Moein Heidari

Moein Heidari, Amirhossein Kazerouni, Milad Soltany et al.

Convolutional neural networks (CNNs) have been the consensus for medical image segmentation tasks. However, they suffer from the limitation in modeling long-range dependencies and spatial correlations due to the nature of convolution operation. Although transformers were first developed to address this issue, they fail to capture low-level features. In contrast, it is demonstrated that both local and global features are crucial for dense prediction, such as segmenting in challenging contexts. In this paper, we propose HiFormer, a novel method that efficiently bridges a CNN and a transformer for medical image segmentation. Specifically, we design two multi-scale feature representations using the seminal Swin Transformer module and a CNN-based encoder. To secure a fine fusion of global and local features obtained from the two aforementioned representations, we propose a Double-Level Fusion (DLF) module in the skip connection of the encoder-decoder structure. Extensive experiments on various medical image segmentation datasets demonstrate the effectiveness of HiFormer over other CNN-based, transformer-based, and hybrid methods in terms of computational complexity, and quantitative and qualitative results. Our code is publicly available at: https://github.com/amirhossein-kz/HiFormer

Amirhossein Kazerouni, Ehsan Khodapanah Aghdam, Moein Heidari et al.

Denoising diffusion models, a class of generative models, have garnered immense interest lately in various deep-learning problems. A diffusion probabilistic model defines a forward diffusion stage where the input data is gradually perturbed over several steps by adding Gaussian noise and then learns to reverse the diffusion process to retrieve the desired noise-free data from noisy data samples. Diffusion models are widely appreciated for their strong mode coverage and quality of the generated samples despite their known computational burdens. Capitalizing on the advances in computer vision, the field of medical imaging has also observed a growing interest in diffusion models. To help the researcher navigate this profusion, this survey intends to provide a comprehensive overview of diffusion models in the discipline of medical image analysis. Specifically, we introduce the solid theoretical foundation and fundamental concepts behind diffusion models and the three generic diffusion modelling frameworks: diffusion probabilistic models, noise-conditioned score networks, and stochastic differential equations. Then, we provide a systematic taxonomy of diffusion models in the medical domain and propose a multi-perspective categorization based on their application, imaging modality, organ of interest, and algorithms. To this end, we cover extensive applications of diffusion models in the medical domain. Furthermore, we emphasize the practical use case of some selected approaches, and then we discuss the limitations of the diffusion models in the medical domain and propose several directions to fulfill the demands of this field. Finally, we gather the overviewed studies with their available open-source implementations at https://github.com/amirhossein-kz/Awesome-Diffusion-Models-in-Medical-Imaging.

Reza Azad, Amirhossein Kazerouni, Moein Heidari et al.

The remarkable performance of the Transformer architecture in natural language processing has recently also triggered broad interest in Computer Vision. Among other merits, Transformers are witnessed as capable of learning long-range dependencies and spatial correlations, which is a clear advantage over convolutional neural networks (CNNs), which have been the de facto standard in Computer Vision problems so far. Thus, Transformers have become an integral part of modern medical image analysis. In this review, we provide an encyclopedic review of the applications of Transformers in medical imaging. Specifically, we present a systematic and thorough review of relevant recent Transformer literature for different medical image analysis tasks, including classification, segmentation, detection, registration, synthesis, and clinical report generation. For each of these applications, we investigate the novelty, strengths and weaknesses of the different proposed strategies and develop taxonomies highlighting key properties and contributions. Further, if applicable, we outline current benchmarks on different datasets. Finally, we summarize key challenges and discuss different future research directions. In addition, we have provided cited papers with their corresponding implementations in https://github.com/mindflow-institue/Awesome-Transformer.

Reza Azad, Moein Heidari, Moein Shariatnia et al.

