State space models (SSM) with selection mechanisms and hardware-aware architectures, namely Mamba, have recently shown significant potential in long-sequence modeling. Since the complexity of transformers’ self-attention mechanism is quadratic with image size, as well as increasing computational demands, researchers are currently exploring how to adapt Mamba for computer vision tasks. This paper is the first comprehensive survey that aims to provide an in-depth analysis of Mamba models within the domain of computer vision. It begins by exploring the foundational concepts contributing to Mamba’s success, including the SSM framework, selection mechanisms, and hardware-aware design. Then, we review these vision Mamba models by categorizing them into foundational models and those enhanced with techniques including convolution, recurrence, and attention to improve their sophistication. Furthermore, we investigate the widespread applications of Mamba in vision tasks, which include their use as a backbone in various levels of vision processing. This encompasses general visual tasks, medical visual tasks (e.g., 2D/3D segmentation, classification, image registration, etc.), and remote sensing visual tasks. In particular, we introduce general visual tasks from two levels: high/mid-level vision (e.g., object detection, segmentation, video classification, etc.) and low-level vision (e.g., image super-resolution, image restoration, visual generation, etc.). We hope this endeavor will spark additional interest within the community to address current challenges and further apply Mamba models in computer vision.

Medical image segmentation has made significant strides with the development of basic models. Specifically, models that combine CNNs with transformers can successfully extract both local and global features. However, these models inherit the transformer’s quadratic computational complexity, limiting their efficiency. Inspired by the recent Receptance Weighted Key Value (RWKV) model, which achieves linear complexity for long-distance modeling, we explore its potential for medical image segmentation. While directly applying vision-RWKV yields suboptimal results due to insufficient local feature exploration and disrupted spatial continuity, we propose a novel nested structure, Zigzag RWKV-in-RWKV (Zig-RiR), to address these issues. It consists of Outer and Inner RWKV blocks to adeptly capture both global and local features without disrupting spatial continuity. We treat local patches as ”visual sentences” and use the Outer Zig-RWKV to explore global information. Then, we decompose each sentence into subpatches (”visual words”) and use the Inner Zig-RWKV to further explore local information among words, at negligible computational cost. We also introduce a Zigzag-WKV attention mechanism to ensure spatial continuity during token scanning. By aggregating visual word and sentence features, our Zig-RiR can effectively explore both global and local information while preserving spatial continuity. Experiments on four medical image segmentation datasets of both 2D and 3D modalities demonstrate the superior accuracy and efficiency of our method, outperforming the state-of-the-art method 14.4 times in speed and reducing GPU memory usage by 89.5% when testing on 1024 × 1024 high-resolution medical images. Our code is available at https://github.com/txchen-USTC/Zig-RiR.

Deformable image registration, the estimation of the spatial transformation between different images, is an important task in medical imaging. Deep learning techniques have been shown to perform 3D image registration efficiently. However, current registration strategies often only focus on the deformation smoothness, which leads to the ignorance of complicated motion patterns (e.g., separate or sliding motions), especially for the intersection of organs. Thus, the performance when dealing with the discontinuous motions of multiple nearby objects is limited, causing undesired predictive outcomes in clinical usage, such as misidentification and mislocalization of lesions or other abnormalities. Consequently, we proposed a novel registration method to address this issue: a new Motion Separable backbone is exploited to capture the separate motion, with a theoretical analysis of the upper bound of the motions' discontinuity provided. In addition, a novel Residual Aligner module was used to disentangle and refine the predicted motions across the multiple neighboring objects/organs. We evaluate our method, Residual Aligner-based Network (RAN), on abdominal Computed Tomography (CT) scans and it has shown to achieve one of the most accurate unsupervised inter-subject registration for the 9 organs, with the highest-ranked registration of the veins (Dice Similarity Coefficient (%)/Average surface distance (mm): 62%/4.9mm for the vena cava and 34%/7.9mm for the portal and splenic vein), with a smaller model structure and less computation compared to state-of-the-art methods. Furthermore, when applied to lung CT, the RAN achieves comparable results to the best-ranked networks (94%/3.0mm), also with fewer parameters and less computation.

In recent advancements in medical image analysis, Convolutional Neural Networks (CNN) and Vision Transformers (ViT) have set significant benchmarks. While the former excels in capturing local features through its convolution operations, the latter achieves remarkable global context understanding by leveraging self-attention mechanisms. However, both architectures exhibit limitations in efficiently modeling long-range dependencies within medical images, which is a critical aspect for precise segmentation. Inspired by the Mamba architecture, known for its proficiency in handling long sequences and global contextual information with enhanced computational efficiency as a State Space Model (SSM), we propose Mamba-UNet, a novel architecture that synergizes the U-Net in medical image segmentation with Mamba's capability. Mamba-UNet adopts a pure Visual Mamba (VMamba)-based encoder-decoder structure, infused with skip connections to preserve spatial information across different scales of the network. This design facilitates a comprehensive feature learning process, capturing intricate details and broader semantic contexts within medical images. We introduce a novel integration mechanism within the VMamba blocks to ensure seamless connectivity and information flow between the encoder and decoder paths, enhancing the segmentation performance. We conducted experiments on publicly available ACDC MRI Cardiac segmentation dataset, and Synapse CT Abdomen segmentation dataset. The results show that Mamba-UNet outperforms several types of UNet in medical image segmentation under the same hyper-parameter setting. The source code and baseline implementations are available.