# MaLViL: Multi-axis Low-rank Vision-LSTM for Medical Image Segmentation

arXiv: https://arxiv.org/abs/2608.17635 · HTML: https://mlsanity.com/paper/2608.17635/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 22 of its 26 references that are in the map.
- First posted on arXiv 18 Aug 2026.

## Builds on (most cited first, 22 of 22)

- [U-Net: Convolutional Networks for Biomedical Image Segmentation](https://mlsanity.com/paper/1505.04597/) (2015)
- [Mamba: Linear-Time Sequence Modeling with Selective State Spaces](https://mlsanity.com/paper/2312.00752/) (2023)
- [TransUNet: Transformers Make Strong Encoders for Medical Image Segmentation](https://mlsanity.com/paper/2102.04306/) (2021)
- [Attention U-Net: Learning Where to Look for the Pancreas](https://mlsanity.com/paper/1804.03999/) (2018)
- [Swin-Unet: Unet-like Pure Transformer for Medical Image Segmentation](https://mlsanity.com/paper/2105.05537/) (2021)
- [PVT v2: Improved Baselines with Pyramid Vision Transformer](https://mlsanity.com/paper/2106.13797/) (2021)
- [PraNet: Parallel Reverse Attention Network for Polyp Segmentation](https://mlsanity.com/paper/2006.11392/) (2020)
- [xLSTM: Extended Long Short-Term Memory](https://mlsanity.com/paper/2405.04517/) (2024)
- [VM-UNet: Vision Mamba UNet for Medical Image Segmentation](https://mlsanity.com/paper/2402.02491/) (2024)
- [TransFuse: Fusing Transformers and CNNs for Medical Image Segmentation](https://mlsanity.com/paper/2102.08005/) (2021)
- [UCTransNet: Rethinking the Skip Connections in U-Net from a Channel-wise Perspective with Transformer](https://mlsanity.com/paper/2109.04335/) (2021)
- [U-KAN Makes Strong Backbone for Medical Image Segmentation and Generation](https://mlsanity.com/paper/2406.02918/) (2024)
- [EMCAD: Efficient Multi-scale Convolutional Attention Decoding for Medical Image Segmentation](https://mlsanity.com/paper/2405.06880/) (2024)
- [EGE-UNet: an Efficient Group Enhanced UNet for skin lesion segmentation](https://mlsanity.com/paper/2307.08473/) (2023)
- [Vision-LSTM: xLSTM as Generic Vision Backbone](https://mlsanity.com/paper/2406.04303/) (2024)
- [UltraLight VM-UNet: Parallel Vision Mamba Significantly Reduces Parameters for Skin Lesion Segmentation](https://mlsanity.com/paper/2403.20035/) (2024)
- [CaraNet: Context Axial Reverse Attention Network for Segmentation of Small Medical Objects](https://mlsanity.com/paper/2301.13366/) (2023)
- [VM-UNET-V2 Rethinking Vision Mamba UNet for Medical Image Segmentation](https://mlsanity.com/paper/2403.09157/) (2024)
- [Beyond Self-Attention: Deformable Large Kernel Attention for Medical Image Segmentation](https://mlsanity.com/paper/2309.00121/) (2023)
- [DermoSegDiff: A Boundary-aware Segmentation Diffusion Model for Skin Lesion Delineation](https://mlsanity.com/paper/2308.02959/) (2023)
- [xLSTM-UNet can be an Effective 2D & 3D Medical Image Segmentation Backbone with Vision-LSTM (ViL) better than its Mamba Counterpart](https://mlsanity.com/paper/2407.01530/) (2024)
- [MSA2Net: Multi-scale Adaptive Attention-guided Network for Medical Image Segmentation](https://mlsanity.com/paper/2407.21640/) (2024)

## Abstract (arXiv)

Vision-LSTM (ViL) enables efficient global modeling, but its cost still scales with the number of spatial tokens, so existing segmenters confine ViL to a coarse bottleneck and lose fine anatomical detail. Rasterizing 2D features into a 1D sequence further breaks adjacency across the orthogonal scan axis. We propose MaLViL, a Multi-axis Low-rank Vision-LSTM network that extends ViL across decoder resolutions. Bidirectional low-rank ViL (Bi-LRViL) reasons on a compact orthonormal subspace and preserves detail through an orthogonal residual; scale-aware SaLViL restores cross-axis neighbors before serialization; and a Cross-Directional Mixer (CDM) fuses orthogonal horizontal and vertical traversal paths. Statistics-Guided Skip Modulation (SGSM) further retains boundary cues in encoder skips. On skin-lesion, ultrasound, and multi-organ CT benchmarks, MaLViL achieves competitive or state-of-the-art segmentation accuracy, while reducing ViL operator memory by up to 83× at fine decoder resolutions. Code is available at: https://github.com/xmindflow/malvil.