# TFFM: Topology-Aware Feature Fusion Module via Latent Graph Reasoning for Retinal Vessel Segmentation

arXiv: https://arxiv.org/abs/2601.19136 · HTML: https://mlsanity.com/paper/2601.19136/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 16 of its 36 references that are in the map.
- First posted on arXiv 27 Jan 2026.

## Builds on (most cited first, 16 of 16)

- [U-Net: Convolutional Networks for Biomedical Image Segmentation](https://mlsanity.com/paper/1505.04597/) (2015)
- [Graph Attention Networks](https://mlsanity.com/paper/1710.10903/) (2017)
- [EfficientNet: Rethinking Model Scaling for Convolutional Neural Networks](https://mlsanity.com/paper/1905.11946/) (2019)
- [Encoder-Decoder with Atrous Separable Convolution for Semantic Image Segmentation](https://mlsanity.com/paper/1802.02611/) (2018)
- [SegFormer: Simple and Efficient Design for Semantic Segmentation with Transformers](https://mlsanity.com/paper/2105.15203/) (2021)
- [UNet++: A Nested U-Net Architecture for Medical Image Segmentation](https://mlsanity.com/paper/1807.10165/) (2018)
- [Swin UNETR: Swin Transformers for Semantic Segmentation of Brain Tumors in MRI Images](https://mlsanity.com/paper/2201.01266/) (2022)
- [3D MRI brain tumor segmentation using autoencoder regularization](https://mlsanity.com/paper/1810.11654/) (2018)
- [clDice -- A Novel Topology-Preserving Loss Function for Tubular Structure Segmentation](https://mlsanity.com/paper/2003.07311/) (2020)
- [Attention Gated Networks: Learning to Leverage Salient Regions in Medical Images](https://mlsanity.com/paper/1808.08114/) (2018)
- [Tversky loss function for image segmentation using 3D fully convolutional deep networks](https://mlsanity.com/paper/1706.05721/) (2017)
- [Beyond the Pixel-Wise Loss for Topology-Aware Delineation](https://mlsanity.com/paper/1712.02190/) (2017)
- [IterNet: Retinal Image Segmentation Utilizing Structural Redundancy in Vessel Networks](https://mlsanity.com/paper/1912.05763/) (2019)
- [Directional Connectivity-based Segmentation of Medical Images](https://mlsanity.com/paper/2304.00145/) (2023)
- [The RETA Benchmark for Retinal Vascular Tree Analysis](https://mlsanity.com/paper/2111.11658/) (2021)
- [Visual Bias and Interpretability in Deep Learning for Dermatological Image Analysis](https://mlsanity.com/paper/2508.04573/) (2025)

## Abstract (arXiv)

Precise segmentation of retinal arteries and veins carries the diagnosis of systemic cardiovascular conditions. However, standard convolutional architectures often yield topologically disjointed segmentations, characterized by gaps and discontinuities that render reliable graph-based clinical analysis impossible despite high pixel-level accuracy. To address this, we introduce a topology-aware framework engineered to maintain vascular connectivity. Our architecture fuses a Topological Feature Fusion Module (TFFM) that maps local feature representations into a latent graph space, deploying Graph Attention Networks to capture global structural dependencies often missed by fixed receptive fields. Furthermore, we drive the learning process with a hybrid objective function, coupling Tversky loss for class imbalance with soft clDice loss to explicitly penalize topological disconnects. Evaluation on the Fundus-AVSeg dataset reveals state-of-the-art performance, achieving a combined Dice score of 90.97% and a 95% Hausdorff Distance of 3.50 pixels. Notably, our method decreases vessel fragmentation by approximately 38% relative to baselines, yielding topologically coherent vascular trees viable for automated biomarker quantification. We open-source our code at https://tffm-module.github.io/.