# Focal Modulation and Bidirectional Feature Fusion Network for Medical Image Segmentation

arXiv: https://arxiv.org/abs/2510.20933 · HTML: https://mlsanity.com/paper/2510.20933/

## Key facts

- Cited by 1 papers in the map (data through 14 Oct 2026).
- Builds on 41 of its 80 references that are in the map.
- First posted on arXiv 23 Oct 2025.

## Builds on (most cited first, 30 of 41)

- [Attention Is All You Need](https://mlsanity.com/paper/1706.03762/) (2017)
- [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)
- [Training data-efficient image transformers & distillation through attention](https://mlsanity.com/paper/2012.12877/) (2020)
- [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)
- [Attention U-Net: Learning Where to Look for the Pancreas](https://mlsanity.com/paper/1804.03999/) (2018)
- [Rethinking Semantic Segmentation from a Sequence-to-Sequence Perspective with Transformers](https://mlsanity.com/paper/2012.15840/) (2020)
- [Swin-Unet: Unet-like Pure Transformer for Medical Image Segmentation](https://mlsanity.com/paper/2105.05537/) (2021)
- [UNet++: Redesigning Skip Connections to Exploit Multiscale Features in Image Segmentation](https://mlsanity.com/paper/1912.05074/) (2019)
- [CoAtNet: Marrying Convolution and Attention for All Data Sizes](https://mlsanity.com/paper/2106.04803/) (2021)
- [TransReID: Transformer-based Object Re-Identification](https://mlsanity.com/paper/2102.04378/) (2021)
- [Bottleneck Transformers for Visual Recognition](https://mlsanity.com/paper/2101.11605/) (2021)
- [Embracing Imperfect Datasets: A Review of Deep Learning Solutions for Medical Image Segmentation](https://mlsanity.com/paper/1908.10454/) (2019)
- [TransFuse: Fusing Transformers and CNNs for Medical Image Segmentation](https://mlsanity.com/paper/2102.08005/) (2021)
- [CoTr: Efficiently Bridging CNN and Transformer for 3D Medical Image Segmentation](https://mlsanity.com/paper/2103.03024/) (2021)
- [Inf-Net: Automatic COVID-19 Lung Infection Segmentation from CT Images](https://mlsanity.com/paper/2004.14133/) (2020)
- [CrossFormer: A Versatile Vision Transformer Hinging on Cross-scale Attention](https://mlsanity.com/paper/2108.00154/) (2021)
- [UTNet: A Hybrid Transformer Architecture for Medical Image Segmentation](https://mlsanity.com/paper/2107.00781/) (2021)
- [A Survey on Instance Segmentation: State of the art](https://mlsanity.com/paper/2007.00047/) (2020)
- [Bi-Directional ConvLSTM U-Net with Densley Connected Convolutions](https://mlsanity.com/paper/1909.00166/) (2019)
- [ResT: An Efficient Transformer for Visual Recognition](https://mlsanity.com/paper/2105.13677/) (2021)
- [Joint Optic Disc and Cup Segmentation Based on Multi-label Deep Network and Polar Transformation](https://mlsanity.com/paper/1801.00926/) (2018)
- [AFTer-UNet: Axial Fusion Transformer UNet for Medical Image Segmentation](https://mlsanity.com/paper/2110.10403/) (2021)
- [Using DUCK-Net for Polyp Image Segmentation](https://mlsanity.com/paper/2311.02239/) (2023)
- [Retinal Vessel Segmentation via a Multi-resolution Contextual Network and Adversarial Learning](https://mlsanity.com/paper/2304.12856/) (2023)
- [RC-Net: A Convolutional Neural Network for Retinal Vessel Segmentation](https://mlsanity.com/paper/2112.11078/) (2021)
- [Feature Enhancer Segmentation Network (FES-Net) for Vessel Segmentation](https://mlsanity.com/paper/2309.03535/) (2023)
- [ESDMR-Net: A Lightweight Network With Expand-Squeeze and Dual Multiscale Residual Connections for Medical Image Segmentation](https://mlsanity.com/paper/2312.10585/) (2023)
- [Advancing Medical Image Segmentation with Mini-Net: A Lightweight Solution Tailored for Efficient Segmentation of Medical Images](https://mlsanity.com/paper/2405.17520/) (2024)

## Built on by (most cited first, 1 of 1)

- [MS-DKC: A Dataset Knowledge Card Framework for Designing and Adapting Medical Image Segmentation Models](https://mlsanity.com/paper/2606.06103/) (2026)

## Abstract (arXiv)

Medical image segmentation is essential for clinical applications such as disease diagnosis, treatment planning, and disease development monitoring because it provides precise morphological and spatial information on anatomical structures that directly influence treatment decisions. Convolutional neural networks significantly impact image segmentation; however, since convolution operations are local, capturing global contextual information and long-range dependencies is still challenging. Their capacity to precisely segment structures with complicated borders and a variety of sizes is impacted by this restriction. Since transformers use self-attention methods to capture global context and long-range dependencies efficiently, integrating transformer-based architecture with CNNs is a feasible approach to overcoming these challenges. To address these challenges, we propose the Focal Modulation and Bidirectional Feature Fusion Network for Medical Image Segmentation, referred to as FM-BFF-Net in the remainder of this paper. The network combines convolutional and transformer components, employs a focal modulation attention mechanism to refine context awareness, and introduces a bidirectional feature fusion module that enables efficient interaction between encoder and decoder representations across scales. Through this design, FM-BFF-Net enhances boundary precision and robustness to variations in lesion size, shape, and contrast. Extensive experiments on eight publicly available datasets, including polyp detection, skin lesion segmentation, and ultrasound imaging, show that FM-BFF-Net consistently surpasses recent state-of-the-art methods in Jaccard index and Dice coefficient, confirming its effectiveness and adaptability for diverse medical imaging scenarios.