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.

本文提出了一种新颖的多尺度架构C2FTrans，它将医学图像分割形式化为粗-细过程。其中包含了一个跨尺度全局Transformer和一个边界感知局部Transformer，能够在保持精细的同时降低计算复杂度，并在三个公共数据集上展现了超过现有CNN和基于Transformer的方法的表现。

C2FTrans: 用于医学图像分割的粗-细双向变换器