3D medical image segmentation has progressed considerably due to Convolutional Neural Networks (CNNs) and Vision Transformers (ViTs), yet these methods struggle to balance long-range dependency acquisition with computational efficiency. To address this challenge, we propose UNETVL (U-Net Vision-LSTM), a novel architecture that leverages recent advancements in temporal information processing. UNETVL incorporates Vision-LSTM (ViL) for improved scalability and memory functions, alongside an efficient Chebyshev Kolmogorov-Arnold Networks (KAN) to handle complex and long-range dependency patterns more effectively. We validated our method on the ACDC and AMOS2022 (post challenge Task 2) benchmark datasets, showing a significant improvement in mean Dice score compared to recent state-of-the-art approaches, especially over its predecessor, UNETR, with increases of 7.3% on ACDC and 15.6% on AMOS, respectively. Extensive ablation studies were conducted to demonstrate the impact of each component in UNETVL, providing a comprehensive understanding of its architecture. Our code is available at https://github.com/tgrex6/UNETVL, facilitating further research and applications in this domain.

Recent advancements in autoregressive networks with linear complexity have driven significant research progress, demonstrating exceptional performance in large language models. A representative model is the Extended Long Short-Term Memory (xLSTM), which incorporates gating mechanisms and memory structures, performing comparably to Transformer architectures in long-sequence language tasks. Autoregressive networks such as xLSTM can utilize image serialization to extend their application to visual tasks such as classification and segmentation. Although existing studies have demonstrated Vision-LSTM's impressive results in image classification, its performance in image semantic segmentation remains unverified. Our study represents the first attempt to evaluate the effectiveness of Vision-LSTM in the semantic segmentation of remotely sensed images. This evaluation is based on a specifically designed encoder-decoder architecture named Seg-LSTM, and comparisons with state-of-the-art segmentation networks. Our study found that Vision-LSTM's performance in semantic segmentation was limited and generally inferior to Vision-Transformers-based and Vision-Mamba-based models in most comparative tests. Future research directions for enhancing Vision-LSTM are recommended. The source code is available from https://github.com/zhuqinfeng1999/Seg-LSTM.