Organizations: Chongqing University of Posts and Telecommunications, China · Aalto University, Finland · Malaviya National Institute of Technology Jaipur, India · Machine & Hybrid Intelligence Lab, Northwestern University, USA · Biomedical Perception & Intelligence Lab, University of South Dakota, USA
Liver cirrhosis plays a critical role in the prognosis of chronic liver disease. Early detection and timely intervention are essential for reducing mortality rates. However, the intricate anatomical architecture and diverse pathological changes of liver tissue complicate the accurate detection and characterization of pathological liver structures in clinical settings. Existing methods underutilize spatial anatomical details in volumetric MRI data, thereby hindering their clinical effectiveness and explainability. To address this challenge, we introduce a novel Mamba-based network, SRMA-Mamba, designed to model the spatial relationships within complex anatomical structures of MRI volumes. By integrating the Spatial Anatomy-Based Mamba module (SABMamba), SRMA-Mamba performs selective Mamba scans within pathological liver tissues and combines anatomical information from the sagittal, coronal, and axial planes to construct a global spatial context representation, enabling efficient volumetric segmentation of pathological liver structures. Furthermore, we introduce the Spatial Reverse Mamba Attention module (SRMA), designed to progressively refine boundary details in the segmentation map, utilizing both the coarse segmentation map and hierarchical encoding features. Extensive experiments demonstrate that SRMA-Mamba surpasses state-of-the-art methods, delivering exceptional performance in 3D pathological liver segmentation. The source code is available at https://github.com/JunZengz/SRMA-Mamba.
Accurate 3D medical image segmentation requires both long-range volumetric context and fine boundary preservation. CNN-based methods have limited global dependency modeling, while Transformer-based models are often computationally expensive for dense 3D inputs. Recent Mamba-based methods provide an efficient alternative, but existing volumetric designs still depend on repeated high-resolution scanning, forward-only sequential modeling, and fixed directional summation, causing high cost, scan-order bias, and suboptimal directional aggregation. We propose BiSegMamba, an efficient bidirectional tri-oriented Mamba network for 3D medical image segmentation. BiSegMamba follows a compact-to-detail design, where a progressive compacting stem (PCS) enables efficient latent-space reasoning while retaining shallow high-resolution features for reconstruction. A multi-scale spatial mixer (MSSM) captures local anatomical patterns in early stages, and the proposed bidirectional tri-oriented Ortho Mamba (Bi-ToOM) block models long-range dependencies from multiple orthogonal views using jointly processed forward and backward scan sequences. Adaptive directional fusion (ADF) learns input-dependent channel-wise weights across scan orientations, replacing fixed summation with orientation-aware fusion. Experiments on a collected carotid CTA dataset and three public benchmarks, BraTS2023, ACDC, and AMOS-CT, show that BiSegMamba generalizes well across vascular, cardiac, brain tumor, and abdominal multi-organ segmentation tasks. Compared with SegMamba-V2, BiSegMamba achieves slightly better performance on BraTS2023 and clear improvements on ACDC and the carotid dataset, while reducing computational cost by up to 77.9% FLOPs, demonstrating a strong accuracy-efficiency balance for general 3D medical image segmentation.
This work demonstrates a full reproduction and extension of MNet, a hybrid 2D/3D convolutional network designed for anisotropic medical image segmentation. The original architecture was re-implemented within the nnU-Net framework to verify its reported performance and robustness to variable voxel spacing, known as anisotropy. Experiments were conducted on PROMISE prostate MRI and a controlled subset of LiTS liver CT under matched preprocessing and compute constraints. The reproduced MNet achieved a Dice similarity coefficient (DSC) of 89.0 +/- 0.9% on PROMISE, within 0.8% of the published result, and 94.3 +/- 1.9% / 54.6 +/- 3.1% for liver and tumor segmentation on LiTS, respectively. Two lightweight extensions were further introduced: (1) a learned Fusion Gating mechanism enabling adaptive 2D-3D feature blending, and (2) a VMamba state-space module for efficient long-range depth modelling. The Spatial Gating variant improved DSC by +0.8% with less than 3% inference overhead, while VMamba improved performance consistency, reducing PROMISE Dice variation to +/- 0.7% and achieving the strongest LiTS liver performance at 95.8% Dice. Both extensions preserved MNet robustness to anisotropy, with delta Dice = 1.5% across 1-4 mm voxel spacing. Overall, the study confirms MNet reproducibility and demonstrates that adaptive fusion and state-space modelling have the potential to further strengthen segmentation reliability under anisotropic conditions. However, further tests are required to provide definitive conclusions.
CNN- and Transformer-based architectures have achieved strong performance in medical image segmentation, but CNNs are limited in modeling long-range dependencies, while Transformers often suffer from quadratic computational and memory complexity. State space models, especially Mamba-based networks, offer an efficient alternative with linear sequence complexity. However, existing Mamba segmentation models still face two limitations: pixel-wise directional scanning can disrupt local 2D spatial structure, and simple summation-based fusion of scan directions cannot adapt well to diverse object sizes, shapes, and boundaries. To address these issues, we propose \textit{Patch-MoE Mamba}, a patch-ordered mixture-of-experts state space architecture for medical image segmentation. It introduces a hierarchical patch-ordered scanning mechanism that preserves local spatial neighborhoods while capturing multi-scale context, and an MoE-based directional fusion module that adaptively combines multiple Mamba scanner outputs using four directional experts, a learnable concatenation expert, and residual directional aggregation. Experiments on five public polyp segmentation benchmarks and the ISIC 2017/2018 skin lesion segmentation datasets demonstrate the effectiveness and generality of Patch-MoE Mamba.