# BOTM: Echocardiography Segmentation via Bi-directional Optimal Token Matching

arXiv: https://arxiv.org/abs/2505.18052 · HTML: https://mlsanity.com/paper/2505.18052/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 23 of its 37 references that are in the map.
- First posted on arXiv 23 May 2025.

## Builds on (most cited first, 23 of 23)

- [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)
- [Segment Anything](https://mlsanity.com/paper/2304.02643/) (2023)
- [SegFormer: Simple and Efficient Design for Semantic Segmentation with Transformers](https://mlsanity.com/paper/2105.15203/) (2021)
- [Sinkhorn Distances: Lightspeed Computation of Optimal Transportation Distances](https://mlsanity.com/paper/1306.0895/) (2013)
- [SuperGlue: Learning Feature Matching with Graph Neural Networks](https://mlsanity.com/paper/1911.11763/) (2019)
- [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)
- [CrossViT: Cross-Attention Multi-Scale Vision Transformer for Image Classification](https://mlsanity.com/paper/2103.14899/) (2021)
- [Deep Learning for Segmentation using an Open Large-Scale Dataset in 2D Echocardiography](https://mlsanity.com/paper/1908.06948/) (2019)
- [Anatomically Constrained Neural Networks (ACNN): Application to Cardiac Image Enhancement and Segmentation](https://mlsanity.com/paper/1705.08302/) (2017)
- [SAM: Self-supervised Learning of Pixel-wise Anatomical Embeddings in Radiological Images](https://mlsanity.com/paper/2012.02383/) (2020)
- [DiffuseMorph: Unsupervised Deformable Image Registration Using Diffusion Model](https://mlsanity.com/paper/2112.05149/) (2021)
- [Cardiac Segmentation with Strong Anatomical Guarantees](https://mlsanity.com/paper/2006.08825/) (2020)
- [Beyond Adapting SAM: Towards End-to-End Ultrasound Image Segmentation via Auto Prompting](https://mlsanity.com/paper/2309.06824/) (2023)
- [Learning Super-Features for Image Retrieval](https://mlsanity.com/paper/2201.13182/) (2022)
- [Echocardiography Segmentation with Enforced Temporal Consistency](https://mlsanity.com/paper/2112.02102/) (2021)
- [Few Shot Medical Image Segmentation with Cross Attention Transformer](https://mlsanity.com/paper/2303.13867/) (2023)
- [Cyclical Self-Supervision for Semi-Supervised Ejection Fraction Prediction from Echocardiogram Videos](https://mlsanity.com/paper/2210.11291/) (2022)
- [CC-SAM: SAM with Cross-feature Attention and Context for Ultrasound Image Segmentation](https://mlsanity.com/paper/2408.00181/) (2024)
- [ACTION++: Improving Semi-supervised Medical Image Segmentation with Adaptive Anatomical Contrast](https://mlsanity.com/paper/2304.02689/) (2023)
- [Bidirectional Recurrence for Cardiac Motion Tracking with Gaussian Process Latent Coding](https://mlsanity.com/paper/2410.20752/) (2024)
- [GL-Fusion: Global-Local Fusion Network for Multi-view Echocardiogram Video Segmentation](https://mlsanity.com/paper/2309.11144/) (2023)

## Abstract (arXiv)

Existed echocardiography segmentation methods often suffer from anatomical inconsistency challenge caused by shape variation, partial observation and region ambiguity with similar intensity across 2D echocardiographic sequences, resulting in false positive segmentation with anatomical defeated structures in challenging low signal-to-noise ratio conditions. To provide a strong anatomical guarantee across different echocardiographic frames, we propose a novel segmentation framework named BOTM (Bi-directional Optimal Token Matching) that performs echocardiography segmentation and optimal anatomy transportation simultaneously. Given paired echocardiographic images, BOTM learns to match two sets of discrete image tokens by finding optimal correspondences from a novel anatomical transportation perspective. We further extend the token matching into a bi-directional cross-transport attention proxy to regulate the preserved anatomical consistency within the cardiac cyclic deformation in temporal domain. Extensive experimental results show that BOTM can generate stable and accurate segmentation outcomes (e.g. -1.917 HD on CAMUS2H LV, +1.9% Dice on TED), and provide a better matching interpretation with anatomical consistency guarantee.