# XAttnRes: Cross-Stage Attention Residuals for Medical Image Segmentation

arXiv: https://arxiv.org/abs/2604.03297 · HTML: https://mlsanity.com/paper/2604.03297/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 32 of its 39 references that are in the map.
- First posted on arXiv 28 Mar 2026.

## Builds on (most cited first, 30 of 32)

- [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)
- [U-Net: Convolutional Networks for Biomedical Image Segmentation](https://mlsanity.com/paper/1505.04597/) (2015)
- [Densely Connected Convolutional Networks](https://mlsanity.com/paper/1608.06993/) (2016)
- [Feature Pyramid Networks for Object Detection](https://mlsanity.com/paper/1612.03144/) (2016)
- [Fully Convolutional Networks for Semantic Segmentation](https://mlsanity.com/paper/1411.4038/) (2014)
- [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)
- [Non-local Neural Networks](https://mlsanity.com/paper/1711.07971/) (2017)
- [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)
- [SegNet: A Deep Convolutional Encoder-Decoder Architecture for Image Segmentation](https://mlsanity.com/paper/1511.00561/) (2015)
- [Attention U-Net: Learning Where to Look for the Pancreas](https://mlsanity.com/paper/1804.03999/) (2018)
- [Deep High-Resolution Representation Learning for Visual Recognition](https://mlsanity.com/paper/1908.07919/) (2019)
- [Swin-Unet: Unet-like Pure Transformer for Medical Image Segmentation](https://mlsanity.com/paper/2105.05537/) (2021)
- [A Survey on Deep Learning in Medical Image Analysis](https://mlsanity.com/paper/1702.05747/) (2017)
- [UNETR: Transformers for 3D Medical Image Segmentation](https://mlsanity.com/paper/2103.10504/) (2021)
- [PVT v2: Improved Baselines with Pyramid Vision Transformer](https://mlsanity.com/paper/2106.13797/) (2021)
- [Skin Lesion Analysis Toward Melanoma Detection: A Challenge at the 2017 International Symposium on Biomedical Imaging (ISBI), Hosted by the International Skin Imaging Collaboration (ISIC)](https://mlsanity.com/paper/1710.05006/) (2017)
- [PraNet: Parallel Reverse Attention Network for Polyp Segmentation](https://mlsanity.com/paper/2006.11392/) (2020)
- [UNet 3+: A Full-Scale Connected UNet for Medical Image Segmentation](https://mlsanity.com/paper/2004.08790/) (2020)
- [Highway Networks](https://mlsanity.com/paper/1505.00387/) (2015)
- [UCTransNet: Rethinking the Skip Connections in U-Net from a Channel-wise Perspective with Transformer](https://mlsanity.com/paper/2109.04335/) (2021)
- [MultiResUNet : Rethinking the U-Net Architecture for Multimodal Biomedical Image Segmentation](https://mlsanity.com/paper/1902.04049/) (2019)
- [Polyp-PVT: Polyp Segmentation with Pyramid Vision Transformers](https://mlsanity.com/paper/2108.06932/) (2021)
- [Mixed Transformer U-Net For Medical Image Segmentation](https://mlsanity.com/paper/2111.04734/) (2021)
- [Attention Residuals](https://mlsanity.com/paper/2603.15031/) (2026)
- [EMCAD: Efficient Multi-scale Convolutional Attention Decoding for Medical Image Segmentation](https://mlsanity.com/paper/2405.06880/) (2024)
- [Stepwise Feature Fusion: Local Guides Global](https://mlsanity.com/paper/2203.03635/) (2022)
- [CaraNet: Context Axial Reverse Attention Network for Segmentation of Small Medical Objects](https://mlsanity.com/paper/2301.13366/) (2023)

## Abstract (arXiv)

In the field of Large Language Models (LLMs), Attention Residuals have recently demonstrated that learned, selective aggregation over all preceding layer outputs can outperform fixed residual connections. We propose Cross-Stage Attention Residuals (XAttnRes), a mechanism that maintains a global feature history pool accumulating both encoder and decoder stage outputs. Through lightweight pseudo-query attention, each stage selectively aggregates from all preceding representations. To bridge the gap between the same-dimensional Transformer layers in LLMs and the multi-scale encoder-decoder stages in segmentation networks, XAttnRes introduces spatial alignment and channel projection steps that handle cross-resolution features with negligible overhead. When added to existing segmentation networks, XAttnRes consistently improves performance across four datasets and three imaging modalities. We further observe that XAttnRes alone, even without skip connections, achieves performance on par with the baseline, suggesting that learned aggregation can recover the inter-stage information flow traditionally provided by predetermined connections.