Deep learning has become the mainstream technology in computer vision, and it has received extensive research interest in developing new medical image processing algorithms to support disease detection and diagnosis. As compared to conventional machine learning technologies, the major advantage of deep learning is that models can automatically identify and recognize representative features through the hierarchal model architecture, while avoiding the laborious development of hand-crafted features. In this paper, we reviewed and summarized more than 200 recently published papers to provide a comprehensive overview of applying deep learning methods in various medical image analysis tasks. Especially, we emphasize the latest progress and contributions of state-of-the-art unsupervised and semi-supervised deep learning in medical images, which are summarized based on different application scenarios, including lesion classification, segmentation, detection, and image registration. Additionally, we also discussed the major technical challenges and suggested the possible solutions in future research efforts.

Recent advances and clinical applications of deep learning in medical image analysis.

Most recent semantic segmentation methods adopt a U-Net framework with an encoder-decoder architecture. It is still challenging for U-Net with a simple skip connection scheme to model the global multi-scale context: 1) Not each skip connection setting is effective due to the issue of incompatible feature sets of encoder and decoder stage, even some skip connection negatively influence the segmentation performance; 2) The original U-Net is worse than the one without any skip connection on some datasets. Based on our findings, we propose a new segmentation framework, named UCTransNet (with a proposed CTrans module in U-Net), from the channel perspective with attention mechanism. Specifically, the CTrans module is an alternate of the U-Net skip connections, which consists of a sub-module to conduct the multi-scale Channel Cross fusion with Transformer (named CCT) and a sub-module Channel-wise Cross-Attention (named CCA) to guide the fused multi-scale channel-wise information to effectively connect to the decoder features for eliminating the ambiguity. Hence, the proposed connection consisting of the CCT and CCA is able to replace the original skip connection to solve the semantic gaps for an accurate automatic medical image segmentation. The experimental results suggest that our UCTransNet produces more precise segmentation performance and achieves consistent improvements over the state-of-the-art for semantic segmentation across different datasets and conventional architectures involving transformer or U-shaped framework. Code: this https URL.

UCTransNet: Rethinking the Skip Connections in U-Net from a Channel-wise Perspective with Transformer.

Most recent semantic segmentation methods adopt a U-Net framework with an encoder-decoder architecture. It is still challenging for U-Net with a simple skip connection scheme to model the global multi-scale context: 1) Not each skip connection setting is effective due to the issue of incompatible feature sets of encoder and decoder stage, even some skip connection negatively influence the segmentation performance; 2) The original U-Net is worse than the one without any skip connection on some datasets. Based on our findings, we propose a new segmentation framework, named UCTransNet (with a proposed CTrans module in U-Net), from the channel perspective with attention mechanism. Specifically, the CTrans (Channel Transformer) module is an alternate of the U-Net skip connections, which consists of a sub-module to conduct the multi-scale Channel Cross fusion with Transformer (named CCT) and a sub-module Channel-wise Cross-Attention (named CCA) to guide the fused multi-scale channel-wise information to effectively connect to the decoder features for eliminating the ambiguity. Hence, the proposed connection consisting of the CCT and CCA is able to replace the original skip connection to solve the semantic gaps for an accurate automatic medical image segmentation. The experimental results suggest that our UCTransNet produces more precise segmentation performance and achieves consistent improvements over the state-of-the-art for semantic segmentation across different datasets and conventional architectures involving transformer or U-shaped framework. Code: https://github.com/McGregorWwww/UCTransNet. 

UCTransNet: Rethinking the Skip Connections in U-Net from a Channel-Wise Perspective with Transformer

Transformer, first applied to the field of natural language processing, is a type of deep neural network mainly based on the self-attention mechanism. Thanks to its strong representation capabilities, researchers are looking at ways to apply transformer to computer vision tasks. In a variety of visual benchmarks, transformer-based models perform similar to or better than other types of networks such as convolutional and recurrent networks. Given its high performance and less need for vision-specific inductive bias, transformer is receiving more and more attention from the computer vision community. In this paper, we review these vision transformer models by categorizing them in different tasks and analyzing their advantages and disadvantages. The main categories we explore include the backbone network, high/mid-level vision, low-level vision, and video processing. We also include efficient transformer methods for pushing transformer into real device-based applications. Furthermore, we also take a brief look at the self-attention mechanism in computer vision, as it is the base component in transformer. Toward the end of this paper, we discuss the challenges and provide several further research directions for vision transformers.

A Survey on Vision Transformer

Recent advances in transformer-based models have drawn attention to exploring these techniques in medical image segmentation, especially in conjunction with the U-Net model (or its variants), which has shown great success in medical image segmentation, under both 2D and 3D settings. Current 2D based methods either directly replace convolutional layers with pure transformers or consider a transformer as an additional intermediate encoder between the encoder and decoder of U-Net. However, these approaches only consider the attention encoding within one single slice and do not utilize the axial-axis information naturally provided by a 3D volume. In the 3D setting, convolution on volumetric data and transformers both consume large GPU memory. One has to either downsample the image or use cropped local patches to reduce GPU memory usage, which limits its performance. In this paper, we propose Axial Fusion Transformer UNet (AFTer-UNet), which takes both advantages of convolutional layers' capability of extracting detailed features and transformers' strength on long sequence modeling. It considers both intra-slice and inter-slice long-range cues to guide the segmentation. Meanwhile, it has fewer parameters and takes less GPU memory to train than the previous transformer-based models. Extensive experiments on three multi-organ segmentation datasets demonstrate that our method outperforms current state-of-the-art methods.

AFTer-UNet: Axial Fusion Transformer UNet for Medical Image Segmentation.

In the past few years, convolutional neural networks (CNNs) have achieved milestones in medical image analysis. Especially, the deep neural networks based on U-shaped architecture and skip-connections have been widely applied in a variety of medical image tasks. However, although CNN has achieved excellent performance, it cannot learn global and long-range semantic information interaction well due to the locality of the convolution operation. In this paper, we propose Swin-Unet, which is an Unet-like pure Transformer for medical image segmentation. The tokenized image patches are fed into the Transformer-based U-shaped Encoder-Decoder architecture with skip-connections for local-global semantic feature learning. Specifically, we use hierarchical Swin Transformer with shifted windows as the encoder to extract context features. And a symmetric Swin Transformer-based decoder with patch expanding layer is designed to perform the up-sampling operation to restore the spatial resolution of the feature maps. Under the direct down-sampling and up-sampling of the inputs and outputs by 4x, experiments on multi-organ and cardiac segmentation tasks demonstrate that the pure Transformer-based U-shaped Encoder-Decoder network outperforms those methods with full-convolution or the combination of transformer and convolution. The codes and trained models will be publicly available at this https URL.

Joy Chen

Papers

Swin-Unet: Unet-like Pure Transformer for Medical Image Segmentation.