Diffusion probabilistic model (DPM) recently becomes one of the hottest topic in computer vision. Its image generation application such as Imagen, Latent Diffusion Models and Stable Diffusion have shown impressive generation capabilities, which aroused extensive discussion in the community. Many recent studies also found it is useful in many other vision tasks, like image deblurring, super-resolution and anomaly detection. Inspired by the success of DPM, we propose the first DPM based model toward general medical image segmentation tasks, which we named MedSegDiff. In order to enhance the step-wise regional attention in DPM for the medical image segmentation, we propose dynamic conditional encoding, which establishes the state-adaptive conditions for each sampling step. We further propose Feature Frequency Parser (FF-Parser), to eliminate the negative effect of high-frequency noise component in this process. We verify MedSegDiff on three medical segmentation tasks with different image modalities, which are optic cup segmentation over fundus images, brain tumor segmentation over MRI images and thyroid nodule segmentation over ultrasound images. The experimental results show that MedSegDiff outperforms state-of-the-art (SOTA) methods with considerable performance gap, indicating the generalization and effectiveness of the proposed model. Our code is released at https://github.com/WuJunde/MedSegDiff.
Medical image segmentation is important for computer-aided diagnosis. Good segmentation demands the model to see the big picture and fine details simultaneously, i.e., to learn image features that incorporate large context while keep high spatial resolutions. To approach this goal, the most widely used methods -- U-Net and variants, extract and fuse multi-scale features. However, the fused features still have small "effective receptive fields" with a focus on local image cues, limiting their performance. In this work, we propose Segtran, an alternative segmentation framework based on transformers, which have unlimited "effective receptive fields" even at high feature resolutions. The core of Segtran is a novel Squeeze-and-Expansion transformer: a squeezed attention block regularizes the self attention of transformers, and an expansion block learns diversified representations. Additionally, we propose a new positional encoding scheme for transformers, imposing a continuity inductive bias for images. Experiments were performed on 2D and 3D medical image segmentation tasks: optic disc/cup segmentation in fundus images (REFUGE'20 challenge), polyp segmentation in colonoscopy images, and brain tumor segmentation in MRI scans (BraTS'19 challenge). Compared with representative existing methods, Segtran consistently achieved the highest segmentation accuracy, and exhibited good cross-domain generalization capabilities. The source code of Segtran is released at https://github.com/askerlee/segtran.