# Rethinking Attention Gated with Hybrid Dual Pyramid Transformer-CNN for Generalized Segmentation in Medical Imaging

arXiv: https://arxiv.org/abs/2404.18199 · HTML: https://mlsanity.com/paper/2404.18199/

## Key facts

- Cited by 3 papers in the map (data through 14 Oct 2026).
- Builds on 19 of its 32 references that are in the map.
- First posted on arXiv 28 Apr 2024.

## Builds on (most cited first, 19 of 19)

- [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)
- [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)
- [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)
- [Swin-Unet: Unet-like Pure Transformer for Medical Image Segmentation](https://mlsanity.com/paper/2105.05537/) (2021)
- [Transformers in Vision: A Survey](https://mlsanity.com/paper/2101.01169/) (2021)
- [PVT v2: Improved Baselines with Pyramid Vision Transformer](https://mlsanity.com/paper/2106.13797/) (2021)
- [Road Extraction by Deep Residual U-Net](https://mlsanity.com/paper/1711.10684/) (2017)
- [VM-UNet: Vision Mamba UNet for Medical Image Segmentation](https://mlsanity.com/paper/2402.02491/) (2024)
- [TransBTS: Multimodal Brain Tumor Segmentation Using Transformer](https://mlsanity.com/paper/2103.04430/) (2021)
- [Transformers in Medical Imaging: A Survey](https://mlsanity.com/paper/2201.09873/) (2022)
- [Gland Segmentation in Colon Histology Images: The GlaS Challenge Contest](https://mlsanity.com/paper/1603.00275/) (2016)
- [UCTransNet: Rethinking the Skip Connections in U-Net from a Channel-wise Perspective with Transformer](https://mlsanity.com/paper/2109.04335/) (2021)
- [Mixed Transformer U-Net For Medical Image Segmentation](https://mlsanity.com/paper/2111.04734/) (2021)
- [U-Net Transformer: Self and Cross Attention for Medical Image Segmentation](https://mlsanity.com/paper/2103.06104/) (2021)
- [Enhancing Medical Image Segmentation with TransCeption: A Multi-Scale Feature Fusion Approach](https://mlsanity.com/paper/2301.10847/) (2023)
- [D-TrAttUnet: Dual-Decoder Transformer-Based Attention Unet Architecture for Binary and Multi-classes Covid-19 Infection Segmentation](https://mlsanity.com/paper/2303.15576/) (2023)

## Built on by (most cited first, 3 of 3)

- [Similarity Memory Prior is All You Need for Medical Image Segmentation](https://mlsanity.com/paper/2507.00585/) (2025)
- [MambaCAFU: Hybrid Multi-Scale and Multi-Attention Model with Mamba-Based Fusion for Medical Image Segmentation](https://mlsanity.com/paper/2510.03786/) (2025)
- [Decoding Matters: Efficient Mamba-Based Decoder with Distribution-Aware Deep Supervision for Medical Image Segmentation](https://mlsanity.com/paper/2603.12547/) (2026)

## Abstract (arXiv)

Inspired by the success of Transformers in Computer vision, Transformers have been widely investigated for medical imaging segmentation. However, most of Transformer architecture are using the recent transformer architectures as encoder or as parallel encoder with the CNN encoder. In this paper, we introduce a novel hybrid CNN-Transformer segmentation architecture (PAG-TransYnet) designed for efficiently building a strong CNN-Transformer encoder. Our approach exploits attention gates within a Dual Pyramid hybrid encoder. The contributions of this methodology can be summarized into three key aspects: (i) the utilization of Pyramid input for highlighting the prominent features at different scales, (ii) the incorporation of a PVT transformer to capture long-range dependencies across various resolutions, and (iii) the implementation of a Dual-Attention Gate mechanism for effectively fusing prominent features from both CNN and Transformer branches. Through comprehensive evaluation across different segmentation tasks including: abdominal multi-organs segmentation, infection segmentation (Covid-19 and Bone Metastasis), microscopic tissues segmentation (Gland and Nucleus). The proposed approach demonstrates state-of-the-art performance and exhibits remarkable generalization capabilities. This research represents a significant advancement towards addressing the pressing need for efficient and adaptable segmentation solutions in medical imaging applications.