# Shaken or Stirred? An Analysis of MetaFormer's Token Mixing for Medical Imaging

arXiv: https://arxiv.org/abs/2510.05971 · HTML: https://mlsanity.com/paper/2510.05971/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 45 of its 70 references that are in the map.
- First posted on arXiv 7 Oct 2025.

## Builds on (most cited first, 30 of 45)

- [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)
- [BERT: Pre-training of Deep Bidirectional Transformers for Language Understanding](https://mlsanity.com/paper/1810.04805/) (2018)
- [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)
- [DINOv2: Learning Robust Visual Features without Supervision](https://mlsanity.com/paper/2304.07193/) (2023)
- [End-to-End Object Detection with Transformers](https://mlsanity.com/paper/2005.12872/) (2020)
- [SGDR: Stochastic Gradient Descent with Warm Restarts](https://mlsanity.com/paper/1608.03983/) (2016)
- [MobileNets: Efficient Convolutional Neural Networks for Mobile Vision Applications](https://mlsanity.com/paper/1704.04861/) (2017)
- [FlashAttention: Fast and Memory-Efficient Exact Attention with IO-Awareness](https://mlsanity.com/paper/2205.14135/) (2022)
- [A ConvNet for the 2020s](https://mlsanity.com/paper/2201.03545/) (2022)
- [Deformable DETR: Deformable Transformers for End-to-End Object Detection](https://mlsanity.com/paper/2010.04159/) (2020)
- [SegFormer: Simple and Efficient Design for Semantic Segmentation with Transformers](https://mlsanity.com/paper/2105.15203/) (2021)
- [Pyramid Vision Transformer: A Versatile Backbone for Dense Prediction without Convolutions](https://mlsanity.com/paper/2102.12122/) (2021)
- [MLP-Mixer: An all-MLP Architecture for Vision](https://mlsanity.com/paper/2105.01601/) (2021)
- [Vision Mamba: Efficient Visual Representation Learning with Bidirectional State Space Model](https://mlsanity.com/paper/2401.09417/) (2024)
- [Deep Networks with Stochastic Depth](https://mlsanity.com/paper/1603.09382/) (2016)
- [Vision Transformers Need Registers](https://mlsanity.com/paper/2309.16588/) (2023)
- [Going deeper with Image Transformers](https://mlsanity.com/paper/2103.17239/) (2021)
- [MedMNIST v2 -- A large-scale lightweight benchmark for 2D and 3D biomedical image classification](https://mlsanity.com/paper/2110.14795/) (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)
- [The Medical Segmentation Decathlon](https://mlsanity.com/paper/2106.05735/) (2021)
- [MetaFormer Is Actually What You Need for Vision](https://mlsanity.com/paper/2111.11418/) (2021)
- [The Liver Tumor Segmentation Benchmark (LiTS)](https://mlsanity.com/paper/1901.04056/) (2019)
- [ConViT: Improving Vision Transformers with Soft Convolutional Inductive Biases](https://mlsanity.com/paper/2103.10697/) (2021)
- [Scaling Local Self-Attention for Parameter Efficient Visual Backbones](https://mlsanity.com/paper/2103.12731/) (2021)
- [MedNeXt: Transformer-driven Scaling of ConvNets for Medical Image Segmentation](https://mlsanity.com/paper/2303.09975/) (2023)
- [MetaFormer Baselines for Vision](https://mlsanity.com/paper/2210.13452/) (2022)
- [Exploring scalable medical image encoders beyond text supervision](https://mlsanity.com/paper/2401.10815/) (2024)

## Abstract (arXiv)

The generalization of the Transformer architecture via MetaFormer has reshaped our understanding of its success in computer vision. By replacing self-attention with simpler token mixers, MetaFormer provides strong baselines for vision tasks. However, while extensively studied on natural image datasets, its use in medical imaging remains scarce, and existing works rarely compare different token mixers, potentially overlooking more suitable designs choices. In this work, we present the first comprehensive study of token mixers for medical imaging. We systematically analyze pooling-, convolution-, and attention-based token mixers within the MetaFormer architecture on image classification (global prediction task) and semantic segmentation (dense prediction task). Our evaluation spans nine datasets (seven 2D and two 3D) covering diverse modalities and common challenges in the medical domain. Given the prevalence of pretraining from natural images to mitigate medical data scarcity, we also examine transferring pretrained weights to new token mixers. Our results show that, for classification, low-complexity token mixers (e.g. grouped convolution or pooling) are sufficient, aligning with findings on natural images. Pretrained weights remain useful in some settings despite the domain gap introduced by the new token mixer. For segmentation, we find that the local inductive bias of convolutional token mixers is essential. Grouped convolutions emerge as the preferred choice, as they reduce runtime and parameter count compared to standard convolutions, while the MetaFormer's channel-MLPs already provide the necessary cross-channel interactions.