# FETALFusion: Resolution-Aware State-Space Modeling for Multi-Domain Fetal Head Segmentation

arXiv: https://arxiv.org/abs/2610.17951 · HTML: https://mlsanity.com/paper/2610.17951/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Placed in Mamba for medical image analysis, one of 10 directions in State-space sequence models (S4, Mamba).
- Builds on 15 of its 25 references that are in the map.
- First posted on arXiv 13 Oct 2026.

## Placed in

- State-space sequence models (S4, Mamba) / [Mamba for medical image analysis](https://mlsanity.com/ssm/mamba-for-medical-image-analysis/)

## Builds on (most cited first, 15 of 15)

- [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)
- [Squeeze-and-Excitation Networks](https://mlsanity.com/paper/1709.01507/) (2017)
- [Mamba: Linear-Time Sequence Modeling with Selective State Spaces](https://mlsanity.com/paper/2312.00752/) (2023)
- [CBAM: Convolutional Block Attention Module](https://mlsanity.com/paper/1807.06521/) (2018)
- [V-Net: Fully Convolutional Neural Networks for Volumetric Medical Image Segmentation](https://mlsanity.com/paper/1606.04797/) (2016)
- [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)
- [Instance Normalization: The Missing Ingredient for Fast Stylization](https://mlsanity.com/paper/1607.08022/) (2016)
- [U-Mamba: Enhancing Long-range Dependency for Biomedical Image Segmentation](https://mlsanity.com/paper/2401.04722/) (2024)
- [VM-UNet: Vision Mamba UNet for Medical Image Segmentation](https://mlsanity.com/paper/2402.02491/) (2024)
- [H-vmunet: High-order Vision Mamba UNet for Medical Image Segmentation](https://mlsanity.com/paper/2403.13642/) (2024)
- [Merging Context Clustering with Visual State Space Models for Medical Image Segmentation](https://mlsanity.com/paper/2501.01618/) (2025)
- [Attention-ResUNet for Automated Fetal Head Segmentation](https://mlsanity.com/paper/2604.18148/) (2026)

## Abstract (arXiv)

Head circumference (HC) measured from 2D ultrasound is a routine marker of fetal growth, and automating it needs segmentations whose boundaries hold up on individual scans, not only on average. We present FETALFusion, a dual-path CNN-Mamba encoder-decoder for fetal head segmentation across acquisition types. It applies four-directional state-space scans only at the two highest-resolution stages, routes bottleneck features through domain-specific channel gates that are averaged at test time, and adds a weak landmark shape prior. We train jointly on transabdominal (HC-18) and transperineal (PSFHS) images and compare ten methods on a held-out test set of 471 images, each trained under one schedule and scored by surface distances at native resolution. FETALFusion reaches a Dice score of 0.963 and an HD95 of 2.10 mm without test-time augmentation or a domain label. It improves on U-Mamba on all five reported metrics (HD95 reduced by 0.31 mm; Holm-corrected (p < 10-4), a lead that holds under test-time augmentation and across two independent training runs, and in the mean on U-Net, Attention U-Net and TransUNet. Residual encoders close the gap: a ResNet-34 UNet++ exceeds FETALFusion, and an ImageNet initialised ResNet-34 U-Net is best overall (HD95 1.75 mm). The ablation agrees. Calibrated against run-to-run variation, it attributes FETALFusion's measurable gains to the landmark shape prior and, on transperineal images, to the domain gates, while removing the state-space branch does not measurably change accuracy. HC from the predicted masks agrees with the clinical reference at an intraclass correlation of 0.9986.