S³-Mamba: Small-Size-Sensitive Mamba for Lesion Segmentation

Small lesions play a critical role in early disease diagnosis and intervention of severe infections. Popular models often face challenges in segmenting small lesions, as it occupies only a minor portion of an image, while down-sampling operations may inevitably lose focus on local features of small lesions. To tackle the challenges, we propose a Small-Size-Sensitive Mamba (S³-Mamba), which promotes the sensitivity to small lesions across three dimensions: channel, spatial, and training strategy. Specifically, an Enhanced Visual State Space block is designed to focus on small lesions through multiple residual connections to preserve local features, and selectively amplify important details while suppressing irrelevant ones through channel-wise attention. A Tensor-based Cross-feature Multi-scale Attention is designed to integrate input image features and intermediate-layer features with edge features and exploit the attentive support of features across multiple scales, thereby retaining spatial details of small lesions at various granularities. Finally, we introduce a novel regularized curriculum learning to automatically assess lesion size and sample difficulty, and gradually focus from easy samples to hard ones like small lesions. Extensive experiments on three medical image segmentation datasets show the superiority of our S³-Mamba, especially in segmenting small lesions.