# DuoFormer: Leveraging Hierarchical Representations by Local and Global Attention Vision Transformer

arXiv: https://arxiv.org/abs/2506.12982 · HTML: https://mlsanity.com/paper/2506.12982/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 26 of its 33 references that are in the map.
- First posted on arXiv 15 Jun 2025.

## Builds on (most cited first, 26 of 26)

- [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)
- [Swin Transformer: Hierarchical Vision Transformer using Shifted Windows](https://mlsanity.com/paper/2103.14030/) (2021)
- [Training data-efficient image transformers & distillation through attention](https://mlsanity.com/paper/2012.12877/) (2020)
- [Deformable DETR: Deformable Transformers for End-to-End Object Detection](https://mlsanity.com/paper/2010.04159/) (2020)
- [CvT: Introducing Convolutions to Vision Transformers](https://mlsanity.com/paper/2103.15808/) (2021)
- [Do Vision Transformers See Like Convolutional Neural Networks?](https://mlsanity.com/paper/2108.08810/) (2021)
- [CoAtNet: Marrying Convolution and Attention for All Data Sizes](https://mlsanity.com/paper/2106.04803/) (2021)
- [TransMIL: Transformer based Correlated Multiple Instance Learning for Whole Slide Image Classification](https://mlsanity.com/paper/2106.00908/) (2021)
- [MViTv2: Improved Multiscale Vision Transformers for Classification and Detection](https://mlsanity.com/paper/2112.01526/) (2021)
- [ConViT: Improving Vision Transformers with Soft Convolutional Inductive Biases](https://mlsanity.com/paper/2103.10697/) (2021)
- [CMT: Convolutional Neural Networks Meet Vision Transformers](https://mlsanity.com/paper/2107.06263/) (2021)
- [Incorporating Convolution Designs into Visual Transformers](https://mlsanity.com/paper/2103.11816/) (2021)
- [Transformers in Medical Imaging: A Survey](https://mlsanity.com/paper/2201.09873/) (2022)
- [Co-Scale Conv-Attentional Image Transformers](https://mlsanity.com/paper/2104.06399/) (2021)
- [UCTransNet: Rethinking the Skip Connections in U-Net from a Channel-wise Perspective with Transformer](https://mlsanity.com/paper/2109.04335/) (2021)
- [Benchmarking Self-Supervised Learning on Diverse Pathology Datasets](https://mlsanity.com/paper/2212.04690/) (2022)
- [Vision Transformer for Small-Size Datasets](https://mlsanity.com/paper/2112.13492/) (2021)
- [Efficient Training of Visual Transformers with Small Datasets](https://mlsanity.com/paper/2106.03746/) (2021)
- [MedViT: A Robust Vision Transformer for Generalized Medical Image Classification](https://mlsanity.com/paper/2302.09462/) (2023)
- [Conv2Former: A Simple Transformer-Style ConvNet for Visual Recognition](https://mlsanity.com/paper/2211.11943/) (2022)
- [RMT: Retentive Networks Meet Vision Transformers](https://mlsanity.com/paper/2309.11523/) (2023)
- [Advances in Medical Image Analysis with Vision Transformers: A Comprehensive Review](https://mlsanity.com/paper/2301.03505/) (2023)
- [Scale-Aware Modulation Meet Transformer](https://mlsanity.com/paper/2307.08579/) (2023)
- [HIGT: Hierarchical Interaction Graph-Transformer for Whole Slide Image Analysis](https://mlsanity.com/paper/2309.07400/) (2023)
- [CLASS-M: Adaptive stain separation-based contrastive learning with pseudo-labeling for histopathological image classification](https://mlsanity.com/paper/2312.06978/) (2023)

## Abstract (arXiv)

Despite the widespread adoption of transformers in medical applications, the exploration of multi-scale learning through transformers remains limited, while hierarchical representations are considered advantageous for computer-aided medical diagnosis. We propose a novel hierarchical transformer model that adeptly integrates the feature extraction capabilities of Convolutional Neural Networks (CNNs) with the advanced representational potential of Vision Transformers (ViTs). Addressing the lack of inductive biases and dependence on extensive training datasets in ViTs, our model employs a CNN backbone to generate hierarchical visual representations. These representations are adapted for transformer input through an innovative patch tokenization process, preserving the inherited multi-scale inductive biases. We also introduce a scale-wise attention mechanism that directly captures intra-scale and inter-scale associations. This mechanism complements patch-wise attention by enhancing spatial understanding and preserving global perception, which we refer to as local and global attention, respectively. Our model significantly outperforms baseline models in terms of classification accuracy, demonstrating its efficiency in bridging the gap between Convolutional Neural Networks (CNNs) and Vision Transformers (ViTs). The components are designed as plug-and-play for different CNN architectures and can be adapted for multiple applications. The code is available at https://github.com/xiaoyatang/DuoFormer.git.