# RotCAtt-TransUNet++: Novel Deep Neural Network for Sophisticated Cardiac Segmentation

arXiv: https://arxiv.org/abs/2409.05280 · HTML: https://mlsanity.com/paper/2409.05280/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 28 of its 35 references that are in the map.
- First posted on arXiv 9 Sep 2024.

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

- [Attention Is All You Need](https://mlsanity.com/paper/1706.03762/) (2017)
- [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)
- [Fully Convolutional Networks for Semantic Segmentation](https://mlsanity.com/paper/1411.4038/) (2014)
- [Squeeze-and-Excitation Networks](https://mlsanity.com/paper/1709.01507/) (2017)
- [Pyramid Scene Parsing Network](https://mlsanity.com/paper/1612.01105/) (2016)
- [CBAM: Convolutional Block Attention Module](https://mlsanity.com/paper/1807.06521/) (2018)
- [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)
- [UNet++: A Nested U-Net Architecture for Medical Image Segmentation](https://mlsanity.com/paper/1807.10165/) (2018)
- [3D U-Net: Learning Dense Volumetric Segmentation from Sparse Annotation](https://mlsanity.com/paper/1606.06650/) (2016)
- [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)
- [UNETR: Transformers for 3D Medical Image Segmentation](https://mlsanity.com/paper/2103.10504/) (2021)
- [ECA-Net: Efficient Channel Attention for Deep Convolutional Neural Networks](https://mlsanity.com/paper/1910.03151/) (2019)
- [Attention Gated Networks: Learning to Leverage Salient Regions in Medical Images](https://mlsanity.com/paper/1808.08114/) (2018)
- [ResUNet-a: a deep learning framework for semantic segmentation of remotely sensed data](https://mlsanity.com/paper/1904.00592/) (2019)
- [Deep learning for cardiac image segmentation: A review](https://mlsanity.com/paper/1911.03723/) (2019)
- [A General Survey on Attention Mechanisms in Deep Learning](https://mlsanity.com/paper/2203.14263/) (2022)
- [ImageCAS: A Large-Scale Dataset and Benchmark for Coronary Artery Segmentation based on Computed Tomography Angiography Images](https://mlsanity.com/paper/2211.01607/) (2022)
- [TransNorm: Transformer Provides a Strong Spatial Normalization Mechanism for a Deep Segmentation Model](https://mlsanity.com/paper/2207.13415/) (2022)
- [Attention Swin U-Net: Cross-Contextual Attention Mechanism for Skin Lesion Segmentation](https://mlsanity.com/paper/2210.16898/) (2022)
- [A Fully Convolutional Neural Network for Cardiac Segmentation in Short-Axis MRI](https://mlsanity.com/paper/1604.00494/) (2016)
- [ImageCHD: A 3D Computed Tomography Image Dataset for Classification of Congenital Heart Disease](https://mlsanity.com/paper/2101.10799/) (2021)
- [A survey on attention mechanisms for medical applications: are we moving towards better algorithms?](https://mlsanity.com/paper/2204.12406/) (2022)
- [Left-Center-Right Separated Neural Network for Aspect-based Sentiment Analysis with Rotatory Attention](https://mlsanity.com/paper/1802.00892/) (2018)
- [U-Netmer: U-Net meets Transformer for medical image segmentation](https://mlsanity.com/paper/2304.01401/) (2023)
- [Cardiac Segmentation on CT Images through Shape-Aware Contour Attentions](https://mlsanity.com/paper/2105.13153/) (2021)

## Abstract (arXiv)

Cardiovascular disease remains a predominant global health concern, responsible for a significant portion of mortality worldwide. Accurate segmentation of cardiac medical imaging data is pivotal in mitigating fatality rates associated with cardiovascular conditions. However, existing state-of-the-art (SOTA) neural networks, including both CNN-based and Transformer-based approaches, exhibit limitations in practical applicability due to their inability to effectively capture inter-slice connections alongside intra-slice information. This deficiency is particularly evident in datasets featuring intricate, long-range details along the z-axis, such as coronary arteries in axial views. Additionally, SOTA methods fail to differentiate non-cardiac components from myocardium in segmentation, leading to the "spraying" phenomenon. To address these challenges, we present RotCAtt-TransUNet++, a novel architecture tailored for robust segmentation of complex cardiac structures. Our approach emphasizes modeling global contexts by aggregating multiscale features with nested skip connections in the encoder. It integrates transformer layers to capture interactions between patches and employs a rotatory attention mechanism to capture connectivity between multiple slices (inter-slice information). Additionally, a channel-wise cross-attention gate guides the fused multi-scale channel-wise information and features from decoder stages to bridge semantic gaps. Experimental results demonstrate that our proposed model outperforms existing SOTA approaches across four cardiac datasets and one abdominal dataset. Importantly, coronary arteries and myocardium are annotated with near-perfect accuracy during inference. An ablation study shows that the rotatory attention mechanism effectively transforms embedded vectorized patches in the semantic dimensional space, enhancing segmentation accuracy.