# Self-distilled Masked Attention guided masked image modeling with noise Regularized Teacher (SMART) for medical image analysis

arXiv: https://arxiv.org/abs/2310.01209 · HTML: https://mlsanity.com/paper/2310.01209/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 33 of its 46 references that are in the map.
- First posted on arXiv 2 Oct 2023.

## Builds on (most cited first, 30 of 33)

- [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)
- [Swin Transformer: Hierarchical Vision Transformer using Shifted Windows](https://mlsanity.com/paper/2103.14030/) (2021)
- [Masked Autoencoders Are Scalable Vision Learners](https://mlsanity.com/paper/2111.06377/) (2021)
- [Emerging Properties in Self-Supervised Vision Transformers](https://mlsanity.com/paper/2104.14294/) (2021)
- [Training data-efficient image transformers & distillation through attention](https://mlsanity.com/paper/2012.12877/) (2020)
- [UMAP: Uniform Manifold Approximation and Projection for Dimension Reduction](https://mlsanity.com/paper/1802.03426/) (2018)
- [BEiT: BERT Pre-Training of Image Transformers](https://mlsanity.com/paper/2106.08254/) (2021)
- [SimMIM: A Simple Framework for Masked Image Modeling](https://mlsanity.com/paper/2111.09886/) (2021)
- [Temporal Ensembling for Semi-Supervised Learning](https://mlsanity.com/paper/1610.02242/) (2016)
- [Going deeper with Image Transformers](https://mlsanity.com/paper/2103.17239/) (2021)
- [MedMNIST v2 -- A large-scale lightweight benchmark for 2D and 3D biomedical image classification](https://mlsanity.com/paper/2110.14795/) (2021)
- [Masked Feature Prediction for Self-Supervised Visual Pre-Training](https://mlsanity.com/paper/2112.09133/) (2021)
- [MONAI: An open-source framework for deep learning in healthcare](https://mlsanity.com/paper/2211.02701/) (2022)
- [Self-Supervised Pre-Training of Swin Transformers for 3D Medical Image Analysis](https://mlsanity.com/paper/2111.14791/) (2021)
- [AMOS: A Large-Scale Abdominal Multi-Organ Benchmark for Versatile Medical Image Segmentation](https://mlsanity.com/paper/2206.08023/) (2022)
- [Med3D: Transfer Learning for 3D Medical Image Analysis](https://mlsanity.com/paper/1904.00625/) (2019)
- [BEVT: BERT Pretraining of Video Transformers](https://mlsanity.com/paper/2112.01529/) (2021)
- [DeepOrgan: Multi-level Deep Convolutional Networks for Automated Pancreas Segmentation](https://mlsanity.com/paper/1506.06448/) (2015)
- [What to Hide from Your Students: Attention-Guided Masked Image Modeling](https://mlsanity.com/paper/2203.12719/) (2022)
- [Revealing the Dark Secrets of Masked Image Modeling](https://mlsanity.com/paper/2205.13543/) (2022)
- [MST: Masked Self-Supervised Transformer for Visual Representation](https://mlsanity.com/paper/2106.05656/) (2021)
- [SemMAE: Semantic-Guided Masking for Learning Masked Autoencoders](https://mlsanity.com/paper/2206.10207/) (2022)
- [Masked Generative Distillation](https://mlsanity.com/paper/2205.01529/) (2022)
- [SimCVD: Simple Contrastive Voxel-Wise Representation Distillation for Semi-Supervised Medical Image Segmentation](https://mlsanity.com/paper/2108.06227/) (2021)
- [Adversarial Masking for Self-Supervised Learning](https://mlsanity.com/paper/2201.13100/) (2022)
- [Bootstrapped Masked Autoencoders for Vision BERT Pretraining](https://mlsanity.com/paper/2207.07116/) (2022)
- [Self-supervised 3D anatomy segmentation using self-distilled masked image transformer (SMIT)](https://mlsanity.com/paper/2205.10342/) (2022)
- [Noisy Self-Knowledge Distillation for Text Summarization](https://mlsanity.com/paper/2009.07032/) (2020)
- [Stare at What You See: Masked Image Modeling without Reconstruction](https://mlsanity.com/paper/2211.08887/) (2022)

## Abstract (arXiv)

Pretraining vision transformers (ViT) with attention guided masked image modeling (MIM) has shown to increase downstream accuracy for natural image analysis. Hierarchical shifted window (Swin) transformer, often used in medical image analysis cannot use attention guided masking as it lacks an explicit [CLS] token, needed for computing attention maps for selective masking. We thus enhanced Swin with semantic class attention. We developed a co-distilled Swin transformer that combines a noisy momentum updated teacher to guide selective masking for MIM. Our approach called textscsetextscmantic textscattention guided co-distillation with noisy teacher textscregularized Swin textscTranstextscFormer (SMARTFormer) was applied for analyzing 3D computed tomography datasets with lung nodules and malignant lung cancers (LC). We also analyzed the impact of semantic attention and noisy teacher on pretraining and downstream accuracy. SMARTFormer classified lesions (malignant from benign) with a high accuracy of 0.895 of 1000 nodules, predicted LC treatment response with accuracy of 0.74, and achieved high accuracies even in limited data regimes. Pretraining with semantic attention and noisy teacher improved ability to distinguish semantically meaningful structures such as organs in a unsupervised clustering task and localize abnormal structures like tumors. Code, models will be made available through GitHub upon paper acceptance.