# Are Vision xLSTM Embedded UNet More Reliable in Medical 3D Image Segmentation?

arXiv: https://arxiv.org/abs/2406.16993 · HTML: https://mlsanity.com/paper/2406.16993/

## Key facts

- Cited by 3 papers in the map (data through 14 Oct 2026).
- Builds on 28 of its 38 references that are in the map.
- First posted on arXiv 24 Jun 2024.

## Builds on (most cited first, 28 of 28)

- [Attention Is All You Need](https://mlsanity.com/paper/1706.03762/) (2017)
- [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)
- [Mamba: Linear-Time Sequence Modeling with Selective State Spaces](https://mlsanity.com/paper/2312.00752/) (2023)
- [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)
- [Attention U-Net: Learning Where to Look for the Pancreas](https://mlsanity.com/paper/1804.03999/) (2018)
- [UNETR: Transformers for 3D Medical Image Segmentation](https://mlsanity.com/paper/2103.10504/) (2021)
- [Sigmoid-Weighted Linear Units for Neural Network Function Approximation in Reinforcement Learning](https://mlsanity.com/paper/1702.03118/) (2017)
- [Swin UNETR: Swin Transformers for Semantic Segmentation of Brain Tumors in MRI Images](https://mlsanity.com/paper/2201.01266/) (2022)
- [Skin Lesion Analysis Toward Melanoma Detection: A Challenge at the 2017 International Symposium on Biomedical Imaging (ISBI), Hosted by the International Skin Imaging Collaboration (ISIC)](https://mlsanity.com/paper/1710.05006/) (2017)
- [U-Mamba: Enhancing Long-range Dependency for Biomedical Image Segmentation](https://mlsanity.com/paper/2401.04722/) (2024)
- [Efficient Attention: Attention with Linear Complexities](https://mlsanity.com/paper/1812.01243/) (2018)
- [xLSTM: Extended Long Short-Term Memory](https://mlsanity.com/paper/2405.04517/) (2024)
- [How Do Vision Transformers Work?](https://mlsanity.com/paper/2202.06709/) (2022)
- [UCTransNet: Rethinking the Skip Connections in U-Net from a Channel-wise Perspective with Transformer](https://mlsanity.com/paper/2109.04335/) (2021)
- [The Illusion of State in State-Space Models](https://mlsanity.com/paper/2404.08819/) (2024)
- [Swin-UMamba: Mamba-based UNet with ImageNet-based pretraining](https://mlsanity.com/paper/2402.03302/) (2024)
- [DS-TransUNet:Dual Swin Transformer U-Net for Medical Image Segmentation](https://mlsanity.com/paper/2106.06716/) (2021)
- [Recent advances and clinical applications of deep learning in medical image analysis](https://mlsanity.com/paper/2105.13381/) (2021)
- [Mixed Transformer U-Net For Medical Image Segmentation](https://mlsanity.com/paper/2111.04734/) (2021)
- [Combo Loss: Handling Input and Output Imbalance in Multi-Organ Segmentation](https://mlsanity.com/paper/1805.02798/) (2018)
- [TransAttUnet: Multi-level Attention-guided U-Net with Transformer for Medical Image Segmentation](https://mlsanity.com/paper/2107.05274/) (2021)
- [Vision-LSTM: xLSTM as Generic Vision Backbone](https://mlsanity.com/paper/2406.04303/) (2024)
- [AFTer-UNet: Axial Fusion Transformer UNet for Medical Image Segmentation](https://mlsanity.com/paper/2110.10403/) (2021)
- [MIST: Medical Image Segmentation Transformer with Convolutional Attention Mixing (CAM) Decoder](https://mlsanity.com/paper/2310.19898/) (2023)
- [Laplacian-Former: Overcoming the Limitations of Vision Transformers in Local Texture Detection](https://mlsanity.com/paper/2309.00108/) (2023)
- [Full-scale Deeply Supervised Attention Network for Segmenting COVID-19 Lesions](https://mlsanity.com/paper/2210.15571/) (2022)

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

- [DKT2: Revisiting Applicable and Comprehensive Knowledge Tracing in Large-Scale Data](https://mlsanity.com/paper/2501.14256/) (2025)
- [An overview of neural architectures for self-supervised audio representation learning from masked spectrograms](https://mlsanity.com/paper/2509.18691/) (2025)
- [APRIL-MedSeg: A Modular Medical Image Segmentation Toolbox Embracing Modern Paradigms](https://mlsanity.com/paper/2606.30577/) (2026)

## Abstract (arXiv)

The development of efficient segmentation strategies for medical images has evolved from its initial dependence on Convolutional Neural Networks (CNNs) to the current investigation of hybrid models that combine CNNs with Vision Transformers (ViTs). There is an increasing focus on creating architectures that are both high-performing and computationally efficient, capable of being deployed on remote systems with limited resources. Although transformers can capture global dependencies in the input space, they face challenges from the corresponding high computational and storage expenses involved. This research investigates the integration of CNNs with Vision Extended Long Short-Term Memory (Vision-xLSTM)s by introducing the novel U-VixLSTM. The Vision-xLSTM blocks capture the temporal and global relationships within the patches extracted from the CNN feature maps. The convolutional feature reconstruction path upsamples the output volume from the Vision-xLSTM blocks to produce the segmentation output. Our primary objective is to propose that Vision-xLSTM forms an appropriate backbone for medical image segmentation, offering excellent performance with reduced computational costs. The U-VixLSTM exhibits superior performance compared to the state-of-the-art networks in the publicly available Synapse, ISIC and ACDC datasets. Code provided: https://github.com/duttapallabi2907/U-VixLSTM