COMMA: Coordinate-Aware Modulated Mamba Network for 3D Dispersed Vessel Segmentation

Accurate segmentation of 3D vascular structures is essential for various medical imaging applications. The dispersed nature of vascular structures leads to inherent spatial uncertainty and necessitates location awareness, yet most current 3D medical segmentation models rely on the patch-wise training strategy that usually loses this spatial context. In this study, we introduce the Coordinate-aware Modulated Mamba Network (COMMA) and contribute a manually labeled dataset of 570 cases, the largest publicly available 3D cerebrovascular dataset to date. COMMA leverages both entire and cropped patch data through global and local branches, ensuring robust and efficient spatial location awareness. Specifically, COMMA employs a channel-compressed Mamba (ccMamba) block to efficiently encode full-resolution image data, capturing long-range dependencies while optimizing computational costs. Additionally, we propose a coordinate-aware modulated (CaM) block to enhance interactions between the global and local branches, allowing the local branch to better perceive spatial information. We evaluate COMMA on six datasets, covering two imaging modalities and five types of vascular tissues. The results demonstrate COMMA's superior performance compared to state-of-the-art methods with computational efficiency, especially in segmenting small vessels. Ablation studies further highlight the importance of our proposed modules and spatial information. The code will be available at COMMA.