Abstract:Recent advancements in medical imaging have resulted in more complex and diverse images, with challenges such as high anatomical variability, blurred tissue boundaries, low organ contrast, and noise. Traditional segmentation methods struggle to address these challenges, making deep learning approaches, particularly U-shaped architectures, increasingly prominent. However, the quadratic complexity of standard self-attention makes Transformers computationally prohibitive for high-resolution images. To address these challenges, we propose MLLA-UNet (Mamba-Like Linear Attention UNet), a novel architecture that achieves linear computational complexity while maintaining high segmentation accuracy through its innovative combination of linear attention and Mamba-inspired adaptive mechanisms, complemented by an efficient symmetric sampling structure for enhanced feature processing. Our architecture effectively preserves essential spatial features while capturing long-range dependencies at reduced computational complexity. Additionally, we introduce a novel sampling strategy for multi-scale feature fusion. Experiments demonstrate that MLLA-UNet achieves state-of-the-art performance on six challenging datasets with 24 different segmentation tasks, including but not limited to FLARE22, AMOS CT, and ACDC, with an average DSC of 88.32%. These results underscore the superiority of MLLA-UNet over existing methods. Our contributions include the novel 2D segmentation architecture and its empirical validation. The code is available via https://github.com/csyfjiang/MLLA-UNet.