3D axial-attention for lung nodule classification

Mundher Al-Shabi, Kelvin Shak, Maxine Tan

    Research output: Contribution to journalArticleResearchpeer-review

    1 Citation (Scopus)


    Purpose: In recent years, Non-Local-based methods have been successfully applied to lung nodule classification. However, these methods offer 2D attention or limited 3D attention to low-resolution feature maps. Moreover, they still depend on a convenient local filter such as convolution as full 3D attention is expensive to compute and requires a big dataset, which might not be available. Methods: We propose to use 3D Axial-Attention, which requires a fraction of the computing power of a regular Non-Local network (i.e., self-attention). Unlike a regular Non-Local network, the 3D Axial-Attention network applies the attention operation to each axis separately. Additionally, we solve the invariant position problem of the Non-Local network by proposing to add 3D positional encoding to shared embeddings. Results: We validated the proposed method on 442 benign nodules and 406 malignant nodules, extracted from the public LIDC-IDRI dataset by following a rigorous experimental setup using only nodules annotated by at least three radiologists. Our results show that the 3D Axial-Attention model achieves state-of-the-art performance on all evaluation metrics, including AUC and Accuracy. Conclusions: The proposed model provides full 3D attention, whereby every element (i.e., pixel) in the 3D volume space attends to every other element in the nodule effectively. Thus, the 3D Axial-Attention network can be used in all layers without the need for local filters. The experimental results show the importance of full 3D attention for classifying lung nodules.

    Original languageEnglish
    Pages (from-to)1319-1324
    Number of pages6
    JournalInternational Journal of Computer Assisted Radiology and Surgery
    Issue number8
    Publication statusPublished - Aug 2021


    • Cancer
    • Computed tomography
    • Lung nodules
    • Non-local
    • Self-attention

    Cite this