# ACM-UNet: Adaptive Integration of CNNs and Mamba for Efficient Medical Image Segmentation

arXiv: https://arxiv.org/abs/2505.24481 · HTML: https://mlsanity.com/paper/2505.24481/

## Key facts

- No citing papers in the map yet (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 37 of its 54 references that are in the map.
- First posted on arXiv 30 May 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 37)

- [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)
- [MobileNets: Efficient Convolutional Neural Networks for Mobile Vision Applications](https://mlsanity.com/paper/1704.04861/) (2017)
- [DeepLab: Semantic Image Segmentation with Deep Convolutional Nets, Atrous Convolution, and Fully Connected CRFs](https://mlsanity.com/paper/1606.00915/) (2016)
- [Encoder-Decoder with Atrous Separable Convolution for Semantic Image Segmentation](https://mlsanity.com/paper/1802.02611/) (2018)
- [Efficiently Modeling Long Sequences with Structured State Spaces](https://mlsanity.com/paper/2111.00396/) (2021)
- [Rethinking Atrous Convolution for Semantic Image Segmentation](https://mlsanity.com/paper/1706.05587/) (2017)
- [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)
- [Deformable Convolutional Networks](https://mlsanity.com/paper/1703.06211/) (2017)
- [Swin-Unet: Unet-like Pure Transformer for Medical Image Segmentation](https://mlsanity.com/paper/2105.05537/) (2021)
- [VMamba: Visual State Space Model](https://mlsanity.com/paper/2401.10166/) (2024)
- [PVT v2: Improved Baselines with Pyramid Vision Transformer](https://mlsanity.com/paper/2106.13797/) (2021)
- [Semantic Image Segmentation with Deep Convolutional Nets and Fully Connected CRFs](https://mlsanity.com/paper/1412.7062/) (2014)
- [On the Parameterization and Initialization of Diagonal State Space Models](https://mlsanity.com/paper/2206.11893/) (2022)
- [Dynamic Convolution: Attention over Convolution Kernels](https://mlsanity.com/paper/1912.03458/) (2019)
- [VM-UNet: Vision Mamba UNet for Medical Image Segmentation](https://mlsanity.com/paper/2402.02491/) (2024)
- [CondConv: Conditionally Parameterized Convolutions for Efficient Inference](https://mlsanity.com/paper/1904.04971/) (2019)
- [TransFuse: Fusing Transformers and CNNs for Medical Image Segmentation](https://mlsanity.com/paper/2102.08005/) (2021)
- [Swin-UMamba: Mamba-based UNet with ImageNet-based pretraining](https://mlsanity.com/paper/2402.03302/) (2024)
- [MixConv: Mixed Depthwise Convolutional Kernels](https://mlsanity.com/paper/1907.09595/) (2019)
- [Advancing Pose-Guided Image Synthesis with Progressive Conditional Diffusion Models](https://mlsanity.com/paper/2310.06313/) (2023)
- [IMAGDressing-v1: Customizable Virtual Dressing](https://mlsanity.com/paper/2407.12705/) (2024)
- [LeViT-UNet: Make Faster Encoders with Transformer for Medical Image Segmentation](https://mlsanity.com/paper/2107.08623/) (2021)
- [Wavelet Convolutions for Large Receptive Fields](https://mlsanity.com/paper/2407.05848/) (2024)
- [Long-Term TalkingFace Generation via Motion-Prior Conditional Diffusion Model](https://mlsanity.com/paper/2502.09533/) (2025)
- [IMAGGarment: Fine-Grained Garment Generation for Controllable Fashion Design](https://mlsanity.com/paper/2504.13176/) (2025)

## Abstract (arXiv)

The U-shaped encoder-decoder architecture with skip connections has become a prevailing paradigm in medical image segmentation due to its simplicity and effectiveness. While many recent works aim to improve this framework by designing more powerful encoders and decoders, employing advanced convolutional neural networks (CNNs) for local feature extraction, Transformers or state space models (SSMs) such as Mamba for global context modeling, or hybrid combinations of both, these methods often struggle to fully utilize pretrained vision backbones (e.g., ResNet, ViT, VMamba) due to structural mismatches. To bridge this gap, we introduce ACM-UNet, a general-purpose segmentation framework that retains a simple UNet-like design while effectively incorporating pretrained CNNs and Mamba models through a lightweight adapter mechanism. This adapter resolves architectural incompatibilities and enables the model to harness the complementary strengths of CNNs and SSMs-namely, fine-grained local detail extraction and long-range dependency modeling. Additionally, we propose a hierarchical multi-scale wavelet transform module in the decoder to enhance feature fusion and reconstruction fidelity. Extensive experiments on the Synapse and ACDC benchmarks demonstrate that ACM-UNet achieves state-of-the-art performance while remaining computationally efficient. Notably, it reaches 85.12% Dice Score and 13.89mm HD95 on the Synapse dataset with 17.93G FLOPs, showcasing its effectiveness and scalability. Code is available at: https://github.com/zyklcode/ACM-UNet.