Convolutional neural networks (CNNs) have been the de facto standard in a diverse set of computer vision tasks for many years. Especially, deep neural networks based on seminal architectures such as U-shaped models with skip-connections or atrous convolution with pyramid pooling have been tailored to a wide range of medical image analysis tasks. The main advantage of such architectures is that they are prone to detaining versatile local features. However, as a general consensus, CNNs fail to capture long-range dependencies and spatial correlations due to the intrinsic property of confined receptive field size of convolution operations. Alternatively, Transformer, profiting from global information modelling that stems from the self-attention mechanism, has recently attained remarkable performance in natural language processing and computer vision. Nevertheless, previous studies prove that both local and global features are critical for a deep model in dense prediction, such as segmenting complicated structures with disparate shapes and configurations. To this end, this paper proposes TransDeepLab, a novel DeepLab-like pure Transformer for medical image segmentation. Specifically, we exploit hierarchical Swin-Transformer with shifted windows to extend the DeepLabv3 and model the Atrous Spatial Pyramid Pooling (ASPP) module. A thorough search of the relevant literature yielded that we are the first to model the seminal DeepLab model with a pure Transformer-based model. Extensive experiments on various medical image segmentation tasks verify that our approach performs superior or on par with most contemporary works on an amalgamation of Vision Transformer and CNN-based methods, along with a significant reduction of model complexity. The codes and trained models are publicly available at https://github.com/rezazad68/transdeeplab

Reza Azad, Mohammad T. AL-Antary, Moein Heidari et al.

In the past few years, convolutional neural networks (CNNs), particularly U-Net, have been the prevailing technique in the medical image processing era. Specifically, the seminal U-Net, as well as its alternatives, have successfully managed to address a wide variety of medical image segmentation tasks. However, these architectures are intrinsically imperfect as they fail to exhibit long-range interactions and spatial dependencies leading to a severe performance drop in the segmentation of medical images with variable shapes and structures. Transformers, preliminary proposed for sequence-to-sequence prediction, have arisen as surrogate architectures to precisely model global information assisted by the self-attention mechanism. Despite being feasibly designed, utilizing a pure Transformer for image segmentation purposes can result in limited localization capacity stemming from inadequate low-level features. Thus, a line of research strives to design robust variants of Transformer-based U-Net. In this paper, we propose Trans-Norm, a novel deep segmentation framework which concomitantly consolidates a Transformer module into both encoder and skip-connections of the standard U-Net. We argue that the expedient design of skip-connections can be crucial for accurate segmentation as it can assist in feature fusion between the expanding and contracting paths. In this respect, we derive a Spatial Normalization mechanism from the Transformer module to adaptively recalibrate the skip connection path. Extensive experiments across three typical tasks for medical image segmentation demonstrate the effectiveness of TransNorm. The codes and trained models are publicly available at https://github.com/rezazad68/transnorm.

Reza Azad, Moein Heidari, Yuli Wu et al.

Currently, convolutional neural networks (CNN) (e.g., U-Net) have become the de facto standard and attained immense success in medical image segmentation. However, as a downside, CNN based methods are a double-edged sword as they fail to build long-range dependencies and global context connections due to the limited receptive field that stems from the intrinsic characteristics of the convolution operation. Hence, recent articles have exploited Transformer variants for medical image segmentation tasks which open up great opportunities due to their innate capability of capturing long-range correlations through the attention mechanism. Although being feasibly designed, most of the cohort studies incur prohibitive performance in capturing local information, thereby resulting in less lucidness of boundary areas. In this paper, we propose a contextual attention network to tackle the aforementioned limitations. The proposed method uses the strength of the Transformer module to model the long-range contextual dependency. Simultaneously, it utilizes the CNN encoder to capture local semantic information. In addition, an object-level representation is included to model the regional interaction map. The extracted hierarchical features are then fed to the contextual attention module to adaptively recalibrate the representation space using the local information. Then, they emphasize the informative regions while taking into account the long-range contextual dependency derived by the Transformer module. We validate our method on several large-scale public medical image segmentation datasets and achieve state-of-the-art performance. We have provided the implementation code in https://github.com/rezazad68/TMUnet.

