# TCSAFormer: Efficient Vision Transformer with Token Compression and Sparse Attention for Medical Image Segmentation

arXiv: https://arxiv.org/abs/2508.04058 · HTML: https://mlsanity.com/paper/2508.04058/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 30 of its 43 references that are in the map.
- First posted on arXiv 6 Aug 2025.

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

- [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)
- [Grad-CAM: Visual Explanations from Deep Networks via Gradient-based Localization](https://mlsanity.com/paper/1610.02391/) (2016)
- [SegFormer: Simple and Efficient Design for Semantic Segmentation with Transformers](https://mlsanity.com/paper/2105.15203/) (2021)
- [Pyramid Scene Parsing Network](https://mlsanity.com/paper/1612.01105/) (2016)
- [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)
- [Swin-Unet: Unet-like Pure Transformer for Medical Image Segmentation](https://mlsanity.com/paper/2105.05537/) (2021)
- [Token Merging: Your ViT But Faster](https://mlsanity.com/paper/2210.09461/) (2022)
- [DynamicViT: Efficient Vision Transformers with Dynamic Token Sparsification](https://mlsanity.com/paper/2106.02034/) (2021)
- [PVT v2: Improved Baselines with Pyramid Vision Transformer](https://mlsanity.com/paper/2106.13797/) (2021)
- [Skin Lesion Analysis Toward Melanoma Detection 2018: A Challenge Hosted by the International Skin Imaging Collaboration (ISIC)](https://mlsanity.com/paper/1902.03368/) (2019)
- [U-Mamba: Enhancing Long-range Dependency for Biomedical Image Segmentation](https://mlsanity.com/paper/2401.04722/) (2024)
- [AMOS: A Large-Scale Abdominal Multi-Organ Benchmark for Versatile Medical Image Segmentation](https://mlsanity.com/paper/2206.08023/) (2022)
- [AdaViT: Adaptive Vision Transformers for Efficient Image Recognition](https://mlsanity.com/paper/2111.15668/) (2021)
- [CE-Net: Context Encoder Network for 2D Medical Image Segmentation](https://mlsanity.com/paper/1903.02740/) (2019)
- [U-KAN Makes Strong Backbone for Medical Image Segmentation and Generation](https://mlsanity.com/paper/2406.02918/) (2024)
- [BiFormer: Vision Transformer with Bi-Level Routing Attention](https://mlsanity.com/paper/2303.08810/) (2023)
- [Patch Slimming for Efficient Vision Transformers](https://mlsanity.com/paper/2106.02852/) (2021)
- [DS-TransUNet:Dual Swin Transformer U-Net for Medical Image Segmentation](https://mlsanity.com/paper/2106.06716/) (2021)
- [Mixed Transformer U-Net For Medical Image Segmentation](https://mlsanity.com/paper/2111.04734/) (2021)
- [KVT: k-NN Attention for Boosting Vision Transformers](https://mlsanity.com/paper/2106.00515/) (2021)
- [Explicit Sparse Transformer: Concentrated Attention Through Explicit Selection](https://mlsanity.com/paper/1912.11637/) (2019)
- [Advances in Medical Image Analysis with Vision Transformers: A Comprehensive Review](https://mlsanity.com/paper/2301.03505/) (2023)
- [MSRF-Net: A Multi-Scale Residual Fusion Network for Biomedical Image Segmentation](https://mlsanity.com/paper/2105.07451/) (2021)
- [DCSAU-Net: A Deeper and More Compact Split-Attention U-Net for Medical Image Segmentation](https://mlsanity.com/paper/2202.00972/) (2022)
- [Accelerating Transformers with Spectrum-Preserving Token Merging](https://mlsanity.com/paper/2405.16148/) (2024)
- [ALGM: Adaptive Local-then-Global Token Merging for Efficient Semantic Segmentation with Plain Vision Transformers](https://mlsanity.com/paper/2406.09936/) (2024)
- [BRAU-Net++: U-Shaped Hybrid CNN-Transformer Network for Medical Image Segmentation](https://mlsanity.com/paper/2401.00722/) (2024)
- [Pubic Symphysis-Fetal Head Segmentation Network Using BiFormer Attention Mechanism and Multipath Dilated Convolution](https://mlsanity.com/paper/2410.10352/) (2024)

## Abstract (arXiv)

In recent years, transformer-based methods have achieved remarkable progress in medical image segmentation due to their superior ability to capture long-range dependencies. However, these methods typically suffer from two major limitations. First, their computational complexity scales quadratically with the input sequences. Second, the feed-forward network (FFN) modules in vanilla Transformers typically rely on fully connected layers, which limits models' ability to capture local contextual information and multiscale features critical for precise semantic segmentation. To address these issues, we propose an efficient medical image segmentation network, named TCSAFormer. The proposed TCSAFormer adopts two key ideas. First, it incorporates a Compressed Attention (CA) module, which combines token compression and pixel-level sparse attention to dynamically focus on the most relevant key-value pairs for each query. This is achieved by pruning globally irrelevant tokens and merging redundant ones, significantly reducing computational complexity while enhancing the model's ability to capture relationships between tokens. Second, it introduces a Dual-Branch Feed-Forward Network (DBFFN) module as a replacement for the standard FFN to capture local contextual features and multiscale information, thereby strengthening the model's feature representation capability. We conduct extensive experiments on three publicly available medical image segmentation datasets: ISIC-2018, CVC-ClinicDB, and Synapse, to evaluate the segmentation performance of TCSAFormer. Experimental results demonstrate that TCSAFormer achieves superior performance compared to existing state-of-the-art (SOTA) methods, while maintaining lower computational overhead, thus achieving an optimal trade-off between efficiency and accuracy.