# MLLA-UNet: Mamba-like Linear Attention in an Efficient U-Shape Model for Medical Image Segmentation

arXiv: https://arxiv.org/abs/2410.23738 · HTML: https://mlsanity.com/paper/2410.23738/

## Key facts

- Cited by 2 papers in the map (data through 14 Oct 2026).
- Placed in Mamba for medical image analysis, one of 10 directions in State-space sequence models (S4, Mamba).
- Builds on 54 of its 72 references that are in the map.
- First posted on arXiv 31 Oct 2024.

## Placed in

- State-space sequence models (S4, Mamba) / [Mamba for medical image analysis](https://mlsanity.com/ssm/mamba-for-medical-image-analysis/)

## Builds on (most cited first, 30 of 54)

- [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)
- [Scaling Laws for Neural Language Models](https://mlsanity.com/paper/2001.08361/) (2020)
- [Fully Convolutional Networks for Semantic Segmentation](https://mlsanity.com/paper/1411.4038/) (2014)
- [RoFormer: Enhanced Transformer with Rotary Position Embedding](https://mlsanity.com/paper/2104.09864/) (2021)
- [V-Net: Fully Convolutional Neural Networks for Volumetric Medical Image Segmentation](https://mlsanity.com/paper/1606.04797/) (2016)
- [Transformers are RNNs: Fast Autoregressive Transformers with Linear Attention](https://mlsanity.com/paper/2006.16236/) (2020)
- [TransUNet: Transformers Make Strong Encoders for Medical Image Segmentation](https://mlsanity.com/paper/2102.04306/) (2021)
- [Inception-v4, Inception-ResNet and the Impact of Residual Connections on Learning](https://mlsanity.com/paper/1602.07261/) (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)
- [A Survey on Deep Learning in Medical Image Analysis](https://mlsanity.com/paper/1702.05747/) (2017)
- [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)
- [UNETR: Transformers for 3D Medical Image Segmentation](https://mlsanity.com/paper/2103.10504/) (2021)
- [ConvNeXt V2: Co-designing and Scaling ConvNets with Masked Autoencoders](https://mlsanity.com/paper/2301.00808/) (2023)
- [CoAtNet: Marrying Convolution and Attention for All Data Sizes](https://mlsanity.com/paper/2106.04803/) (2021)
- [CSWin Transformer: A General Vision Transformer Backbone with Cross-Shaped Windows](https://mlsanity.com/paper/2107.00652/) (2021)
- [Self-Supervised Pre-Training of Swin Transformers for 3D Medical Image Analysis](https://mlsanity.com/paper/2111.14791/) (2021)
- [U-Mamba: Enhancing Long-range Dependency for Biomedical Image Segmentation](https://mlsanity.com/paper/2401.04722/) (2024)
- [Conditional Positional Encodings for Vision Transformers](https://mlsanity.com/paper/2102.10882/) (2021)
- [AMOS: A Large-Scale Abdominal Multi-Organ Benchmark for Versatile Medical Image Segmentation](https://mlsanity.com/paper/2206.08023/) (2022)
- [CMT: Convolutional Neural Networks Meet Vision Transformers](https://mlsanity.com/paper/2107.06263/) (2021)
- [VM-UNet: Vision Mamba UNet for Medical Image Segmentation](https://mlsanity.com/paper/2402.02491/) (2024)
- [nnU-Net Revisited: A Call for Rigorous Validation in 3D Medical Image Segmentation](https://mlsanity.com/paper/2404.09556/) (2024)
- [LocalMamba: Visual State Space Model with Windowed Selective Scan](https://mlsanity.com/paper/2403.09338/) (2024)
- [ViTAE: Vision Transformer Advanced by Exploring Intrinsic Inductive Bias](https://mlsanity.com/paper/2106.03348/) (2021)

## Built on by (most cited first, 2 of 2)

- [UNet with Self-Adaptive Mamba-Like Attention and Causal-Resonance Learning for Medical Image Segmentation](https://mlsanity.com/paper/2505.15234/) (2025)
- [USEMA: a Scalable Efficient Mamba Like Attention for Medical Image Segmentation](https://mlsanity.com/paper/2605.11131/) (2026)

## Abstract (arXiv)

Recent advancements in medical imaging have resulted in more complex and diverse images, with challenges such as high anatomical variability, blurred tissue boundaries, low organ contrast, and noise. Traditional segmentation methods struggle to address these challenges, making deep learning approaches, particularly U-shaped architectures, increasingly prominent. However, the quadratic complexity of standard self-attention makes Transformers computationally prohibitive for high-resolution images. To address these challenges, we propose MLLA-UNet (Mamba-Like Linear Attention UNet), a novel architecture that achieves linear computational complexity while maintaining high segmentation accuracy through its innovative combination of linear attention and Mamba-inspired adaptive mechanisms, complemented by an efficient symmetric sampling structure for enhanced feature processing. Our architecture effectively preserves essential spatial features while capturing long-range dependencies at reduced computational complexity. Additionally, we introduce a novel sampling strategy for multi-scale feature fusion. Experiments demonstrate that MLLA-UNet achieves state-of-the-art performance on six challenging datasets with 24 different segmentation tasks, including but not limited to FLARE22, AMOS CT, and ACDC, with an average DSC of 88.32%. These results underscore the superiority of MLLA-UNet over existing methods. Our contributions include the novel 2D segmentation architecture and its empirical validation. The code is available via https://github.com/csyfjiang/MLLA-UNet.