Reza Azad, Moein Heidari, Julien Cohen-Adad et al.

Accurate and automatic segmentation of intervertebral discs from medical images is a critical task for the assessment of spine-related diseases such as osteoporosis, vertebral fractures, and intervertebral disc herniation. To date, various approaches have been developed in the literature which routinely relies on detecting the discs as the primary step. A disadvantage of many cohort studies is that the localization algorithm also yields false-positive detections. In this study, we aim to alleviate this problem by proposing a novel U-Net-based structure to predict a set of candidates for intervertebral disc locations. In our design, we integrate the image shape information (image gradients) to encourage the model to learn rich and generic geometrical information. This additional signal guides the model to selectively emphasize the contextual representation and suppress the less discriminative features. On the post-processing side, to further decrease the false positive rate, we propose a permutation invariant 'look once' model, which accelerates the candidate recovery procedure. In comparison with previous studies, our proposed approach does not need to perform the selection in an iterative fashion. The proposed method was evaluated on the spine generic public multi-center dataset and demonstrated superior performance compared to previous work. We have provided the implementation code in https://github.com/rezazad68/intervertebral-lookonce

Sina Ghorbani Kolahi, Seyed Kamal Chaharsooghi, Toktam Khatibi et al.

Medical image segmentation involves identifying and separating object instances in a medical image to delineate various tissues and structures, a task complicated by the significant variations in size, shape, and density of these features. Convolutional neural networks (CNNs) have traditionally been used for this task but have limitations in capturing long-range dependencies. Transformers, equipped with self-attention mechanisms, aim to address this problem. However, in medical image segmentation it is beneficial to merge both local and global features to effectively integrate feature maps across various scales, capturing both detailed features and broader semantic elements for dealing with variations in structures. In this paper, we introduce MSA$^2$Net, a new deep segmentation framework featuring an expedient design of skip-connections. These connections facilitate feature fusion by dynamically weighting and combining coarse-grained encoder features with fine-grained decoder feature maps. Specifically, we propose a Multi-Scale Adaptive Spatial Attention Gate (MASAG), which dynamically adjusts the receptive field (Local and Global contextual information) to ensure that spatially relevant features are selectively highlighted while minimizing background distractions. Extensive evaluations involving dermatology, and radiological datasets demonstrate that our MSA$^2$Net outperforms state-of-the-art (SOTA) works or matches their performance. The source code is publicly available at https://github.com/xmindflow/MSA-2Net.

Mustansar Fiaz, Moein Heidari, Rao Muhammad Anwer et al.

Microscopic image segmentation is a challenging task, wherein the objective is to assign semantic labels to each pixel in a given microscopic image. While convolutional neural networks (CNNs) form the foundation of many existing frameworks, they often struggle to explicitly capture long-range dependencies. Although transformers were initially devised to address this issue using self-attention, it has been proven that both local and global features are crucial for addressing diverse challenges in microscopic images, including variations in shape, size, appearance, and target region density. In this paper, we introduce SA2-Net, an attention-guided method that leverages multi-scale feature learning to effectively handle diverse structures within microscopic images. Specifically, we propose scale-aware attention (SA2) module designed to capture inherent variations in scales and shapes of microscopic regions, such as cells, for accurate segmentation. This module incorporates local attention at each level of multi-stage features, as well as global attention across multiple resolutions. Furthermore, we address the issue of blurred region boundaries (e.g., cell boundaries) by introducing a novel upsampling strategy called the Adaptive Up-Attention (AuA) module. This module enhances the discriminative ability for improved localization of microscopic regions using an explicit attention mechanism. Extensive experiments on five challenging datasets demonstrate the benefits of our SA2-Net model. Our source code is publicly available at \url{https://github.com/mustansarfiaz/SA2-Net}.

Moein Heidari, Reza Rezaeian, Reza Azad et al.

