M³-TransUNet: Medical Image Segmentation Based on Spatial Prior Attention and Multi-Scale Gating

Medical image segmentation presents substantial challenges arising from the diverse scales and morphological complexities of target anatomical structures. Although existing Transformer-based models excel at capturing global dependencies, they encounter critical bottlenecks in multi-scale feature representation, spatial relationship modeling, and cross-layer feature fusion. To address these limitations, we propose the M³-TransUNet architecture, which incorporates three key innovations: (1) MSGA (Multi-Scale Gate Attention) and MSSA (Multi-Scale Selective Attention) modules to enhance multi-scale feature representation; (2) ME-MSA (Manhattan Enhanced Multi-Head Self-Attention) to integrate spatial priors into self-attention computations, thereby overcoming spatial modeling deficiencies; and (3) MKGAG (Multi-kernel Gated Attention Gate) to optimize skip connections by precisely filtering noise and preserving boundary details. Extensive experiments on public datasets-including Synapse, CVC-ClinicDB, and ISIC-demonstrate that M³-TransUNet achieves state-of-the-art performance. Specifically, on the Synapse dataset, our model outperforms recent TransUNet variants such as J-CAPA, improving the average DSC to 82.79% (compared to 82.29%) and significantly reducing the average HD95 from 19.74 mm to 10.21 mm.