# MCANet: Medical Image Segmentation with Multi-Scale Cross-Axis Attention

arXiv: https://arxiv.org/abs/2312.08866 · HTML: https://mlsanity.com/paper/2312.08866/

## Key facts

- Cited by 5 papers in the map (data through 14 Oct 2026).
- Builds on 60 of its 79 references that are in the map.
- First posted on arXiv 14 Dec 2023.

## Builds on (most cited first, 30 of 60)

- [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)
- [Swin Transformer: Hierarchical Vision Transformer using Shifted Windows](https://mlsanity.com/paper/2103.14030/) (2021)
- [Squeeze-and-Excitation Networks](https://mlsanity.com/paper/1709.01507/) (2017)
- [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)
- [Non-local Neural Networks](https://mlsanity.com/paper/1711.07971/) (2017)
- [Pyramid Vision Transformer: A Versatile Backbone for Dense Prediction without Convolutions](https://mlsanity.com/paper/2102.12122/) (2021)
- [TransUNet: Transformers Make Strong Encoders for Medical Image Segmentation](https://mlsanity.com/paper/2102.04306/) (2021)
- [UNet++: A Nested U-Net Architecture for Medical Image Segmentation](https://mlsanity.com/paper/1807.10165/) (2018)
- [Attention U-Net: Learning Where to Look for the Pancreas](https://mlsanity.com/paper/1804.03999/) (2018)
- [Deep High-Resolution Representation Learning for Visual Recognition](https://mlsanity.com/paper/1908.07919/) (2019)
- [Swin-Unet: Unet-like Pure Transformer for Medical Image Segmentation](https://mlsanity.com/paper/2105.05537/) (2021)
- [Paying More Attention to Attention: Improving the Performance of Convolutional Neural Networks via Attention Transfer](https://mlsanity.com/paper/1612.03928/) (2016)
- [UNETR: Transformers for 3D Medical Image Segmentation](https://mlsanity.com/paper/2103.10504/) (2021)
- [CCNet: Criss-Cross Attention for Semantic Segmentation](https://mlsanity.com/paper/1811.11721/) (2018)
- [UNet++: Redesigning Skip Connections to Exploit Multiscale Features in Image Segmentation](https://mlsanity.com/paper/1912.05074/) (2019)
- [PraNet: Parallel Reverse Attention Network for Polyp Segmentation](https://mlsanity.com/paper/2006.11392/) (2020)
- [Axial Attention in Multidimensional Transformers](https://mlsanity.com/paper/1912.12180/) (2019)
- [Axial-DeepLab: Stand-Alone Axial-Attention for Panoptic Segmentation](https://mlsanity.com/paper/2003.07853/) (2020)
- [Medical Transformer: Gated Axial-Attention for Medical Image Segmentation](https://mlsanity.com/paper/2102.10662/) (2021)
- [Attention Gated Networks: Learning to Leverage Salient Regions in Medical Images](https://mlsanity.com/paper/1808.08114/) (2018)
- [TransBTS: Multimodal Brain Tumor Segmentation Using Transformer](https://mlsanity.com/paper/2103.04430/) (2021)
- [Auto-DeepLab: Hierarchical Neural Architecture Search for Semantic Image Segmentation](https://mlsanity.com/paper/1901.02985/) (2019)
- [TransFuse: Fusing Transformers and CNNs for Medical Image Segmentation](https://mlsanity.com/paper/2102.08005/) (2021)
- [SegNeXt: Rethinking Convolutional Attention Design for Semantic Segmentation](https://mlsanity.com/paper/2209.08575/) (2022)
- [Sparse Sinkhorn Attention](https://mlsanity.com/paper/2002.11296/) (2020)
- [Transformers in Medical Imaging: A Survey](https://mlsanity.com/paper/2201.09873/) (2022)

## Built on by (most cited first, 5 of 5)

- [Frontiers in Intelligent Colonoscopy](https://mlsanity.com/paper/2410.17241/) (2024)
- [Multi-Granularity Vision Fastformer with Fusion Mechanism for Skin Lesion Segmentation](https://mlsanity.com/paper/2504.03108/) (2025)
- [Machine Learning-Based Ultrasonic Weld Characterization Using Hierarchical Wave Modeling and Diffusion-Driven Distribution Alignment](https://mlsanity.com/paper/2510.13023/) (2025)
- [Intelligent Communication Mixture-of-Experts Boosted-Medical Image Segmentation Foundation Model](https://mlsanity.com/paper/2510.17684/) (2025)
- [WaveSeg: Enhancing Segmentation Precision via High-Frequency Prior and Mamba-Driven Spectrum Decomposition](https://mlsanity.com/paper/2510.21079/) (2025)

## Abstract (arXiv)

Efficiently capturing multi-scale information and building long-range dependencies among pixels are essential for medical image segmentation because of the various sizes and shapes of the lesion regions or organs. In this paper, we present Multi-scale Cross-axis Attention (MCA) to solve the above challenging issues based on the efficient axial attention. Instead of simply connecting axial attention along the horizontal and vertical directions sequentially, we propose to calculate dual cross attentions between two parallel axial attentions to capture global information better. To process the significant variations of lesion regions or organs in individual sizes and shapes, we also use multiple convolutions of strip-shape kernels with different kernel sizes in each axial attention path to improve the efficiency of the proposed MCA in encoding spatial information. We build the proposed MCA upon the MSCAN backbone, yielding our network, termed MCANet. Our MCANet with only 4M+ parameters performs even better than most previous works with heavy backbones (e.g., Swin Transformer) on four challenging tasks, including skin lesion segmentation, nuclei segmentation, abdominal multi-organ segmentation, and polyp segmentation. Code is available at https://github.com/haoshao-nku/medical_seg.