Implicit Neural Representation (INR), leveraging a neural network to transform coordinate input into corresponding attributes, has recently driven significant advances in several vision-related domains. However, the performance of INR is heavily influenced by the choice of the nonlinear activation function used in its multilayer perceptron (MLP) architecture. To date, multiple nonlinearities have been investigated, but current INRs still face limitations in capturing high-frequency components and diverse signal types. We show that these challenges can be alleviated by introducing a novel approach in INR architecture. Specifically, we propose SL$^{2}$A-INR, a hybrid network that combines a single-layer learnable activation function with an MLP that uses traditional ReLU activations. Our method performs superior across diverse tasks, including image representation, 3D shape reconstruction, and novel view synthesis. Through comprehensive experiments, SL$^{2}$A-INR sets new benchmarks in accuracy, quality, and robustness for INR. Our Code is publicly available on~\href{https://github.com/Iceage7/SL2A-INR}{\textcolor{magenta}{GitHub}}.

Ali Mehrabian, Parsa Mojarad Adi, Moein Heidari et al.

Implicit neural representations (INRs) use neural networks to provide continuous and resolution-independent representations of complex signals with a small number of parameters. However, existing INR models often fail to capture important frequency components specific to each task. To address this issue, in this paper, we propose a Fourier Kolmogorov Arnold network (FKAN) for INRs. The proposed FKAN utilizes learnable activation functions modeled as Fourier series in the first layer to effectively control and learn the task-specific frequency components. In addition, the activation functions with learnable Fourier coefficients improve the ability of the network to capture complex patterns and details, which is beneficial for high-resolution and high-dimensional data. Experimental results show that our proposed FKAN model outperforms three state-of-the-art baseline schemes, and improves the peak signal-to-noise ratio (PSNR) and structural similarity index measure (SSIM) for the image representation task and intersection over union (IoU) for the 3D occupancy volume representation task, respectively. The code is available at github.com/Ali-Meh619/FKAN.

Moein Heidari, Ali Mehrabian, Mohammad Amin Roohi et al.

Echocardiography interpretation requires integrating multi-view temporal evidence with quantitative measurements and guideline-grounded reasoning, yet existing foundation-model pipelines largely solve isolated subtasks and fail when tool outputs are noisy or values fall near clinical cutoffs. We propose Echo-CoPilot, an end-to-end agentic framework that combines a multi-perspective workflow with knowledge-graph guided measurement selection. Echo-CoPilot runs three independent ReAct-style agents, structural, pathological, and quantitative, that invoke specialized echocardiography tools to extract parameters while querying EchoKG to determine which measurements are required for the clinical question and which should be avoided. A self-contrast language model then compares the evidence-grounded perspectives, generates a discrepancy checklist, and re-queries EchoKG to apply the appropriate guideline thresholds and resolve conflicts, reducing hallucinated measurement selection and borderline flip-flops. On MIMICEchoQA, Echo-CoPilot provides higher accuracy compared to SOTA baselines and, under a stochasticity stress test, achieves higher reliability through more consistent conclusions and fewer answer changes across repeated runs. Our code is publicly available at~\href{https://github.com/moeinheidari7829/Echo-CoPilot}{\textcolor{magenta}{GitHub}}.

Alvin Kimbowa, Moein Heidari, David Liu et al.

While U-Net architectures remain the gold standard for medical image segmentation, their deployment in resource-constrained environments demands aggressive model compression. However, finding an optimally efficient configuration is computationally prohibitive, typically requiring exhaustive train-and-evaluate cycles to find the smallest model that maintains peak performance. In this paper, we introduce a training-free selection framework to automatically identify ultralightweight, dataset-specific U-Net configurations directly at initialization. We observe that systematically scaling down U-Net channel width induces a sharp transition from a stable performance plateau to representational capacity collapse. To pinpoint this boundary without training, we propose a Jacobian-based sensitivity metric that scores discrete, width-capped U-Net variants using a small set of unlabeled images. By analyzing the total variation of this sensitivity curve, we isolate the smallest stable configuration, which we denote as XTinyU-Net. Evaluated across six diverse medical datasets within the nnU-Net framework, XTinyU-Net achieves segmentation accuracy comparable to the heavy nnU-Net baseline with 400x-1600x fewer parameters, and outperforms contemporary lightweight architectures while utilizing 5x-72x fewer parameters. Code is publicly accessible on https://github.com/alvinkimbowa/nntinyunet.git.

