C2FTrans: Coarse-to-Fine Transformers for Medical Image Segmentation

Convolutional neural networks (CNN), the most prevailing architecture for deep-learning based medical image analysis, are still functionally limited by their intrinsic inductive biases and inadequate receptive fields. Transformer, born to address this issue, has drawn explosive attention in natural language processing and computer vision due to its remarkable ability in capturing long-range dependency. However, most recent transformer-based methods for medical image segmentation directly apply vanilla transformers as an auxiliary module in CNN-based methods, resulting in severe detail loss due to the rigid patch partitioning scheme in transformers. To address this problem, we propose C2FTrans, a novel multi-scale architecture that formulates medical image segmentation as a coarse-to-fine procedure. C2FTrans mainly consists of a cross-scale global transformer (CGT) which addresses local contextual similarity in CNN and a boundary-aware local transformer (BLT) which overcomes boundary uncertainty brought by rigid patch partitioning in transformers. Specifically, CGT builds global dependency across three different small-scale feature maps to obtain rich global semantic features with an acceptable computational cost, while BLT captures mid-range dependency by adaptively generating windows around boundaries under the guidance of entropy to reduce computational complexity and minimize detail loss based on large-scale feature maps. Extensive experimental results on three public datasets demonstrate the superior performance of C2FTrans against state-of-the-art CNN-based and transformer-based methods with fewer parameters and lower FLOPs. We believe the design of C2FTrans would further inspire future work on developing efficient and lightweight transformers for medical image segmentation. The source code of this paper is publicly available at https://github.com/xianlin7/C2FTrans.