Architecture-Agnostic Modality-Isolated Gated Fusion for Robust Multi-Modal Prostate MRI Segmentation

Abstract: Multi-parametric prostate MRI -- combining T2-weighted, apparent diffusion coefficient, and high b-value diffusion-weighted sequences -- is central to non-invasive detection of clinically significant prostate cancer, yet in routine practice individual sequences may be missing or degraded by motion, artifacts, or abbreviated protocols. Existing multi-modal fusion strategies typically assume complete inputs and entangle modality-specific information at early layers, offering limited resilience when one channel is corrupted or absent. We propose Modality-Isolated Gated Fusion (MIGF), an architecture-agnostic module that maintains separate modality-specific encoding streams before a learned gating stage, combined with modality dropout training to enforce compensation behavior under incomplete inputs. We benchmark six bare backbones and assess MIGF-equipped models under seven missing-modality and artifact scenarios on the PI-CAI dataset (1,500 studies, fold-0 split, five random seeds). Among bare backbones, nnUNet provided the strongest balance of performance and stability. MIGF improved ideal-scenario Ranking Score for UNet, nnUNet, and Mamba by 2.8%, 4.6%, and 13.4%, respectively; the best model, MIGFNet-nnUNet (gating + ModDrop, no deep supervision), achieved 0.7304 +/- 0.056. Mechanistic analysis reveals that robustness gains arise from strict modality isolation and dropout-driven compensation rather than adaptive per-sample quality routing: the gate converged to a stable modality prior, and deep supervision was beneficial only for the largest backbone while degrading lighter models. These findings support a simpler design principle for robust multi-modal segmentation: structurally contain corrupted inputs first, then train explicitly for incomplete-input compensation.