Moein Heidari, Alireza Morsali, Tohid Abedini et al.

Free-form image inpainting is the task of reconstructing parts of an image specified by an arbitrary binary mask. In this task, it is typically desired to generalize model capabilities to unseen mask types, rather than learning certain mask distributions. Capitalizing on the advances in diffusion models, in this paper, we propose a Denoising Diffusion Probabilistic Model (DDPM) based model capable of filling missing pixels fast as it models the backward diffusion process using the generator of a generative adversarial network (GAN) network to reduce sampling cost in diffusion models. Experiments on general-purpose image inpainting datasets verify that our approach performs superior or on par with most contemporary works.

Moein Heidari, Reza Azad, Sina Ghorbani Kolahi et al.

Intrigued by the inherent ability of the human visual system to identify salient regions in complex scenes, attention mechanisms have been seamlessly integrated into various Computer Vision (CV) tasks. Building upon this paradigm, Vision Transformer (ViT) networks exploit attention mechanisms for improved efficiency. This review navigates the landscape of redesigned attention mechanisms within ViTs, aiming to enhance their performance. This paper provides a comprehensive exploration of techniques and insights for designing attention mechanisms, systematically reviewing recent literature in the field of CV. This survey begins with an introduction to the theoretical foundations and fundamental concepts underlying attention mechanisms. We then present a systematic taxonomy of various attention mechanisms within ViTs, employing redesigned approaches. A multi-perspective categorization is proposed based on their application, objectives, and the type of attention applied. The analysis includes an exploration of the novelty, strengths, weaknesses, and an in-depth evaluation of the different proposed strategies. This culminates in the development of taxonomies that highlight key properties and contributions. Finally, we gather the reviewed studies along with their available open-source implementations at our \href{https://github.com/mindflow-institue/Awesome-Attention-Mechanism-in-Medical-Imaging}{GitHub}\footnote{\url{https://github.com/xmindflow/Awesome-Attention-Mechanism-in-Medical-Imaging}}. We aim to regularly update it with the most recent relevant papers.

Yasamin Medghalchi, Milad Yazdani, Amirhossein Dabiriaghdam et al.

Ultrasound is widely used in clinical practice due to its portability, cost-effectiveness, safety, and real-time imaging capabilities. However, image acquisition and interpretation remain highly operator dependent, motivating the development of robust AI-assisted analysis methods. Vision-language models (VLMs) have recently demonstrated strong multimodal reasoning capabilities and competitive performance in medical image analysis, including ultrasound. However, emerging evidence highlights significant concerns about their trustworthiness. In particular, adversarial robustness is critical because Med-VLMs operate via natural-language instructions, rendering prompt formulation a realistic and practically exploitable point of vulnerability. Small variations (typos, shorthand, underspecified requests, or ambiguous wording) can meaningfully shift model outputs. We propose a scalable adversarial evaluation framework that leverages a large language model (LLM) to generate clinically plausible adversarial prompt variants via "humanized" rewrites and minimal edits that mimic routine clinical communication. Using ultrasound multiple-choice question answering benchmarks, we systematically assess the vulnerability of SOTA Med-VLMs to these attacks, examine how attacker LLM capacity influences attack success, analyze the relationship between attack success and model confidence, and identify consistent failure patterns across models. Our results highlight realistic robustness gaps that must be addressed for safe clinical translation. Code will be released publicly following the review process.

Pooria Ashrafian, Milad Yazdani, Moein Heidari et al.

