HSMLA: Hierarchical Softmax Multi-scale Linear Attention for Efficient Vision Transformers

Dense prediction is a fundamental requirement for many medical vision tasks such as medical image restoration, registration, and segmentation. The most popular vision model, Convolutional Neural Networks (CNNs), has reached bottlenecks due to the intrinsic locality of convolution operations. Recently, transformers have been widely adopted for dense prediction for their capability to capture long-range visual dependence. However, due to the high computational complexity and large memory consumption of self-attention operations, transformers are usually used at downsampled feature resolutions. Such usage cannot effectively leverage the tissue-level textural information available only at the full image resolution. This textural information is crucial for medical dense prediction as it can differentiate the subtle human anatomy in medical images. In this study, we hypothesize that Multi-layer Perceptrons (MLPs) are superior alternatives to transformers in medical dense prediction where tissue-level details dominate the performance, as MLPs enable long-range dependence at the full image resolution. To validate our hypothesis, we develop a full-resolution hierarchical MLP framework that uses MLPs beginning from the full image resolution. We evaluate this framework with various MLP blocks on a wide range of medical dense prediction tasks including restoration, registration, and segmentation. Extensive experiments on six public well-benchmarked datasets show that, by simply using MLPs at full resolution, our framework outperforms its CNN and transformer counterparts and achieves state-of-the-art performance on various medical dense prediction tasks.

This paper introduces Exact Linear Attention (ELA), a mechanism that achieves linear computational complexity for Transformer attention by exploiting the exact decomposition property of kernel functions, thereby eliminating approximation error. We identify and address two key limitations of prior linear attention -- gradient explosion and token attention dilution -- by imposing kernel constraints that ensure non-negativity, discriminability, and geometric interpretability. Several kernel functions are proposed, including the Hadamard Exp Kernel, Summation Squared Euclidean Distance Kernel, and Subtraction Squared Euclidean Distance Kernel, each tailored for specific attention behaviors. Beyond the core attention formulation, the paper presents three engineering innovations: (1) a Hyper-Link structure that replaces traditional residual connections to mitigate gradient degradation; (2) a Memory Lobe module based on bidirectional linear attention, which captures "transformation flow" across layers to implement qualitative memory and an implicit reinforcement learning paradigm; and (3) a routing-score-based bias mechanism for Mixture-of-Experts (MoE) to improve interpretability and semantic alignment. Experimental results demonstrate that ELA achieves up to 6x faster decoding speed and 75% reduction in KV cache memory usage compared to full attention, while maintaining comparable or superior training performance. The proposed memory module accelerates convergence and enhances generalization. Furthermore, we extend the linear attention principle to vision models, yielding YOLO-LAT, which attains up to 4.3x GPU inference speedup and 7.9x parameter reduction with competitive detection accuracy. These results underline the broad applicability of exact linear attention for scaling Transformer models to ultra-long sequences and efficient visual tasks.

Vision Transformers (ViTs) achieve strong data-driven scaling by leveraging all-to-all self-attention. However, this flexibility incurs a computational cost that scales quadratically with image resolution, limiting ViTs in high-resolution domains. Underlying this approach is the assumption that pairwise token interactions are necessary for learning rich visual-semantic representations. In this work, we challenge this assumption, demonstrating that effective visual representations can be learned without any direct patch-to-patch interaction. We propose VECA (Visual Elastic Core Attention), a vision transformer architecture that uses efficient linear-time core-periphery structured attention enabled by a small set of learned cores. In VECA, these cores act as a communication interface: patch tokens exchange information exclusively through the core tokens, which are initialized from scratch and propagated across layers. Because the $N$ image patches only directly interact with a resolution invariant set of $C$ learned "core" embeddings, this yields linear complexity $O(N)$ for predetermined $C$, which bypasses quadratic scaling. Compared to prior cross-attention architectures, VECA maintains and iteratively updates the full set of $N$ input tokens, avoiding a small $C$-way bottleneck. Combined with nested training along the core axis, our model can elastically trade off compute and accuracy during inference. Across classification and dense tasks, VECA achieves performance competitive with the latest vision foundation models while reducing computational cost. Our results establish elastic core-periphery attention as a scalable alternative building block for Vision Transformers.