RotCAtt-TransUNet++: Novel Deep Neural Network for Sophisticated Cardiac Segmentation

Cardiovascular disease is a major global health concern, contributing significantly to global mortality. Accurately segmenting cardiac medical imaging data is crucial for reducing fatality rates associated with these conditions. However, current state-of-the-art (SOTA) neural networks, including CNN-based and Transformer-based approaches, face challenges in capturing both inter-slice connections and intra-slice details, especially in datasets featuring intricate, long-range details along the z-axis like coronary arteries. Existing methods also struggle with differentiating non-cardiac components from the myocardium, resulting in segmentation inaccuracies and the "spraying" phenomenon. To address these issues, we introduce RotCAtt-TransUNet++, a novel architecture designed for robust segmentation of intricate cardiac structures. Our approach enhances global context mod-eling through multiscale feature aggregation and nested skip connections in the encoder. Transformer layers facilitate capturing intra-slice interactions, while a rotatory attention mechanism handles inter-slice connectivity. A channel-wise cross-attention gate integrates multiscale information and decoder features, effectively bridging semantic gaps. Experimental results across multiple datasets demonstrate superior performance over current methods, achieving near-perfect annotation of coronary arteries and myocardium. Ablation studies confirm that our rotatory attention mechanism significantly improves segmentation accuracy by transforming embedded vectorized patches in semantic dimensional space.