High-quality, large-scale data is essential for robust deep learning models in medical applications, particularly ultrasound image analysis. Diffusion models facilitate high-fidelity medical image generation, reducing the costs associated with acquiring and annotating new images. This paper utilizes recent vision-language models to produce diverse and realistic synthetic echocardiography image data, preserving key features of the original images guided by textual and semantic label maps. Specifically, we investigate three potential avenues: unconditional generation, generation guided by text, and a hybrid approach incorporating both textual and semantic supervision. We show that the rich contextual information present in the synthesized data potentially enhances the accuracy and interpretability of downstream tasks, such as echocardiography segmentation and classification with improved metrics and faster convergence. Our implementation with checkpoints, prompts, and the created synthetic dataset will be publicly available at \href{https://github.com/Pooria90/DiffEcho}{GitHub}.

Yasamin Medghalchi, Moein Heidari, Clayton Allard et al.

Deep neural networks (DNNs) offer significant promise for improving breast cancer diagnosis in medical imaging. However, these models are highly susceptible to adversarial attacks--small, imperceptible changes that can mislead classifiers--raising critical concerns about their reliability and security. Traditional attacks rely on fixed-norm perturbations, misaligning with human perception. In contrast, diffusion-based attacks require pre-trained models, demanding substantial data when these models are unavailable, limiting practical use in data-scarce scenarios. In medical imaging, however, this is often unfeasible due to the limited availability of datasets. Building on recent advancements in learnable prompts, we propose Prompt2Perturb (P2P), a novel language-guided attack method capable of generating meaningful attack examples driven by text instructions. During the prompt learning phase, our approach leverages learnable prompts within the text encoder to create subtle, yet impactful, perturbations that remain imperceptible while guiding the model towards targeted outcomes. In contrast to current prompt learning-based approaches, our P2P stands out by directly updating text embeddings, avoiding the need for retraining diffusion models. Further, we leverage the finding that optimizing only the early reverse diffusion steps boosts efficiency while ensuring that the generated adversarial examples incorporate subtle noise, thus preserving ultrasound image quality without introducing noticeable artifacts. We show that our method outperforms state-of-the-art attack techniques across three breast ultrasound datasets in FID and LPIPS. Moreover, the generated images are both more natural in appearance and more effective compared to existing adversarial attacks. Our code will be publicly available https://github.com/yasamin-med/P2P.

Moein Heidari, Afshin Bozorgpour, AmirHossein Zarif-Fakharnia et al.

Left ventricular ejection fraction (LVEF) is a critical metric for assessing cardiac function, widely used in diagnosing heart failure and guiding clinical decisions. Despite its importance, conventional LVEF estimation remains time-consuming and operator-dependent. Recent deep learning advancements have enhanced automation, yet many existing models are computationally demanding, hindering their feasibility for real-time clinical applications. Additionally, the interplay between spatial and temporal features is crucial for accurate estimation but is often overlooked. In this work, we propose Echo-E$^3$Net, an efficient Endo-Epi spatio-temporal network tailored for LVEF estimation. Our method introduces the Endo-Epi Cardial Border Detector (E$^2$CBD) module, which enhances feature extraction by leveraging spatial and temporal landmark cues. Complementing this, the Endo-Epi Feature Aggregator (E$^2$FA) distills statistical descriptors from backbone feature maps, refining the final EF prediction. These modules, along with a multi-component loss function tailored to align with the clinical definition of EF, collectively enhance spatial-temporal representation learning, ensuring robust and efficient EF estimation. We evaluate Echo-E$^3$Net on the EchoNet-Dynamic dataset, achieving a RMSE of 5.15 and an R$^2$ score of 0.82, setting a new benchmark in efficiency with 6.8 million parameters and only 8.49G Flops. Our model operates without pre-training, data augmentation, or ensemble methods, making it well-suited for real-time point-of-care ultrasound (PoCUS) applications. Our Code is publicly available on~\href{https://github.com/moeinheidari7829/Echo-E3Net}{\textcolor{magenta}{GitHub}}.

