paper/1810.11654/) (2018)
- [TransFuse: Fusing Transformers and CNNs for Medical Image Segmentation](https://mlsanity.com/paper/2102.08005/) (2021)
- [3D UX-Net: A Large Kernel Volumetric ConvNet Modernizing Hierarchical Transformer for Medical Image Segmentation](https://mlsanity.com/paper/2209.15076/) (2022)

## Abstract (arXiv)

Since the emergence of convolutional neural networks (CNNs) and, later, vision transformers (ViTs), deep learning architectures have predominantly relied on identical block types with varying hyperparameters. We propose a novel block alternation strategy to leverage the complementary strengths of different architectural designs, assembling structurally distinct components similar to Lego blocks. We introduce LegoNet, a deep learning framework that alternates CNN-based and SwinViT-based blocks to enhance feature learning for medical image segmentation. We investigate three variations of LegoNet and apply this concept to a previously unexplored clinical problem: the segmentation of the internal mammary artery (IMA), aorta, and perivascular adipose tissue (PVAT) from computed tomography angiography (CTA) scans. These PVAT regions have been shown to possess prognostic value in assessing cardiovascular risk and primary clinical outcomes. We evaluate LegoNet on large datasets, achieving superior performance to other leading architectures. Furthermore, we assess the model's generalizability on external testing cohorts, where an expert clinician corrects the model's segmentations, achieving DSC > 0.90 across various external, international, and public cohorts. To further validate the model's clinical reliability, we perform intra- and inter-observer variability analysis, demonstrating strong agreement with human annotations. The proposed methodology has significant implications for diagnostic cardiovascular management and early prognosis, offering a robust, automated solution for vascular and perivascular segmentation and risk assessment in clinical practice, paving the way for personalised medicine.