# Flemme: A Flexible and Modular Learning Platform for Medical Images

arXiv: https://arxiv.org/abs/2408.09369 · HTML: https://mlsanity.com/paper/2408.09369/

## Key facts

- Cited by 3 papers in the map (data through 14 Oct 2026).
- Builds on 27 of its 35 references that are in the map.
- First posted on arXiv 18 Aug 2024.

## Builds on (most cited first, 27 of 27)

- [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)
- [BERT: Pre-training of Deep Bidirectional Transformers for Language Understanding](https://mlsanity.com/paper/1810.04805/) (2018)
- [Adam: A Method for Stochastic Optimization](https://mlsanity.com/paper/1412.6980/) (2014)
- [An Image is Worth 16x16 Words: Transformers for Image Recognition at Scale](https://mlsanity.com/paper/2010.11929/) (2020)
- [Denoising Diffusion Probabilistic Models](https://mlsanity.com/paper/2006.11239/) (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)
- [Denoising Diffusion Implicit Models](https://mlsanity.com/paper/2010.02502/) (2020)
- [Classifier-Free Diffusion Guidance](https://mlsanity.com/paper/2207.12598/) (2022)
- [Layer Normalization](https://mlsanity.com/paper/1607.06450/) (2016)
- [Mamba: Linear-Time Sequence Modeling with Selective State Spaces](https://mlsanity.com/paper/2312.00752/) (2023)
- [A ConvNet for the 2020s](https://mlsanity.com/paper/2201.03545/) (2022)
- [TransUNet: Transformers Make Strong Encoders for Medical Image Segmentation](https://mlsanity.com/paper/2102.04306/) (2021)
- [Group Normalization](https://mlsanity.com/paper/1803.08494/) (2018)
- [Transformers are SSMs: Generalized Models and Efficient Algorithms Through Structured State Space Duality](https://mlsanity.com/paper/2405.21060/) (2024)
- [Swin-Unet: Unet-like Pure Transformer for Medical Image Segmentation](https://mlsanity.com/paper/2105.05537/) (2021)
- [Vision Mamba: Efficient Visual Representation Learning with Bidirectional State Space Model](https://mlsanity.com/paper/2401.09417/) (2024)
- [VMamba: Visual State Space Model](https://mlsanity.com/paper/2401.10166/) (2024)
- [Conditional Image Generation with PixelCNN Decoders](https://mlsanity.com/paper/1606.05328/) (2016)
- [FFJORD: Free-form Continuous Dynamics for Scalable Reversible Generative Models](https://mlsanity.com/paper/1810.01367/) (2018)
- [The RSNA-ASNR-MICCAI BraTS 2021 Benchmark on Brain Tumor Segmentation and Radiogenomic Classification](https://mlsanity.com/paper/2107.02314/) (2021)
- [fastMRI: An Open Dataset and Benchmarks for Accelerated MRI](https://mlsanity.com/paper/1811.08839/) (2018)
- [FractalNet: Ultra-Deep Neural Networks without Residuals](https://mlsanity.com/paper/1605.07648/) (2016)
- [Skin Lesion Analysis toward Melanoma Detection: A Challenge at the International Symposium on Biomedical Imaging (ISBI) 2016, hosted by the International Skin Imaging Collaboration (ISIC)](https://mlsanity.com/paper/1605.01397/) (2016)
- [Mamba-UNet: UNet-Like Pure Visual Mamba for Medical Image Segmentation](https://mlsanity.com/paper/2402.05079/) (2024)
- [ImageCAS: A Large-Scale Dataset and Benchmark for Coronary Artery Segmentation based on Computed Tomography Angiography Images](https://mlsanity.com/paper/2211.01607/) (2022)

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

- [Hierarchical Feature Learning for Medical Point Clouds via State Space Model](https://mlsanity.com/paper/2504.13015/) (2025)
- [Adapting Foundation Models for Few-Shot Medical Image Segmentation: Actively and Sequentially](https://mlsanity.com/paper/2502.01000/) (2025)
- [High-Fidelity Medical Shape Generation via Skeletal Latent Diffusion](https://mlsanity.com/paper/2603.07504/) (2026)

## Abstract (arXiv)

As the rapid development of computer vision and the emergence of powerful network backbones and architectures, the application of deep learning in medical imaging has become increasingly significant. Unlike natural images, medical images lack huge volumes of data but feature more modalities, making it difficult to train a general model that has satisfactory performance across various datasets. In practice, practitioners often suffer from manually creating and testing models combining independent backbones and architectures, which is a laborious and time-consuming process. We propose Flemme, a FLExible and Modular learning platform for MEdical images. Our platform separates encoders from the model architectures so that different models can be constructed via various combinations of supported encoders and architectures. We construct encoders using building blocks based on convolution, transformer, and state-space model (SSM) to process both 2D and 3D image patches. A base architecture is implemented following an encoder-decoder style, with several derived architectures for image segmentation, reconstruction, and generation tasks. In addition, we propose a general hierarchical architecture incorporating a pyramid loss to optimize and fuse vertical features. Experiments demonstrate that this simple design leads to an average improvement of 5.60% in Dice score and 7.81% in mean interaction of units (mIoU) for segmentation models, as well as an enhancement of 5.57% in peak signal-to-noise ratio (PSNR) and 8.22% in structural similarity (SSIM) for reconstruction models. We further utilize Flemme as an analytical tool to assess the effectiveness and efficiency of various encoders across different tasks. Code is available at https://github.com/wlsdzyzl/flemme.