# A Reverse Mamba Attention Network for Pathological Liver Segmentation

arXiv: https://arxiv.org/abs/2502.18232 · HTML: https://mlsanity.com/paper/2502.18232/

## Key facts

- Cited by 3 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 34 of its 53 references that are in the map.
- First posted on arXiv 23 Feb 2025.

## 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 34)

- [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)
- [Mamba: Linear-Time Sequence Modeling with Selective State Spaces](https://mlsanity.com/paper/2312.00752/) (2023)
- [Efficiently Modeling Long Sequences with Structured State Spaces](https://mlsanity.com/paper/2111.00396/) (2021)
- [VMamba: Visual State Space Model](https://mlsanity.com/paper/2401.10166/) (2024)
- [Simplified State Space Layers for Sequence Modeling](https://mlsanity.com/paper/2208.04933/) (2022)
- [Combining Recurrent, Convolutional, and Continuous-time Models with Linear State-Space Layers](https://mlsanity.com/paper/2110.13985/) (2021)
- [The Liver Tumor Segmentation Benchmark (LiTS)](https://mlsanity.com/paper/1901.04056/) (2019)
- [Hungry Hungry Hippos: Towards Language Modeling with State Space Models](https://mlsanity.com/paper/2212.14052/) (2022)
- [PraNet: Parallel Reverse Attention Network for Polyp Segmentation](https://mlsanity.com/paper/2006.11392/) (2020)
- [Diagonal State Spaces are as Effective as Structured State Spaces](https://mlsanity.com/paper/2203.14343/) (2022)
- [VM-UNet: Vision Mamba UNet for Medical Image Segmentation](https://mlsanity.com/paper/2402.02491/) (2024)
- [Long Range Language Modeling via Gated State Spaces](https://mlsanity.com/paper/2206.13947/) (2022)
- [ResUNet++: An Advanced Architecture for Medical Image Segmentation](https://mlsanity.com/paper/1911.07067/) (2019)
- [UNeXt: MLP-based Rapid Medical Image Segmentation Network](https://mlsanity.com/paper/2203.04967/) (2022)
- [Swin-UMamba: Mamba-based UNet with ImageNet-based pretraining](https://mlsanity.com/paper/2402.03302/) (2024)
- [Mamba-UNet: UNet-Like Pure Visual Mamba for Medical Image Segmentation](https://mlsanity.com/paper/2402.05079/) (2024)
- [DoubleU-Net: A Deep Convolutional Neural Network for Medical Image Segmentation](https://mlsanity.com/paper/2006.04868/) (2020)
- [Reverse Attention for Salient Object Detection](https://mlsanity.com/paper/1807.09940/) (2018)
- [Selective Structured State-Spaces for Long-Form Video Understanding](https://mlsanity.com/paper/2303.14526/) (2023)
- [UltraLight VM-UNet: Parallel Vision Mamba Significantly Reduces Parameters for Skin Lesion Segmentation](https://mlsanity.com/paper/2403.20035/) (2024)
- [Automatic Liver and Lesion Segmentation in CT Using Cascaded Fully Convolutional Neural Networks and 3D Conditional Random Fields](https://mlsanity.com/paper/1610.02177/) (2016)
- [RA-UNet: A hybrid deep attention-aware network to extract liver and tumor in CT scans](https://mlsanity.com/paper/1811.01328/) (2018)
- [VM-UNET-V2 Rethinking Vision Mamba UNet for Medical Image Segmentation](https://mlsanity.com/paper/2403.09157/) (2024)
- [Bilateral Attention Network for RGB-D Salient Object Detection](https://mlsanity.com/paper/2004.14582/) (2020)
- [TransNetR: Transformer-based Residual Network for Polyp Segmentation with Multi-Center Out-of-Distribution Testing](https://mlsanity.com/paper/2303.07428/) (2023)
- [TransResU-Net: Transformer based ResU-Net for Real-Time Colonoscopy Polyp Segmentation](https://mlsanity.com/paper/2206.08985/) (2022)
- [NanoNet: Real-Time Polyp Segmentation in Video Capsule Endoscopy and Colonoscopy](https://mlsanity.com/paper/2104.11138/) (2021)
- [Large Scale MRI Collection and Segmentation of Cirrhotic Liver](https://mlsanity.com/paper/2410.16296/) (2024)
- [SAR-U-Net: squeeze-and-excitation block and atrous spatial pyramid pooling based residual U-Net for automatic liver segmentation in Computed Tomography](https://mlsanity.com/paper/2103.06419/) (2021)

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

- [When CNNs Outperform Transformers and Mambas: Revisiting Deep Architectures for Dental Caries Segmentation](https://mlsanity.com/paper/2511.14860/) (2025)
- [FocusNet: Transformer-enhanced Polyp Segmentation with Local and Pooling Attention](https://mlsanity.com/paper/2504.13597/) (2025)
- [SRMA-Mamba: Spatial Reverse Mamba Attention Network for Pathological Liver Segmentation in MRI Volumes](https://mlsanity.com/paper/2508.12410/) (2025)

## Abstract (arXiv)

We present RMA-Mamba, a novel architecture that advances the capabilities of vision state space models through a specialized reverse mamba attention module (RMA). The key innovation lies in RMA-Mamba's ability to capture long-range dependencies while maintaining precise local feature representation through its hierarchical processing pipeline. By integrating Vision Mamba (VMamba)'s efficient sequence modeling with RMA's targeted feature refinement, our architecture achieves superior feature learning across multiple scales. This dual-mechanism approach enables robust handling of complex morphological patterns while maintaining computational efficiency. We demonstrate RMA-Mamba's effectiveness in the challenging domain of pathological liver segmentation (from both CT and MRI), where traditional segmentation approaches often fail due to tissue variations. When evaluated on a newly introduced cirrhotic liver dataset (CirrMRI600+) of T2-weighted MRI scans, RMA-Mamba achieves the state-of-the-art performance with a Dice coefficient of 92.08%, mean IoU of 87.36%, and recall of 92.96%. The architecture's generalizability is further validated on the cancerous liver segmentation from CT scans (LiTS: Liver Tumor Segmentation dataset), yielding a Dice score of 92.9% and mIoU of 88.99%. Our code is available for public: https://github.com/JunZengz/RMAMamba.