Moein Heidari, Yasamin Medghalchi, Mahdi Khoursha et al.

Parameter-efficient fine-tuning (PEFT) has gained widespread adoption across various applications. Among PEFT techniques, Low-Rank Adaptation (LoRA) and its extensions have emerged as particularly effective, allowing efficient model adaptation while significantly reducing computational overhead. However, existing approaches typically rely on global low-rank factorizations, which overlook local or multi-scale structure, failing to capture complex patterns in the weight updates. To address this, we propose WaRA, a novel PEFT method that leverages wavelet transforms to decompose the weight update matrix into a multi-resolution representation. By performing low-rank factorization in the wavelet domain and reconstructing updates through an inverse transform, WaRA obtains compressed adaptation parameters that harness multi-resolution analysis, enabling it to capture both coarse and fine-grained features while providing greater flexibility and sparser representations than standard LoRA. Through comprehensive experiments and analysis, we demonstrate that WaRA performs superior on diverse vision tasks, including image generation, classification, and semantic segmentation, significantly enhancing generated image quality while reducing computational complexity. Although WaRA was primarily designed for vision tasks, we further showcase its effectiveness in language tasks, highlighting its broader applicability and generalizability. The code is publicly available at \href{GitHub}{https://github.com/moeinheidari7829/WaRA}.

Moein Heidari, Sina Ghorbani Kolahi, Sanaz Karimijafarbigloo et al.

Sequence modeling plays a vital role across various domains, with recurrent neural networks being historically the predominant method of performing these tasks. However, the emergence of transformers has altered this paradigm due to their superior performance. Built upon these advances, transformers have conjoined CNNs as two leading foundational models for learning visual representations. However, transformers are hindered by the $\mathcal{O}(N^2)$ complexity of their attention mechanisms, while CNNs lack global receptive fields and dynamic weight allocation. State Space Models (SSMs), specifically the \textit{\textbf{Mamba}} model with selection mechanisms and hardware-aware architecture, have garnered immense interest lately in sequential modeling and visual representation learning, challenging the dominance of transformers by providing infinite context lengths and offering substantial efficiency maintaining linear complexity in the input sequence. Capitalizing on the advances in computer vision, medical imaging has heralded a new epoch with Mamba models. Intending to help researchers navigate the surge, this survey seeks to offer an encyclopedic review of Mamba models in medical imaging. Specifically, we start with a comprehensive theoretical review forming the basis of SSMs, including Mamba architecture and its alternatives for sequence modeling paradigms in this context. Next, we offer a structured classification of Mamba models in the medical field and introduce a diverse categorization scheme based on their application, imaging modalities, and targeted organs. Finally, we summarize key challenges, discuss different future research directions of the SSMs in the medical domain, and propose several directions to fulfill the demands of this field. In addition, we have compiled the studies discussed in this paper along with their open-source implementations on our GitHub repository.

Moein Heidari, Ehsan Khodapanah Aghdam, Alexander Manzella et al.

The retroperitoneum hosts a variety of tumors, including rare benign and malignant types, which pose diagnostic and treatment challenges due to their infrequency and proximity to vital structures. Estimating tumor volume is difficult due to their irregular shapes, and manual segmentation is time-consuming. Automatic segmentation using U-Net and its variants, incorporating Vision Transformer (ViT) elements, has shown promising results but struggles with high computational demands. To address this, architectures like the Mamba State Space Model (SSM) and Extended Long-Short Term Memory (xLSTM) offer efficient solutions by handling long-range dependencies with lower resource consumption. This study evaluates U-Net enhancements, including CNN, ViT, Mamba, and xLSTM, on a new in-house CT dataset and a public organ segmentation dataset. The proposed ViLU-Net model integrates Vi-blocks for improved segmentation. Results highlight xLSTM's efficiency in the U-Net framework. The code is publicly accessible on GitHub.