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Our proposed MSAU-Net model was transformed into two versions V1(with one Multi-Scale Feature Extraction and Fusion (MSFEF) module in each MSA block) and V2 (with two parallel MSEFE modules in each MSA blcok). The performances of V1 and V2 were evaluated and compared with four other derivatives of U-Net or state-of-the-art models quantitatively using seven commonly-used metrics, and qualitatively by comparison against experienced physicians\u2019 assessment.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>MSAU-Net V1 and V2 models both outperformed the comparative models across most quantitative metrics with better segmentation accuracy and boundary delineation. The optimal number of MSA was three for V1 and two for V2. Qualitative evaluations confirmed that they produced results closer to physicians\u2019 annotations. External validation revealed that MSAU-Net V2 exhibited better generalization capability.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>The MSAU-Net V1 and V2 both exhibited outstanding performance in gallbladder segmentation, demonstrating strong potential for clinical application. The MSA block enhances spatial information capture, improving the model\u2019s ability to segment small and complex structures with greater precision. These advantages position the MSAU-Net V1 and V2 as valuable tools for broader clinical adoption.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s12880-025-01737-7","type":"journal-article","created":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T12:31:35Z","timestamp":1748608295000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Multi-spatial-attention U-Net: a novel framework for automated gallbladder segmentation on CT images"],"prefix":"10.1186","volume":"25","author":[{"given":"Henan","family":"Lou","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaobo","family":"Wen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fanxia","family":"Lin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhan","family":"Peng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qiuxiao","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruimei","family":"Ren","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junlin","family":"Xu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jinfei","family":"Fan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hao","family":"Song","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaomeng","family":"Ji","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huiyu","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiangyin","family":"Sun","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yinying","family":"Dong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,5,30]]},"reference":[{"issue":"7","key":"1737_CR1","doi-asserted-by":"publisher","first-page":"101130","DOI":"10.1016\/j.disamonth.2021.101130","volume":"67","author":"R Lam","year":"2021","unstructured":"Lam R, Zakko A, Petrov JC, Kumar P, Duffy AJ, Muniraj T. 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